Q: I am going on 58 years old and have had diabetes since 1980. Initially I weighed 127 at 5' 8". I was unusual in that I was not overweight. The first 8 years my control was micronase and jogging with poor results, including 11 pounds of weight and muscle loss, and for the last six have been on insulin. I am now on regular before meals and ultra lente at bedtime. For the last four years I've been on a 3 day weekly weight lifting and cardio program at Gold's gym. By 1993 I had gained 29 pounds with much of that being muscle. A diet change to more vegetarian brought me to my present 136. Until last October I was completely debilitated after exercise to the point I would have to take a nap and felt like I was hit by a truck. In October, with a new trainer, I decreased my weights and started doing the same routine each day, with a new cardio routine, actually more strenuous in part. My routine is 12 minutes on the Gauntlet, and 13 on the treadmill, and 1 1/2 hours weight lifting.

My problem is I could lift the weights but the debilitation left me unable to function afterwards on those days. The leg press was the most difficult from which to recoup. I like the strength and stamina my program gives me, and fell I'm in the best condition in my life except for the diabetes. My questions are:

1. How can I increase the weights with less body stress?
2. Is there anything about weight lifting that pertains specifically to insulin dependent diabetes?

I have also sometimes experienced a rise in BS before playing golf or going cross country skiing or hiking. I understand this is a normal condition, with the liver preparing the body by releasing more glycogen. I wonder if this is common in other people with diabetes and if you could inform me more about this, I would appreciate it.

I enjoyed reading your column in the Jan./Feb. DIABETES HEALTH. After I read it I renewed my subscription. I really have not found the help want about exercise within my coverage at my Kaiser HMO.

Carol Zedlitz
Pleasanton, CA

A: An hour and a half of weight training daily in addition to 25 minutes of aerobic exercise is a very heavy workload. Your loss of energy and "blah" feelings might be due to low glycogen in your muscles. Glycogen is the stored form of glucose and is a major fuel during exercise. The more intense the exercise and the more energy burned, the more that is used up. Even Olympians are unable to train long or vigorously every day because they cannot resynthesize muscle glycogen rapidly enough. Consequently, they train vigorously only on alternate days and many only twice a week.

Alternate days of weight training and aerobic activity, and don't try to make every session overly strenuous. As a famous coach once advised, "Train, don't strain." This should allow for more complete replacement of muscle glycogen and should also allow time for repair of muscle and connective tissue which may be slightly damaged after long, arduous training sessions.

You can enhance resynthesis of muscle glycogen by eating carbohydrates in the first two hours following an exercise session and then several more feedings as the day progresses. An enzyme in the muscle is very responsive to rapidly forming new glycogen in the first hour or two following exertion. Check your blood glucose (BG) after exercise to make sure it is not too low and realize that BG continues to drop slowly for several hours after exercise because it is taken into the muscle for conversion to glycogen. Some of your fatigue might even be explained by low BG hours later.

You state that your are vegetarian so I assume that carbohydrates such as grains, cereals, bread, fruit, and veggies comprise a good portion of your diet. Highly active people such as yourself should consume about 60-65% of total calories from carbs. Examine your diet to make sure that it is loaded with carbs and not fats such as found in oils, cheese, egg yolk, whole milk, and margarine. If you are a strict vegetarian and do not eat meats, or only rarely do so, you could also be deficient in iron. Highly active people lose more iron and so need more than inactive people. Before you run out and buy an iron supplement, however, first try some of the alterations discussed above. Consuming food with vitamin C increases iron absorption from the food you eat, so mixing fruit, fruit juices, and veggies into your meal plan may also help.

Kris Berg, EdD
Omaha, NE