Exercise and Type 1 Diabetes
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image by Heather Aitken

I am not a diabetes expert. I just happen to be an exercise and fitness professional with type 1 diabetes. This does not mean I have all the answers but it does give me some insight into the unique challenges of exercising with type 1 diabetes. (For simplicities sake, I will use diabetes for the remainder of this post. Just know I am referring to type 1.)

Growing up with diabetes was an excuse not to do things. I used it so often that I started to believe it was true. I believed I couldn’t run or do anything strenuous because my blood sugar would go low. It was a great excuse in the beginning to stop doing something before it became too uncomfortable.

Then I realized to change my body I was going to have to get a little uncomfortable. I started liking how it felt to push a little harder. I didn’t want to stop. I decided I would have to be more proactive instead of reactive – a common them in my fitness transformation.

The diabetes educator who trained me on my pump was the most hopeful, helping me with timing to avoid lows on long bike rides and making sure I knew all the features my Omnipod has to offer.  Other than that, most of what I have learned has been on my own.

One of the best sources for exercise related information is the Diabetic Athlete’s Handbook

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. Here are a couple of basic rules from the book that every type 1 diabetics should know before starting an exercise program.

  • If your blood glucose level is < 100 mg/dl (5.6 mmol/L) then eat some carbs before beginning your workout/activity
  • If your blood glucose level is > 250 mg/dl (13.9 mmol/L) with ketosis avoid exercise. If your blood glucose level is > 300 mg/dl (16.7 mmol/L) but no ketosis then proceed with caution. (I have the hardest time with this one. When I want to workout I want to workout!)
  • Always have some form of quick acting carbs with you while exercising. I’ve used glucose tables for a long time but I am loving a new product called Level Life Glucose Gel.

My other best source has been experimentation. I test, I notate and then I adjust. Here are some things that I’ve learned (your mileage may very, always test):

If I’m going to do long, steady state cardio I do NOT put my Omnipod on my legs. Working my big muscles with my pump on either thigh will almost always lead to lows. I make sure to put my pod on my back for Sunday bike rides, hiking or running.

When I do put my pump on my leg, I secure it with Tender Tape during any workout.  Just a set or 2 of jump squats or jumping jacks can make things start to flop around. Tender Tape wrapped around the pump and leg keeps everything where it is supposed to be.

Strength training and sprinting may actually cause glucose levels to go up. These activities don’t drop like they do with most cardio although exercise does make my muscles more sensitive to insulin. This is because 10-30 second bursts of high intensity activity can actually stimulate glucose raising hormones. Depending on the intensity of my workout I can actually see a rise in blood glucose. While I often suspend my basal dose during cardio (it depends on time of day and glucose reading prior to the workout) I vary rarely do it with weights.

Carb drinks can help make it through a workout. In general I am opposed to drinks like Gatorade for those who aren’t working out longer than an hour. But I have learned that coconut water or Starbucks Refreshers can be a good choice to drink during a workout on a day when I have been fighting low blood sugar. I may have a small snack and drink coconut water during my workout to keep my blood sugar from dipping.

These are the critical lessons I’ve learned thus far. I am, like every type 1 diabetic, a work in progress. It’s a 24 hour job, but it’s worth it. I don’t let diabetes act as an excuse anymore. I feel good. I feel strong. Some days I almost feel normal.

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