Exercise for Type 1 Diabetics

Lets take a look at exercise and Type 1 diabetes.

Straight out I have to say that exercise will not improve a type 1's blood glucose control. So why, you may ask, should they bother? Blood glucose control, though immensely important, is not everything in life.

What you will get out of exercise is:-
1. Better general fitness
2. Improved cardio-respiratory endurance.
3. Improved blood lipid profiles.
4. Muscle strength
5. Lower blood pressure.
6. Stabilisation of weight. Many type 1's gain weight after starting on insulin.
7. Possible lower insulin requirements.
8. A better self-image.

As type ones have no beta cells and have to get their insulin from injections it is very easy for them to have too much or too little insulin present at times that do not fit in with the normal automatic system's.

Firstly, if they have to much insulin present when the muscles have used up the glucose in the blood there is nothing to tell the liver to do it's job and the resulting drop in BG levels can cause hypoglycaemia. To add to the complications exercise may cause insulin to be absorbed faster or work better.

Secondly, if to little insulin is present the muscles will have difficulty pulling sufficient glucose from the blood, keeping the BG levels high.

At the same time the low levels of insulin are what tell the liver to get busy, so it releases yet more glucose into the already overstocked bloodstream. This results in raised BG levels and possible hyperglycaemia.

So is there anything one can do to minimise these problems?

Yes. Various guidelines are given on this subject and I will list them below.

1. Know your personal pattern, everyone is different. This means monitoring your BG before, during and after exercise. You will then learn how you need to adapt your insulin and food to your exercise regime.

2. When exercising the usual signs of hypoglycaemia can be difficult to recognise (the normal results of exercise mimic many of them, eg sweating, tiredness etc), so BG measurement is essential after around 30 minutes of exercise.

3. Understand your insulin - know when it peaks and avoid exercising at these times.

4. Remember one of the keywords for diabetes - regularity. Try and exercise at the same time each day. It makes knowing what works for you so much easier.

5. Carry a quick form of carbohydrate snack with you always (glucose tablets or fruit, juice are some suggestions) so you can quickly treat a low blood sugar if you have one.

6. If your BG is over 14mmol/L (250mg/dl), you should check for ketones in the urine. If these are present that means you are lacking insulin and exercising will increase your blood sugars. Wait to exercise until your BG is down.

7. If your BG is less than 6 mmol/L (108mg/dl) it is getting low and exercise should wait until you have had something to eat to bring it back up.

8. Sometimes it is necessary to reduce the insulin dose given at the meal prior to your exercising. Exercise tends to improve the bodies ability to use insulin. Up to 50 % reduction may be required for moderately vigorous exercise.

9. Late hypoglycaemia can occur because muscle and liver stores of glycogen have been used up. Keep a check on your BG levels after exercise. You may need to snack or eat more carbs at the meal following your exercise.

10. Use the abdomen as your injection site as, for some reason, during exercise the absorption of insulin appears to be more consistent there than from the thigh.

11. Try not to exercise alone and never go swimming on your own.

12. Always wear a medic alert bracelet.

A special word needs to be said here in regards to children. Children, especially young ones, tend to be more spontaneous about their exercise. What child plans when to play, or how vigorous that play is going to be? Not being able to anticipate this exercise means you cannot decrease the insulin dose prior to it, so you may need to make sure the child has plenty of snacks afterwards to bring his/her BG back up again.

Types of exercise suggested for Type 1 diabetics.
1. Walking.
2. Cycling.
3. Resistance training.
4. Swimming.
5. Cardiovascular conditioning.

If you would like more advice on how to adjust exercise, food and insulin try the following link Diabetes Net.

Also, you might like to take a look at our comments about treadmills. While this is mostly aimed at type 2 diabetics, it is equally applicable to type 1’s

Back to top