28 Nov How to Exercise for Type 1 Diabetes

What is Type 1 Diabetes?

Type 1 Diabetes is a condition in which the immune system has been incorrectly activated to destroy the cells in the pancreas which are responsible for producing insulin. Unlike Type 2 Diabetes, Type 1 is not linked to any modifiable lifestyle factors and it cannot be prevented. Essentially, it is down to luck.

According to the Australian Department of Health, there is approximately 158,900 Australian’s living with Type 1 Diabetes. And yes, I’m one of those lucky ones.

How can exercise help manage your diabetes?

Exercise, in all it’s wonderful forms can be extremely beneficial in managing Type 1 Diabetes and the associated complications. Exercise can assist with the following factors in Type 1 Diabetes management:

• Help insulin work more efficiently.
• Maintain or achieve a healthy body composition.
• Lower blood pressure.
• Reduce risk of heart disease.
• Reduce stress.
• Increase energy levels.
• Enhance Mood.
• Improve immunity.
• Improve sleep.

In pediatric populations, exercise is shown to improve cardiovascular risk factors and reduce HbA1c by 0-3%. It is also shown to improve body composition, cardiorespiratory fitness, endothelial function and blood lipid profiles (Cholesterol) in children and young people.

Adults who exercise regularly are less likely to experience diabetic retinopathy (eye condition) and microalbuminuria (sign of kidney damage). They also have a greater chance of achieving their target HbA1c, blood pressure and BMI than inactive patients.

Exercise & Blood Glucose Levels

When exercising, it’s important to understand the effect that it will have on your Blood Glucose Level (BGL). Whilst each individual’s response will vary somewhat, the following is a general guideline for consideration:

How much exercise & what intensity?

There is limited information regarding the specifics of exercise prescription and Type 1 Diabetes management. However, it is widely accepted that any activity is better than none. Before commencing an exercise routine, speak to your GP or an Exercise Physiologist to ensure you are exercising safely and appropriately. The following tips should also be considered when exercising:

• Drink fluid (water) before, during and after exercise to avoid dehydration.
• Carry extra carbohydrate with you to ensure you are prepared in case of hypoglycemia. Extra carbohydrate may also be required after exercise.
• Monitor and record your BGL before, during and after exercise to ensure you remain in a safe range. Recording this data will also assist to further understand how your body reacts to exercise.
• Your insulin dosage may need to be adjusted. It is best to discuss this with your GP, Endocrinologist or Credentialed Diabetes Educator.
• It’s best not to exercise if your BGLs are unstable or high (>14.0 mmol/L). Exercise in these circumstances can elevate your BGL and increase ketone production.
• If you have experienced a hypoglycemic event prior to exercise, then you are at a higher risk of hypoglycemia for the remainder of the day. Consider this when deciding when and how you exercise.

Tips for someone with diabetes – from personal experience!

The single greatest tool I have in my Type 1 Diabetes management kit is consistency. Consistency in exercise, consistency in nutrition, consistency in sleep, consistency in stress management, consistency in schedule.

Exercise at the same time on the same day each week.

Mark it in your diary and plan adequate time to workout. Your body will become accustomed to this routine and you will find it is easier to manage your meals and BGLs.

Eat similar meals at the same time each day.

Each day, I have a reminder in my phone to remind me when to eat my breakfast, lunch and dinner. While delays and different times are inevitable, being as consistent as possible has been a great help.

Aim for a similar nutritional breakdown each meal.

If your carbohydrate, fat and protein levels are drastically changing between meals, it’s difficult to reach consistency as your insulin dosing is constantly changing. My Fitness Pal is a great phone app which helps with nutritional breakdown of foods. BE AWARE that protein and fat will also have an effect on your BGLs. As a rough guide, 3g of fat/protein will have the same effect on your blood sugar as 1g of carbohydrate. You will also find the effect on BGL to be slower so consider this when dosing your insulin for a high fat / protein meal.

Change your mindset

The most empowering thing you can do is switch exercise from a chore to a reward. Try to change your mindset from “if I don’t exercise, I’ll be unfit, overweight and my blood glucose control will be terrible” to “I exercise because it makes me feel good and my body deserves the best”. Your attitude, approach and commitment to exercise will change.

Finally, just remember that Type 1 Diabetes sometimes has a mind of its own.

You absolutely get out what you put in, but sometimes your BGLs will do whatever they feel like doing, with no rhyme or reason. Don’t punish yourself over it. You just learn from experience and try again the next day. Nobody is perfect and it’s just about a consistent effort and doing the small things right.

Talk to an expert

If you’re living with Type 1 Diabetes and want to know how to exercise right, chat to an Accredited Exercise Physiologist. To find one near you, click here.

Sam is an Accredited Exercise Physiologist and Performance Coach at Ion Training. He also lives with Type 1 Diabetes and uses exercise to help manage his condition.