Fitness Articles

Exercising Safely with Type 1 Diabetes

Considerations, Concerns and Checklists


Exercise Risk #1: Hypoglycemia
Exercise typically reduces blood sugar levels—especially when combined with insulin injections. When blood sugar drops too low, a complication known as hypoglycemia (low blood sugar) occurs. Hypoglycemia can happen during exercise, right after exercise, or even up to 24 hours after you work out. Symptoms of hypoglycemia can be mild and gradual, but it is more common for them to occur quickly. In rare cases, individuals may not experience any symptoms of hypoglycemia at all. By paying close attention to how you’re feeling, and by knowing how to recognize and treat symptoms of low blood sugar correctly, you can prevent problems before they put you at risk of injury.

Because the risk of hypoglycemia increases with exercise, it is important to plan your new exercise regimen carefully (more on that below). Here are some ways people with type 1 diabetes can reduce their risk of hypoglycemia during and after exercise.
  • Always check your blood sugar before, during, and after exercise.
  • Talk with your doctor about whether adjusting your insulin doses (or basal infusion rates, if you use an insulin pump) around planned exercise is right for you. Adjusting insulin doses around planned exercise can minimize your need for extra snacks prior to exercise, thereby helping you manage your weight.
  • NEVER adjust these doses under any circumstances, without consulting your physician first.
  • Eat 15-30 grams of carbohydrates 30 minutes prior to any physical activity that is not part of your regular fitness plan for diabetes management. Talk to your doctor or diabetes educator for specific guidelines.
  • In order to ensure that insulin is not absorbed too quickly, increasing the risk of hypoglycemia, it is best to avoid giving any insulin injections prior to exercise into areas of the body that will be worked during exercise (upper thighs and tricep region of the upper arms).
  • Do not skip planned meals prior to exercise or go too long without eating.
  • Carry an easy-to-consume source of fast-acting sugar (such as juice, hard candy, or glucose tablets) when you exercise. You will use this to treat hypoglycemia should it occur.
  • Drink plenty of water before and during exercise. Dehydration can affect blood glucose levels.
  • Avoid exercising in extreme weather conditions.
  • In special cases, athletes and people who have successfully adopted a long-term fitness plans will need specific self-management instructions from their physicians.
Exercise Risk #2: Poor Blood Sugar Control
In some cases, exercise can cause blood sugar levels to rise, resulting in hyperglycemia. If your blood glucose levels are not in your target range, talk to your doctor before beginning an exercise program. To prevent exercise-related blood sugar problems:
  • Do NOT exercise if your blood glucose is above 250 mg/dL and you have ketones in your urine. Call your doctor’s office for additional advice.
  • Check your glucose level before, during, and after exercise, to see how your exercise has affected it. Share this information with your doctor.
Exercise Risk #3: Diabetic Retinopathy
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