Exercise is hugely important – it has the potential to improve wellbeing (physical and mental) as well as providing long- term benefits in maintaining health. Unfortunately many people with diabetes will avoid exercise due to fear of hypoglycaemia. However, with the correct precautions, there is no reason to fear exercise and indeed there are many examples of elite athletes with type 1 diabetes. Getting dose adjustments and carb intake just right, tends to require some ‘trial and error’ and can vary a lot from person to person.
- Ideally aim for a glucose between 5 – 10 mmol/L prior to exercise.
- If the activity is less than 45 minutes:
- Take 20 – 30g of carb if glucose less than 7 mmol/L.
- Take 10 – 20g of carb if glucose between 7 and 10 mmol/L.
- If glucose between 10 to 14 mmol/L – no extra carb required.
- If glucose greater than 14 mmol/L – consider postponing exercise.
- If exercise is prolonged (more than 4 hours) or intense (running / aerobic class) reduce quick acting insulin before exercise by 30 – 50% (you will need to assess what is right or you).
- For exercise more than 4 hours, background and quick acting may need cut by up to 50%.
Depending on the intensity and duration of the exercise, it is likely that extra carbohydrate will need to be consumed during the exercise.
- A 10 – 20% reduction in night time background insulin is likely to be required after exercise – it is easier to do this if you are on a split twice- daily background insulin (like Levemir).
- Extra carbohydrate before bed may be required to help restore muscle glucose stores.