For many, the word “yoga” connotes a peaceful state of being. You might picture a cross-legged yogi in Lotus Pose, meditating on the rhythm of the breath, the hint of a beatific smile. For many people with type 1 diabetes (T1D), however, the path to Namaste can be just a little more complicated. The technology on which many people rely for blood-glucose management?with all the tubes, infusion sets, and delicate circuitry?can really get in the way of executing a proper Triangle Pose. For anyone who may have shied away from yoga for these reasons, take heart. Many people with T1D have mastered Monkey Pose and gone deep into Downward Dog—all while comfortably sporting an insulin pump.
So let’s start with insulin pumps?possibly the most common computerized T1D treatment technology. The issue with pumps is fairly straightforward: how do you keep the reservoir firmly attached to your person, and how do you keep free and clear of the tubing while you’re bending and bowing every which way? For that, a little careful trial and error often resolves the issue. Many people report beginning their yoga practice with the reservoir at the waist and moving it throughout the sequence, depending on the pose. That can be impractical if you practice something like Vinyasa Yoga, which requires continuous movement from each pose into the next. Many people in those cases opt to remove their pumps and use injectable insulin just for class. And for some women (sorry, guys), a fitted sports bra can hold a pump securely.
Many people also bring their continuous glucose monitors (CGMs) into the yoga studio, but with a CGM, there is more to consider than just where to put it. CGMs can cause discomfort in certain poses if the skin near the infusion site is stretched or if weight is shifted to that part of the body. If you, like many others, keep your infusion site in the abdomen area, just practice forward folds, side stretches, and backbends with a little extra attention.
Blood sugar and sweat?without the tears
Unless you’re practicing Restorative Yoga, you’ll probably work up at least a little sweat, and that can interfere with a CGM as well. Firstly, it can loosen the adhesive patches that keep the infusion set and the sensor glued to your skin. For that problem, many people report success with one of the various adhesive wipes, liquids, or tapes that are available for just that purpose. But sweat can also get to a CGM’s wiring, where it might produce a faulty reading. Have a blood-glucose meter ready to double-check your CGM reading.
Now that we’ve got you thinking up a sweat, let’s talk about heat?specifically, the various styles of Hot Yoga. A room heated to 100+ degrees may do wonders for your Locust Pose, but not for your diabetes supplies. In particular, blood-glucose meters and one or more components of a CGM may be inoperable in extreme heat, and insulin begins to degrade and become unusable. For testing devices, one solution is to keep the meter or the CGM receiver in a specially designated spot just outside the classroom. Even more convenient, bring a small cooler and place it right next to your yoga mat.
Of course, insulin and electronics are not the only things that heat can affect. Any yoga practice, in fact?whether in a hot room or otherwise?can induce effects in the body that look and feel similar to symptoms of hypoglycemia. Sweating, loss of concentration, and muscle trembling are all fairly common in yoga, even for people without T1D—especially if you’re new to the practice. Having your testing device nearby should help you learn to distinguish between a normal reaction and low blood glucose.
One size does not fit all
The practice of yoga can accelerate the effectiveness of insulin in some people, while slowing it down in others. And different styles of yoga may have different effects for the same person. The Restorative Yoga class you attend Sunday evening may burn up blood sugar more slowly than your Tuesday-morning Bikram class, for example.
Believe it or not, even meditation can affect insulin needs. Michael Mahanger is a certified yoga teacher familiar with several schools of yoga. He is very experienced with T1D, having lived with the disease for 37 years. “Several years ago, I attended a 10-day meditation retreat. After only the first day, I needed to reduce my basal rate—by 45 percent,” he says. “It stayed at that low level for the remaining nine days, and as soon as the retreat was over, my basal requirement went back up.”
This all means one important thing for yoga beginners with T1D: check your blood-glucose level frequently, at least during your first few classes. And before beginning any yoga class for the first time, talk to the instructor. Yoga is most often taught in a group setting, but yoga teachers can be an invaluable one-on-one resource. To start your practice right, we’ve provided a list of questions to ask a yoga instructor before you take your first class.
Now that you’re armed with a little yoga 411, you can get on the mat and on your way to transformation.
The information in this article is offered for general educational purposes and is not intended to replace professional medical advice. You should not make any changes to the management of type 1 diabetes without first consulting your physician or other qualified medical professional.