Exercise and Sport in Diabetes / Edition 2

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The new edition of this acclaimed title provides a practical guide to the risks and benefits of undertaking sport and general exercise for patients with diabetes.

Fully updated to reflect the progress and understanding in the field, the book features new chapters and material on insulin pump therapy and exercise, physical activity and prevention of type 2 diabetes, dietary advice for exercise and sport in type 1diabetes, and fluid and electrolyte replacement.

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Editorial Reviews

From the Publisher
"Recommended purchase for diabetic clinics and sports scientists and psychologists." (E-STREAMS, June 2007)

"…an extremely useful resource for any member of the diabetes care team…" (Doody's Health Services)

"A revised edition … is a practical guide for members of a diabetes care team." (Diabetes Voice, March 2006)

"An important book to be available in any diabetic clinic" (Pediatric Endocrinology Reviews (PER)Volume 3:March 2006)

Doody's Review Service
Reviewer: Matthew H. Corcoran, MD (Lehigh Valley Hospital)
Description: This is a contemporary review of the clinical aspects of exercise therapy and management for those with type 1 and type 2 diabetes, as well as their healthcare providers. This second edition, an update of the 1999 publication, highlights the recently well-documented scientific evidence for the prevention and management of type 2 diabetes through lifestyle modification, while continuing the effort to explore the appropriate management of diabetes, exercise, and sport for those with type 1 diabetes.
Purpose: The editor sets out to compile a useful resource for both healthcare professionals and patients on the need for increased resources to help diabetes teams tackle the lifestyle problems of people with type 2 diabetes and to help provide people with type 1 or type 2 diabetes the detailed advice to help them exercise safely and with maximum enjoyment. The authors might also consider the challenge of providing a resource and detailed advice to allow the exerciser or athlete maximum performance as well, although there are many unanswered questions in this realm. The objective is worthy and the book is much needed, yet facing a challenge as it attempts to be a resource for healthcare providers and patients. This approach risks leaving the healthcare provider hungry for more information and the lay person feeling a bit overwhelmed. Having said this, the authors have done an admirable job reaching both audiences. The lay population is extremely hungry for more information; and in general, healthcare providers are undereducated regarding lifestyle therapy, nutrition, and physical activity/exercise. This permits the authors the luxury of addressing both audiences with this book, which serves as an excellent resource for the clinician, diabetes team, or person with diabetes who wants to begin to explore the world of diabetes and exercise.
Audience: It is written for both lay people and all healthcare providers on the diabetes team. The editor and contributors are credible authorities in providing diabetes teams with the necessary information to assist them in the development of their own diabetes and exercise resource centers.
Features: The book outlines the challenges of the management of type 1 diabetes during sport and exercise and explores the compelling arguments justified by recent research for more resources to tackle the lifestyle problems of people with type 2. The book provides a basic review of exercise physiology and its disturbances in those with diabetes, prior to exploring some of the basic nutritional and therapeutic strategies necessary to allow for safe and productive participation in sport and exercise for those with type 1 diabetes. This includes updates to the first edition with sections on nutritional management and insulin pump therapy. It also summarizes the recently confirmed beneficial role of physical activity and lifestyle change in preventing or delaying the onset of diabetes in those at risk for type 2 diabetes and outlines all of the potential cardiovascular benefits of an exercise program. Finally, the book offers some basic introductory insight into the role of, and techniques for, the diabetes team to assist persons with diabetes in achieving their goals in a safe and productive way. The authors do a nice job of illustrating their main points with easy to read graphics and illustrations, and an easy to use table of contents points the reader to the appropriate section with ease. The sequence is a bit disjointed, as many sections that primarily, although not entirely, relate to type1 diabetes are interrupted by the section on type 2 diabetes. Perhaps the authors might want to explore a separate book devoted to each.
Assessment: This is an extremely useful resource for any member of the diabetes care team who wishes to explore the intricacies of diabetes and exercise, as well as for those living active lives (or wanting to live active lives) with diabetes. Given the recent explosion of data relating to the health benefits of exercise for those with or at risk for diabetes, this second edition is a nice complement to the first. Given the amount of information forthcoming, it may be time to consider separate books devoted to type 1 diabetes and type 2 diabetes.
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Product Details

  • ISBN-13: 9780470022061
  • Publisher: Wiley
  • Publication date: 2/10/2006
  • Series: Practical Diabetes Series, #17
  • Edition description: Revised Edition
  • Edition number: 2
  • Pages: 236
  • Product dimensions: 6.89 (w) x 9.72 (h) x 0.77 (d)

Table of Contents

Foreword to the First Edition.

Preface to the First Edition.

Preface to the Second edition.

