Endocrinology (including Diabetes)/Slow recovery


My son is 20 years old and was diagnosed as  a type 1 diabetic February 2011. He had been a cycling enthusiast for about 2 years before being diagnosed utilizing all of the aspects of endurance training including nutrition and proper recovery techniques. He is very responsible with his diabetes managing a pump and cgm to monitor his bg closely. However, his legs do not seem to recover well at all from the easiest of rides, making training impossible. It seems to be 4 days before he could think of riding again, all the while suffering muscle fatigue and aches for just climbing stairs or simple tasks of daily living. An easy, short game of football with minimal participation or any other similar athletic activity causes the same fatigue. Conversely, he is able to lift weights with his upper body and recover quickly. This causes great discouragement as cycling is his passion and has helped in controlling his diabetes. Is this a metabolic problem? His last A1C was 6.1. Any help would be greatly appreciated. Thank you.

  Your son is not the first person I have heard complain about similar issues.  My first thought is that he's low on magnesium.  That mineral can be depleted by insulin use, and its critical for the proper functioning of over 300 metabolic pathways in the body. It may be that he's simply not able to metabolize the carbs that he takes in and restore them as glycogen in his muscles after rides.  So, I would consider having him start taking a daily magnesium supplement.  You may also want to get him a B-complex vitamin supplement, too, as many of those vitamins are also involved in carbohydrate metabolism.  The other thought I have is that he needs to make sure he has adequate carbohydrate intake--matched with insulin--during the 24 hours following a ride.  It sounds like he's not restoring his muscle carbohydrate stores very effectively, and it takes insulin to do that.  His A1c is great, but it may be a timing thing.  Have you or he read my book called Diabetic Athlete's Handbook?  It has a lot of the physiology in there that can be helpful to better understand.  You can find out more about it on my web site at www.shericolberg.com, as well as other helpful articles.  Sheri

Endocrinology (including Diabetes)

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Sheri Colberg, PhD


I am an exercise physiologist with a PhD who specializes in diabetes--as such I CANNOT answer general questions about other endocrine problems as I am neither an expert in all areas of endocrinology nor am I a medical doctor. My expertise lies in answering questions about diabetes (of any type) and physical activity, so please limit your questions to those areas. I can help you if you want to begin exercise or if you're already a diabetic athlete, and I am prepared to respond to questions about physical activity to which even your diabetologist may not know the answer. I can give suggestions about changes in your diabetic medications that differing types and intensities of exercise may necessitate, but I will have to refer you to your regular health care team to get final approval to make such changes. I can also answer questions about physical fitness, exercise metabolism, prediabetes reversal, and prevention of type 2 diabetes and diabetic complications.


I have both personal and professional experience in the areas of diabetes and exercise/physical activity. On a personal level, I have had type 1 diabetes since 1968, and I have been an avid exerciser since I was a child. Professionally, I have been conducting clinical studies on diabetes and exercise since 1992, largely with funding from the American Diabetes Association. I am also the author of 8 books related to diabetes, exercise, and more: The Diabetic Athlete (2001), Diabetes-Free Kids (2005), The 7 Step Diabetes Fitness Plan (2006), 50 Secrets of the Longest Living People with Diabetes (2007), The Science of Staying Young (2007), Matt Hoover's Guide to Life, Love, and Losing Weight (2008), Diabetic Athlete's Handbook (2009), and Diabetes? No Problema! (2009).

I am a Fellow of the American College of Sports Medicine, a professional member of the American Diabetes Association (and professional volunteer for the ADA), and a former member of the Board of Directors of the Diabetes Exercise & Sports Association.

I have published research and review articles in the following journals and magazines: Diabetes Care, Diabetes, Journal of Diabetes & Its Complications, Diabetes Self-Management, Medicine & Science in Sports & Exercise, Journal of Applied Physiology, The Physician and Sportsmedicine, Journal of Clinical Investigation, International Journal of Obesity, FASEB Journal, The Diabetes Educator, Journal of Physical Education, Recreation, and Dance, Clinical Exercise Physiology, Clinical Diabetes Reviews, Insulin, ACSM's Health & Fitness Journal, Biomechanics, On the Cutting Edge, Diabetes Technology & Therapeutics, Microvascular Research, Drug Benefit Trends, ACSM Certified News, Diabetes Health, SportEX Health, Diabetes Focus, Diabetes In Control, dLife-For Your Diabetes Life, Pediatrics for Parents, and My TCOYD (Taking Control of Your Diabetes) Newsletter. I have also been interviewed in myriad other magazines, such as Men's Health, Men's Fitness, Diabetes Forecast, Countdown Magazine, Joe Weider's Muscle & Fitness, Health, Tidewater Parent, Barron's News, Diabetes New Day, and Newsweek International.

I have an undergraduate degree (1985) from Stanford University, a Master's degree in exercise physiology (1987) from the University of California, Davis, and a Ph.D. (1992) from the University of California, Berkeley, in the same field. I also spent two years in an NIH-funded postdoctoral research position in endocrinology (studying obesity, diabetes, metabolism, and exercise) at the University of Pittsburgh School of Medicine (1993-1994).

Awards and Honors
Fellow, American College of Sports Medicine (FACSM) - 1996 Old Dominion University Darden College of Education Young Investigator Grant Award 2003 Honor Society of Phi Kappa Phi, Old Dominion University Chapter 2004-Present Great Women of the 21st Century by the American Biographical Institute 2005 Edition Old Dominion University Darden College of Education Largest Research Grant Award 2006 Old Dominion University Darden College of Education Publications Award (for greatest number) 2006 Saint Louis University, The Max K. Horwitt Memorial Lecture Distinguished Lectureship Award 2008 Old Dominion University Darden College of Education Publications Award 2009 Old Dominion University Darden College of Research Grants Award 2009

Past/Present Clients
I have consulted for numerous groups, including Can-Am Care, Numera|Social, California Commission on Peace Officer Standards and Training(about candidates with diabetes), Animas Corporation (an insulin pump company), Therasense, Inc. (makers of the Freestyle blood glucose meters), Council of Healthcare Advisors, and the City of Chesapeake (Virginia) Health Department.

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