If you have type 1 diabetes, staying active can help lower your chances of developing complications. These can include high blood pressure, heart disease, nerve damage, and vision loss.
Regular exercise may also help improve your overall quality of life.
Regular exercise can help you manage your weight, improve your mood, and contribute to better sleep. These are some reasons why the
But some people with type 1 diabetes may hesitate to exercise. That’s understandable, since regular exercise may change your approach to diabetes management.
Strenuous activity can cause your blood sugar to drop. This can lead to low blood sugar, which is called hypoglycemia. Intense bouts of exercise can also cause your blood sugar to rise. If it rises above normal levels, it’s known as hyperglycemia.
Despite these facts, exercise can play an important role in maintaining overall health and supporting type 1 diabetes management. Exercise can
Take a moment to learn how you can exercise with type 1 diabetes while keeping your blood sugar in a safe range.
According to the American Diabetes Association (ADA), most adults with type 1 diabetes should aim for at least 150 minutes of moderate- to vigorous-intensity aerobic exercise per week. But many people may have to work up to this amount, gradually increasing the frequency, duration, and intensity of exercise.
The ADA further recommends daily exercise to help reduce insulin resistance, no matter what type of diabetes you have.
The relationship between exercise and blood sugar levels varies for each individual with type 1 diabetes. This is important to keep in mind when you choose a new workout routine. Diabetes UK says there’s no one type of exercise that’s best — it’s about finding what works for you.
Since there is little conclusive research on how exercise affects blood glucose in people with type 1 diabetes, researchers come back to three basic guidelines for diabetes exercise management:
- eating enough carbohydrates
- monitoring glucose before, during, and after exercise
- adjusting insulin as necessary
Here are some exercise and workout ideas for people with type 1 diabetes.
Resistance activities
The ADA encourages adults with type 1 diabetes to complete two to three sessions of resistance activities per week. Resistance activities include:
- muscle-strengthening workouts, such as weight lifting
- resistance band exercises
- bodyweight exercises
High-intensity interval training
A workout using high-intensity interval training (HIIT) involves short bursts of activity broken up by recovery periods.
While a 2020 study of people with type 1 diabetes and obesity found that HIIT did not significantly reduce A1C after a 12-week program, the authors used their data to speculate that perhaps glycemic control could occur with a continued commitment to this exercise regimen.
Swimming
Swimming is an aerobic activity that is easy on joints but still increases heart rate. This is an ideal activity for people with diabetic peripheral neuropathy (DPN). Although people with DPN can participate in weight bearing exercise, experts recommend non-weight-bearing activities for those with severe neuropathy to prevent injury.
If you wear an insulin pump, check that it is waterproof before swimming.
Cycling
Riding a bike gives you lots of options to increase or decrease the intensity of your workout. You can ride slowly in your neighborhood or increase the pace if it works for you. Bikes can also come equipped with motors that can give you extra support, especially when you are getting started.
You can also attach a bag or basket to a bike to keep your carbohydrates, fluids, testing supplies, and insulin handy.
Running
If you enjoy going for a run, that may be the best exercise for you. As with any type of activity, take note of your body’s response, especially as you are trying out a new routine.
A jog around your block may work for you at the beginning, but you may need time to work up to longer distances.
Mixed aerobic and anaerobic activities
Different workouts can affect your blood sugar in different ways, depending on the type, intensity, and duration of the exercise.
- Aerobic (lower intensity, longer duration): Blood sugar levels may drop.
- Anaerobic (higher intensity, shorter duration): Blood sugar levels may spike.
- Combination of aerobic and anaerobic: Blood sugar levels may fluctuate.
Some research has found it may help to incorporate short sprints or high-intensity intervals into aerobic workouts to reduce the drop in your blood sugar level. For example, it may help to sprint for 5 seconds every 2 minutes during a 30-minute cycling session. While more research is needed, some findings suggest this vigorous activity may trigger the release of hormones that decrease the drop in blood sugar.