1 Physiological responses to exercise (Clyde Williams).

1.1 Introduction.

1.2 Maximal exercise.

1.3 Submaximal exercise.

1.4 Endurance training.

1.5 Muscle fibre composition.

1.6 Muscle metabolism during exercise.

1.7 Anaerobic and lactate thresholds.

1.8 Fatigue and carbohydrate metabolism.

1.9 Carbohydrate nutrition and exercise.

1.10  Fluid intake before exercise.

1.11 Summary.


2 Exercise in type 1 diabetes (Jean-Jacques Grimm).

2.1 Introduction.

2.2 Exercise physiology.

2.3 Insulin absorption.

2.4 Hypoglycaemia.

2.5 Hyperglycaemia.

2.6 Strategy for treatment adjustments.

2.7 Evaluation of the intensity and duration of the effort.

2.8 Nutritional treatments and adaptations.

2.9 Insulin dose adjustment.

2.10 Conclusions.


3 Diet and nutritional strategies during sport and exercise in type 1 diabetes (Elaine Hibbert-Jones and Gill Regan).

3.1 What is exercise?.

3.2 The athlete with diabetes.

3.3 Nutritional principles for optimizing sports performance.

3.4 Puttting theory into practice.

3.5 Identifying nutritional goals.

3.6 Energy.

3.7 Carbohydrate.

3.8 Guidelines for carbohydrate intake before, during and after exercise.

3.9 Protein.

3.10 Fat.

3.11 Vitamins and minerals.

3.12 Fluid and hydration.

3.13 Pulling it all together.



4 The role of physical activity in the prevention of type 2 diabetes (Dinesh K. Nagi).

4.1 Exercise and prevention of type 2 diabetes.


5 Exercise, metabolic syndrome and type 2 diabetes (Dinesh K. Nagi).

5.1 Physical activity in type 2 diabetes.

5.2 Type 2 diabetes, insulin resistance and the metabolic syndrome.

5.3 Effect of exercise on the metabolic syndrome of type 2 diabetes.

5.4 What kind of exercise, aerobic or resistance training.

5.5 Effects on cardiovascular risk factors.

5.6 Regulation of carbohydrate metabolism during exercise in type 2 diabetes.

5.7 Effect of physical activity on insulin sensitivity.


6 The role of exercise in the management of type 2 diabetes (Dinesh K. Nagi).

6.1 Introduction.

6.2 Benefits of regular physical activity in type 2 diabetes.

6.3 Effects on long-term mortality.

6.4 Risks of physical activity.

6.5 Conclusions.


7 Exercise in children and adolescents (Diarmuid Smith, Alan Connacher, Ray Newton and Chris Thompson).

7.1 Introduction.

7.2 Metabolic effects of exercise.

7.3 Attitudes to exercise in young adults with type 1 diabetes.

7.4 The Firbush camp.

7.5 Precautions during exercise.

7.6 Summary.


8  Insuling pump therapy and exercise (Peter Hammond and Sandra Dudley).

8.1 Introduction.

8.2 Potential advantages of CSII.

8.3 CSII usage.

8.4 Benefits of CSII over multiple daily injections.

8.5 Potential advantages for CSII use with exercise.

8.6 Studies of response to exercise in CSII users.

8.7 Practicalities for using CSII with exercise.

8.8 Cautions for using CSII with exercise.


9  Diabetes and the marathon (Bill Burr).

9.1 Introduction.

9.2 Guidelines.

9.3 Personal views.

9.4 Summary.


Useful Addresses.

10  Diabetes and specific sports (Mark Sherlock and Chris Thompson).

10.1   General principles.

10.2   Canoeing.

10.3   Golf.

10.4   Hillwalking.

10.5   Extreme altitude mountaineering.

10.6   Rowing.

10.7  Soccer and rugby.

10.8  Tennis.

10.9  Sub-aqua (scuba) diving.

10.10  Skiing.

10.11  Restrictions imposed by sports governing bodies.

10.12  Conclusions.


11 Becoming and staying physically active (Elizabeth Marseden and Alison Kirk).

11.1   Recommendations for physical activity and exercise.

11.2   Essential attributes of a physical activity programme for people with diabetes.

11.3   Preparation for exercise.

11.4   Changing behaviour.


Appendix 1: Stretching exercises.

Appendix 2: Muscular endurance exercises.

12 The role of the diabetes team in promoting physical activity (Dinesh Nagi and Bill Burr).

12.1 Introduction.

12.2 Educating the diabetes team.

12.3 Exercise therapist as part of the team.

12.4 Assessment of patients.

12.5 The exercise prescription.

12.6 Patient education.

12.7 Motivating patients and changing behaviour.

12.8 Conclusions.



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