January 17, 2024 – If you have got type 1 diabetes and have vowed to exercise more this yr, there are doctor-approved methods that may enable you reach your goal and stay secure.
Many individuals with type 1 diabetes don't get enough exercise, and apart from the standard complaining that daunts people from physical activity, Research suggests that a fear of Hypoglycemia – in case your blood sugar levels get too low – may very well be a specific problem for patients with type 1 diabetes.
Exercise, food, insulin, and blood sugar can turn into a crazy balancing act in a matter of minutes, especially should you're recent to physical activity. To make matters worse, exercise can mask the signs of hypoglycemia, making it harder to detect.
“Exercise leads to false symptoms such as sweating, increased heart rate and fatigue,” he said Michael RiddellPhD, Professor of Kinesiology and Health Sciences at York University in Toronto and co-chair of the Type 1 Diabetes Exercise Initiative, the most important observational exercise study in adults with type 1 diabetes.
Riddell also lives with Type 1 diabetes, exercises frequently and is a vocal advocate for helping patients get more exercise.
“Doctors [who have patients with type 1 diabetes] “It should really encourage exercise because it has so many health benefits,” Riddell said.
These include better blood sugar control and reduced insulin requirements, Riddell said. In one review Riddell stated that patients with type 1 diabetes who exercised at least twice a week had a lower body mass index, better A1c levels and fewer complications such as retinopathy and microalbuminuria, meaning they experienced an increase in have protein in their urine. They were also less likely to suffer from problems with cholesterol and high blood pressure.
If you're still having trouble exercising, remember that doing so will help reduce all of these risks, Riddell said.
All about timing
For many people, the best time to exercise is simple: whenever they can. Nevertheless, the right timing can be helpful in controlling blood sugar.
For example, think about meal times. “Do not exercise if you have taken a (dose of) insulin with a meal,” Riddell said. “Your insulin is already working and your blood sugar is starting to drop. If you also exercise, it may drop too quickly.”
While exercise before a meal is best, exercise after a meal is also OK — just be sure to reduce your insulin dose during the meal, as exercise increases its effects, Riddell said.
Some Research suggested that exercise in the morning before eating could reduce the risk of hypoglycemia. One randomized trial found that people with type 1 diabetes who exercised before breakfast had a 50% lower risk of experiencing a dangerous drop in blood sugar over the next 24 hours than those who exercised after lunch. In addition, these people had more blood sugar levels in the normal range on the days after morning exercise than on the days after.
Hormones may play a role. “Cortisol is produced in larger amounts in the morning and leads to higher blood sugar levels,” he said Sarah Kim, MD, endocrinologist at UCLA Health. So your blood sugar levels may not drop as much.
Then there's this Dawn phenomenon, when hormones (like cortisol) signal the liver to produce extra glucose to wake you up. It occurs in about half of patients with type 1 diabetes, and a morning workout can help counteract the effects.
But regardless of when you exercise, it's important to stay consistent.
“Routine is really important,” he said Jason Baker, MD, assistant professor of medicine and endocrinologist at Weill Cornell Medicine in New York City. By always exercising at the same time and with the same duration and intensity, you can learn how your body reacts so you know what to expect and how to prepare, Baker said.
Start tracking at T-Minus 30
Patients should monitor their glucose levels about half an hour before exercise. Continuous glucose monitors (CGMs) are excellent tools for this. However, please note that there may be a 10 to 15 minute delay between the sensor and blood glucose changes.
“I always recommend that patients continue to finger prick,” Baker said, “to ensure they have good data and are making the right treatment decision.”
If the numbers trend down, patients can have a snack without insulin immediately before starting exercise, Kim said. “If blood sugar is 150-200 mg/dL, they might still wish to eat without insulin, as we expect the exercise itself will lower blood sugar to a traditional range.” If blood sugar is higher, you can skip the snack waive.
Stay alert, be prepared
Training intensity is important, so it's good to be aware of how hard you're training. However, many things can affect the effort.
For example, a small one randomized trial Studies published last year suggest that immersive fitness video games may impair your ability to recognize how hard you're working. The game's graphics, music and interaction could distract you from your body feelings, the researchers explained.
Instead of relying on feeling alone, take a regular look at your blood sugar levels during exercise, Riddell said.
If you have one Insulin pumpYou It may be possible to connect the pump to the glucose monitor so that insulin can be adjusted based on the CGM data.
If this is not possible, the pump may still have an activity or training mode. “This will reduce the amount of basal insulin the pump delivers,” Kim said. “The patient can turn it on for the duration of the workout” – and leave it on after the workout until blood sugar levels return to a stable range.
Patients should always have a source of sugar in their pocket just in case, Baker said. “Don’t plan on running to the store across the street or back to your locker at the gym to grab some sugar,” Baker said. “If blood sugar levels drop, you may feel unwell and unable to think clearly.”
A source with 15g Carbohydrate, about three to four glucose tablets or six Lifesavers[ZM1] Sweets can cause blood sugar levels to rise quickly.
How to choose the best type of exercise
In general, aerobic exercise (steady state, moderate intensity) lowers blood sugar, while anaerobic exercise (shorter bursts, higher intensity) increases it.
Riddell's suggestion: Do interval training with a mix of both. The combination can help keep blood sugar levels in check.
Try 30 minutes of aerobic exercise with mixed anaerobic activities such as sprints, push-ups, sit-ups, burpees, or squats.
Beginners should “train for no longer than 30 minutes,” Riddell added. Prolonged use could lower blood sugar levels too much.
Change your habits, change your insulin
“As doctors, we have to remember this [patients] “If they change their behavior, they have to change their insulin,” Riddell said. The more physically active a patient is, the less insulin they are likely to need.
“You can take 20% less basal insulin throughout the day and up to 50% less insulin with meals if you are physically active after a meal,” Riddell said. “Then there's weight reduction, you don't must take as many carbohydrates, and also you don't have as much hypoglycemia.”