Studies also suggest that doing resistance activities before an aerobic workout may help keep your blood sugar steadier. For instance, consider lifting weights before you go for a jog or swim laps. On their own, resistance activities tend to cause smaller drops in blood sugar than aerobic exercises.
No matter what type of exercise you do, it’s important to check your blood sugar level before and after each workout. Coordinating your food and insulin intake with your workouts can help keep your blood sugar in a normal range.
A comprehensive consensus statement in
- better chance of reaching A1C targets
- greater achievement of blood pressure targets
- decrease in total daily insulin needs
- reduced heart disease risk factors, like dyslipidemia and hypertension
- reduced risk for diabetic complications, like retinopathy and microalbuminuria
- less risk of experiencing diabetic ketoacidosis or severe hypoglycemia with coma
These are all in addition to the benefits of exercise for everyone, regardless of whether they live with type 1 diabetes, like reduced risk of myocardial ischemia (blockage of blood flow to the heart), coronary artery disease, and stroke.
Before you start a new exercise routine, it’s best to talk to your doctor or diabetes educator. They can help you decide which workouts are safe for you. They can also guide you on how to keep your blood sugar in a safe range by coordinating your meals, snacks, and medications with your routine.
To prevent low blood sugar during and after exercise, your doctor or diabetes educator might advise you to take one or more of the following steps:
- Reduce the amount of bolus or basal insulin that you take before, during, or after exercising.
- Increase the number of carbohydrates that you eat before, during, or after exercising.
- Incorporate sprints or high-intensity intervals into your aerobic workouts.
- Complete resistance activities before your aerobic workouts.
- Adjust the timing, intensity, or duration of your workouts.
To stay safe while exercising with type 1 diabetes, consider working out with someone who knows you have type 1 diabetes and can recognize and treat severe hypoglycemia. A sport-friendly medical ID bracelet can also assist emergency personnel.
Remember to listen to your body. If you start to feel sick, shaky, or confused, stop and check your blood sugar level. If you are sick before you start exercising, consider rescheduling the activity.
Here are some additional tips to monitor blood sugar and maintain a healthy exercise routine:
- Plan to finish your workout at least 2 hours before you go to bed. This may help prevent delayed hypoglycemia while you sleep.
- Check your blood sugar before and right after each workout. If you’re exercising for an extended period, check your blood sugar every 30 to 60 minutes during your workout, too.
- In the hours after your workout, recheck your blood sugar. Your blood sugar can continue to drop for several hours after exercise, which may cause delayed hypoglycemia.
- Have fast-acting carbohydrates available to treat low blood sugar that might develop during or after your workout. For example, carry glucose tablets, fruit juice, or non-diet soda with you.
- If your blood sugar is lower than 100 milligrams per deciliter (mg/dL) or 5.6 millimoles per liter (mmol/L) before you begin your workout, eat around 15 grams of fast-acting carbohydrates before you start exercising. If you’re planning to work out for an hour or more, include some protein in your snack too.
If your blood sugar is higher than 250 mg/dL (13.9 mmol/L) before you start your workout, test your urine or blood for ketones. If you have a high level of ketones in your urine or blood, it’s not safe to exercise. Contact your doctor and follow their instructions to treat the elevated ketones.
If your blood sugar is higher than 250 mg/dL (13.9 mmol/L) but you have no ketones or only trace ketones in your urine or blood, you can proceed with your workout.
In most cases, exercise causes blood sugar to drop. But sometimes, short, intense bouts of exercise can cause your blood sugar to rise. This is due to the effects of stress hormones released during high-intensity activity.
If your blood sugar level is high before you begin your workout, check your blood sugar more frequently during and after your workout. Make sure that you drink plenty of water or other liquids to stay hydrated. Dehydration
If your blood sugar level is still high after exercising, you can take a small bolus of rapid-acting insulin to lower it. If you use an insulin pump, you can temporarily increase your basal insulin infusion until your blood sugar returns to the normal range.
