How to Build Muscle with Type 1 Diabetes

For someone without diabetes there are a lot of factors to consider when trying to build muscle. Some key things would be ensuring adequate protein intake from quality food sources, running a calorie surplus, following well programmed resistance training and getting enough rest to name but a few. For type 1 diabetics though there is another major factor that can seriously stifle gains even if all other aspects of a muscle building program appear to be in check. That factor is hyperglycemia.

Hyperglycemia refers to high blood glucose. For a type 1 diabetic this occurs when not enough insulin has been administered. Insulin is a vital hormone that unlocks the body's cells to allow glucose to enter for use as energy. If there is not enough insulin this means the glucose can't enter body's cells and instead floats in the bloodstream with nowhere to go. The problem is, the body still needs an energy source or it will starve so it instead uses ketones and amino acids as fuel.

When building muscle a process called muscle protein synthesis (MPS) occurs. This is a naturally occurring process in the body that produces protein to repair damaged muscle tissue caused by resistance training. Muscle protein breakdown (MPB) is an opposing force to MPS which, as the name suggests, involves the breakdown of muscle protein. The difference between MPS and MPB is known as the net muscle protein balance (NMPB = MPS - MPB). In order to build muscle muscle, protein synthesis needs to exceed muscle protein breakdown.

With hyperglycaemia however, protein synthesis decreases and protein breakdown increases. After all, type 1 diabetes is a catabolic disease when exogenous insulin is deprived. It doesn't end there though - hyperglycemia can lead to a vicious cycle. Decreased muscle mass as a result of negative NMPB will lead to a decrease in strength. A decrease in strength will lead to a decreased training stimulus which is one of the key requirements in order to build muscle. To rub salt into the wound, decreased muscle mass will decrease basal metabolic rate. This means less calories will be burnt at rest which worsens the body composition most of us are trying to achieve.

Fear not though, type 1 diabetes doesn't end all hope of building muscle. In fact you can pack on some serious muscle when the condition is well controlled. To start, regularly monitor blood glucose levels to ensure you are within acceptable levels all day or as much as possible. As a guide, this is considered to be 4 to 7 mmol/L before meals and under 9 mmol/L after meals although I personally target the lower range of the pre-meal range. A continuous glucose monitoring system and insulin pump can help so be sure to mention it to your diabetic consultant.

Secondly, log what affects your glucose levels and be aware of any patterns. Studying how and to what extent your food intake, exercise and stress alter your blood glucose can help counter imbalances in the future. For example, you may find your blood glucose level spikes after heavy low-rep weight training. Noticing this pattern and altering insulin administration or food intake pre or post workout can help avoid sustained hyperglycemia.

Another tool used by many is carb counting. This involves actively calculating the amount of carbohydrates in every meal and matching insulin to compensate. Although I personally don't use carb counting strictly given the wide range of other factors affecting blood glucose such as stress, exercise type, meal timing, fat/protein consumption and illness, you may find it a useful guide for your own circumstances. The truth is, over time you will learn your body and how your blood glucose levels are affected by a host of factors either in isolation or in combination which will lead you to make better decisions to better manage the condition.

It can be easy to slip up from time to time. The hassle of pricking your finger for blood, lugging around a glucose monitor, administering insulin and studying food consumption can no doubt be a pain to say the least. The way to look at it though, is to focus on the outcome we are trying to achieve. The benefits of maintaining good blood glucose levels on a consistent basis far outweighs the inconvenience of the process.

Ultimately we must be aware that uncontrolled type 1 diabetes is a catabolic condition that depletes energy stores and protein. It is therefore imperative for type 1 diabetics to meticulously study factors that affect their own blood glucose levels and adjust food consumption and insulin levels to compensate in order to maintain optimal blood glucose levels. Please be sure to consult with a diabetes professional before before making any changes to your diabetes management.