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Exercise and T1D

Exercise and physical activity is essential for each and every human being towards remaining fit, healthy and full of vitality. People I work with through my various exercise outlets, be it academic research or sports training, often forget that we are a species who are highly dependent on movement and activity. Genetically speaking we have not changed a whole pile over the past 100,000 years, except for natural selection development, which is mostly governed by the landscape and nutrition of different areas in the world. Why am I pointing this out? Well, people have seemed to forget over the past 100 years that we are, by all means, a physically active race. We once climbed trees all day everyday, that itself is a demanding physical activity, we are the first species to rely on standing on two legs which are (amongst all mammals) the longest leg to body ratio. This is purely because we ran places. Before cars, trains, buses, planes, trams, bicycles even hover boards we walked and ran. We have developed the most efficient maintenance system with our ability to sweat to maintain a core body temperature, and we are the best endurance movement species on the face of the earth.

So still, why am I telling you this? Because we need physical activity to ensure our bodies, from cells to systems remain in top functional condition. Unfortunately different diseases can be a huge factor and complicate things but it is essential to know that exercise is still necessary, on any level and can be a huge asset in treating and managing diabetes.

So some key information to remember...

Preventing Lows

Your blood glucose response to exercise will vary depending on:

  • your blood glucose level before starting activity,

  • the intensity of the activity,

  • the length of time you are active,

  • and changes you’ve made to insulin doses.

Sometimes people experience a drop in blood glucose during or after exercise, so it is very important to monitor your blood glucose, take proper precautions, and be prepared to treat hypoglycemia (low blood glucose).

Learn how different types of activity affect you, you should frequently check your blood glucose before, during, and after exercise.

Put a trial and error system into place. For example, increased activity may mean that you need to lower your insulin dose or eat some extra carbohydrates before exercising to keep your blood glucose in a safe range. Some activities may cause your blood glucose to drop quickly while others do not.

If your blood glucose levels are trending down before a workout, have a pre-exercise snack. Always carry a carbohydrate food or drink (like juice or glucose tabs) that will quickly raise your blood glucose. It may take a while to figure out what works best for you.

If your blood glucose level is less than 100 mg/dl before you start your activity, try having a small carbohydrate snack (about 15 grams) to increase your blood glucose and reduce your risk for hypoglycemia. This is especially important if you anticipate that your body’s circulating insulin levels will be higher during the time you exercise and if you will be exercising for longer than 30 minutes.

If you use an insulin pump, you may be able to avoid adding an extra snack by lowering your basal insulin rate during the activity.

If you have repeated problems with your blood glucose dropping during or after exercise, consult your doctor.

When Your Blood Glucose is High

Blood glucose can also run high during or after exercise, particularly when you do a high-intensity exercise that increases your stress hormone levels.

If your blood glucose is high before starting exercise, check your blood or urine for ketones. If you test positive for ketones, avoid vigorous activity.

If you do not have ketones in your blood or urine and you feel well, it should be fine to exercise.

If you ever have any questions, or wish to just keep up to date on the latest work, then follow me on Twitter @DeanMinnock

By Dean Minnock.

PhD Candidate at UCD & Physiologist at InsulCheck

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