If your blood sugar rises higher than 250 mg/dL (13.9 mmol/L), measure the ketones in your urine or blood. If your ketone level is high, contact your doctor. Follow their treatment instructions and avoid vigorous activity until your blood sugar and ketone level return to normal.
When you exercise, your body pulls sugar from your bloodstream to fuel the activity. It also draws on sugar stored as glycogen in your muscles and liver.
This is why your blood sugar level tends to drop during a workout. It’s common for blood sugar to continue to drop for several hours after exercise, too.
If your blood sugar level drops to 70 mg/dL (3.9 mmol/L) or lower, it’s known as low blood sugar, or hypoglycemia. In most cases, hypoglycemia can be treated by eating or drinking fast-acting carbohydrates. In severe cases, hypoglycemia must be treated with a medication known as glucagon.
When you take a dose of insulin, it signals the cells in your muscles, liver, and fat to absorb sugar from your bloodstream. This helps prevent your blood sugar from getting too high when you eat.
Exercising can also cause your blood sugar to drop. That’s why it’s important to coordinate your insulin intake with your meals, snacks, and workouts.
To help prevent low blood sugar during and after workouts, your doctor or diabetes educator might advise you to reduce your insulin intake on days when you exercise.
It can take some trial and error to learn how your body responds to changes in your insulin intake, carbohydrate intake, and exercise routine.
Keep records of your insulin intake, food intake, exercise activities, and blood sugar to help you learn how to coordinate your medication, meals, and snacks on days you work out.
To treat hypoglycemia in its early stages, consume about 15 grams of fast-acting carbohydrates, such as:
- glucose tablets or glucose gel (follow the package directions for dosage)
- ½ cup of fruit juice or non-diet soft drink
- 1 cup of milk
After eating or drinking 15 grams of fast-acting carbs, wait 15 minutes and check your blood sugar level again. If your blood sugar level is still 70 mg/dL or lower, eat or drink another 15 grams of fast-acting carbs. Repeat these steps until your blood sugar level returns to a normal range.
After your blood sugar returns to normal, eat a small snack with carbs and protein. This can help keep your blood sugar steady.
If left untreated, hypoglycemia can become severe. Severe hypoglycemia is a potentially life threatening condition that can cause seizures and loss of consciousness.
If you develop seizures or loss of consciousness, you won’t be able to swallow any foods or drinks with fast-acting carbs safely. Instead, you’ll need a medication known as glucagon.
Your doctor can give you a prescription for a glucagon emergency kit or glucagon nasal powder. Consider telling your coach, trainer, or workout buddy where to find your glucagon. Teach them when and how to use it in case of an emergency.
If your blood sugar is lower than 150 mg/dL (8.3 mmol/L) before your workout, eat a carbohydrate-rich snack to help keep your blood sugar up while you’re exercising.
Aim to eat about 15 to 30 grams of carbohydrates in your preworkout snack.
If you’re planning to exercise for an hour or longer, include some protein in your snack, too.
Each of the following snacks typically contains about
- ½ cup of applesauce
- 1 small banana
- 1 cup of milk
- 2/3 cup of yogurt
- 2 slices of bread
If you’re planning to exercise for an hour or more, check your blood sugar every 30 to 60 minutes. If your blood sugar drops below 100 mg/dL (5.6 mmol/L), take a break to snack on some carbs.
If you don’t have a meal scheduled within the next hour or so, eat a postworkout snack that contains both carbs and protein to help stabilize your blood sugar.
When it comes time to eat your next meal, be sure to include both carbs and protein. This will help replenish your body’s store of glycogen and promote muscle repair.
To support your overall health and well-being, take part in regular exercise, including aerobic and resistance activities.
Exercise tends to lower your blood sugar, which can lead to hypoglycemia. To prevent hypoglycemia, try reducing your insulin dosage on days when you exercise or eat more carbs before your workouts. You might also consider adjusting the exercise activities that you do.
Your doctor and dietitian can help you learn how to coordinate your medication, meals, snacks, and workouts to keep your blood sugar in a safe range.