May 02, 2018 Effective strategies for managing exercise in type 1 diabetes

When you have diabetes, physical activity should be an important part of your treatment plan: Among its many benefits, it will help improve your blood sugar and lipid levels, increase your energy and your heart’s and lung’s fitness, and keep your weight at a healthy level.

But getting started with an exercise program can seem challenging if you are starting to exercise for the first time or are getting back into a workout routine. It can feel especially intimidating for people with type 1 diabetes, who may worry about the risk that exercise will cause low blood sugar (hypoglycemia).

You do not need to let the fear of low blood sugar keep you from enjoying the benefits of exercise, though: Here are some ideas for incorporating physical activity into your lifestyle when you have type 1 diabetes.

Start with a plan

If you are new to exercise, start with a gentle activity, such as walking or cycling, and see how your blood sugar (glucose) responds. Based on what you learn from your blood sugar readings, make small changes in duration and intensity if needed, or try another activity (for example, if your blood sugar is too high after you have gone for a bike ride, try a slower pace or a shorter distance next time).

Use technology for tracking

With a cell phone app (e.g., DiaBits) or an activity tracker watch, you can track your steps, minutes of exercise, heart rate intensity, carbohydrates, and more, says Michael Riddell, a professor in the School of Kinesiology and Health Science at Toronto’s York University, and a co-author of the chapter about physical activity and diabetes in the Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Another useful piece of technology: the continuous glucose monitor (CGM), which is a tiny sensor placed under the skin. “Users check the CGM as they’re exercising and then can make adjustments to their snacking pattern or change their insulin infusion rate well before they develop either low or high blood sugar,” says Riddell.

Add variety for the best outcome

Practise different types of exercise to experience maximum health benefits—aerobic and resistance training as well as stretching and balance training. “People with diabetes often develop poor balance and joint stiffness,” says Riddell. “Yoga and stretching can help with both of these.” While it can sometimes be inconvenient to include dumbbell curls, push-ups, and other resistance exercises to your day, keep in mind that just 20 minutes of resistance training twice a week can lead to major improvements in body weight and blood sugar levels, says Riddell.

Be ready for challenges

Be ready for—but not fearful of—a potential case of low blood sugar. Carry some form of fast-acting carbohydrate with you in case you need to treat low levels, such as glucose tablets (the preferred treatment) or Life Savers. Also, monitor your blood sugar before, during, and many hours after your activity to see how it affects your blood sugar levels.

Stick to it for your quality of life

“Don’t ever stop trying to find a customized plan that works for you,” says Riddell. “People who are physically active have better mental health, more energy, and more confidence around self-management [of their diabetes].” Leading an active lifestyle with diabetes can be challenging, but the benefits far outweigh the risks.

Did you know?

If you have been inactive for some time, talk to your doctor before starting any exercise program. Once you do get started, be sure to wear shoes that are comfortable and fit you properly, and always wear your MedicAlert bracelet or necklace. For more information, visit Planning for Regular Physical Activity.

Visit the Diabetes Canada podcast with Michael Riddell in which he offers further insights into being active with type 1 diabetes. You can also subscribe to the podcast in iTunes or in Android.

Do you have a story about the difference physical activity has made for you and your health? Please let us know at dialogue@diabetes.ca.

(This article appeared in Diabetes Dialogue, Spring 2018)