Mark Koekemoer (32) was diagnosed with type 1
diabetes at age 15. Type 1 diabetics cannot make their own insulin, and to keep
functioning they have to either use an insulin pump or injections. Yet despite his condition, Mark is a CrossFit
coach at Cape CrossFit where he trains and regularly takes part in athletic
Anyone who knows anything about diabetes will
probably be surprised at this intense level of exercise given his diabetes. But
according to Mark his regular vigorous exercise, coupled with a ‘clean’ diet is
what’s key to managing his condition.
“You can’t really ever ‘control’ diabetes –
every day is different. But good management means having good blood glucose
levels, which I manage with insulin injections, the right food, and exercise.
It's also important to have a good attitude, otherwise this disease will get
you down,” he says.
Diabetes is a disorder of carbohydrate metabolism. In
type 1 diabetes, the pancreas cannot produce the hormone insulin. Insulin is
produced by the beta cells of the pancreas which is secreted in response to an
increased concentration of glucose in the blood and is vital in controlling
blood glucose levels. A person with diabetes cannot control their blood glucose
and they become hyperglycaemic – meaning that they have abnormally high levels of
glucose in the blood.
Mark believes exercise is vital for managing
glucose levels, as it makes the body more sensitive to insulin. This in turn
means he can eat the same amount of food and use less insulin. “It's a little
more tricky than just doing exercise, though,” he adds.
types of exercise
“I've always been very active and in my
experience I found that different types of exercise affect my blood sugars
differently. Anaerobic sports – short bursts, high intensity – such as lifting
weights and sprinting raise my sugar levels. While aerobic sports – longer
duration, low intensity – will quickly lower my levels. There are other contributing
factors, but that's generally the effects that different sporting activities
have on blood sugar.”
In order to keep a check on his glucose
levels during his workouts, Mark tests himself regularly.
“As a diabetic my body cannot respond to high
or low glucose levels very well due to lack of insulin, so I need to pretty
much manage it by regularly checking my levels and either taking glucose to
raise it, or insulin to lower it. I've experimented quite a bit, and
this has given me some guidelines on what to do before, during and after
“Different types of exercise have different affects. If I don't have
enough insulin on board before I go into a CrossFit workout for example, my
glucose level will tend to skyrocket, and I will be very weak during the
workout. However, if I head for a climb up Table Mountain and don't eat a
banana before I go, my sugar will probably go very low and I will need to take
a break to recover from hypoglycaemia.”
Research has also shown that people with type 1
diabetes may have better blood sugar control during workouts if they lift
weights before cardio exercise. In the study researchers interrupted
participants if their blood sugar fell below 4.5 mmol/L and got them to eat a
When they did aerobic exercise first, their
blood sugar dropped closer to that threshold and remained lower for the
duration of the workout than when they lifted weights first and ran second.
Lifting weights first was also associated
with less severe drops in blood sugar hours after exercise, and post-exercise
drops that did occur tended to last a shorter period of time. In this instance the
researchers concluded that people with type 1 diabetes who have a tendency to
develop low blood sugar during exercise should consider performing their
resistance exercise first – which is often the way crossfit workouts are
structured and how Mark workouts out.
Yet, while regular exercise is part of
Mark’s life, he says that diet remains the most important pillar of managing his
Type 1 diabetes is treated primarily with
insulin therapy either injected through shots or a pump that delivers it
through a tiny tube placed under the skin. Although a diet change cannot prevent or
eliminate the need for insulin in type 1 diabetics, they can still generally
can eat most foods as they then give themselves a dose of insulin based on the
carbohydrates in the meal they're eating.
Experts do recommend that people with type
1 diabetes consume the same sorts of healthy foods they recommend to everyone
to prevent heart disease, cancer and other life-threatening conditions.
Mark however, says that he has noticed a
big difference since he started eating ‘clean’.
“I will always need insulin, but by making
conscious decisions about the food I eat it makes it so much easier to live
with the disease. For a long time while growing up with diabetes I always felt
like I could never really understand how it worked – what made my sugar levels
go up and down, etc. After many years of self study and experience, however, I became
more adept at handling the situation.”
“Then in 2011 I switched to eating ‘clean’,
and for the first time I felt I could really manage my disease. I felt
empowered, and it's that feeling I want to share with other diabetics by means
of the health and lifestyle coaching I do.”
Training with type 1
So while Mark is a great role model for type 1 diabetics, he does point
out that its taken him a while to get the formula that works for him, right.
Before you jump into any heavy lifting exercise as a diabetic, Mark advises
you check your blood sugar before you start your workout, during a workout and
“If you go into the workout low, you risk passing out from
hypoglycaemia. Normally you’d feel it though, as symptoms include shakiness, feeling
hot and bothered, irritability, not making sense when speaking,” he says.
So if you’re at the gym and someone you know is a diabetic feels any of
these symptoms and has very low blood sugar Mark says you need to get them sugar/honey/fruit
juice – and put it in their mouth and under the tongue if they cannot do it
If they pass out, you will of course need to call an ambulance.
To find out more about Mark, his philosophy to coaching and how he can help you reach your health goals, click through to his about.me page here.