A 22 year old male has been referred to me, and I need information about body building and type�1 diabetes. I want to be able to learn more about it and also to provide him with some resources.

Weight training is certainly an important component of a well-rounded fitness program for people with and without diabetes. There is an excellent chapter in The Diabetic Athlete by Sheri Colberg, PhD explaining the physiology behind such power sports as weight training. Dr. Colberg outlines typical glucose responses to the specific exercise and compensatory diabetes management techniques. She includes recommendations regarding adjustments for NPH, Lente, Ultralente, and insulin pumps. It is truly a fantastic reference for both patients and professionals.

In addition, there are a number of other on-line resources that you might find helpful including:

National Strength and Conditioning Association
American College of Sports Medicine
International Diabetic Athletes Association

IDAA has regional chapters, newsletters, educational conferences and provides significant support for athletes with diabetes. Lastly, although not a science journal, you might wish to scan an issue of Muscle and Fitness, Flex magazine, or similar publication for exposure to the popular culture.

For healthcare professionals, there is a need for awareness regarding the many common yet potentially harmful practices in the body building world. These include protein requirements and intake, supplementation, anabolic steroid use — testosterone, growth hormone, etc. Even insulin is currently being abused by some body builders for its potential weight gain effects! Realize too that the practices surrounding preparations for a body building competition are physically challenging and potentially dangerous. These may include an extremely low carb/high protein diet intake in the weeks leading up to the competition, self-induced dehydration during the days immediately prior (for best muscle striation/definition), and intake of a highly concentrated glucose drink immediately before going on stage to compete (makes veins bulge). All this during the stress of an intensified training regimen as well! An unhealthy approach for people both with and without diabetes. You don’t say to what level your patient’s involvement is, but I mention these aspects to heighten awareness.

DMW