Exercising With Type 1 Diabetes: How to Manage Your Insulin

We all know that exercise is good for us. It reduces the risk of cardiovascular disease, helps with weight management and is good for your overall health and well-being. Plus, an added benefit for those with type 1 diabetes (T1D), increased physical activity can make your cells more sensitive to insulin, reducing insulin resistance.

Different types of exercise and physical activity can have different effects on people with type 1 diabetes, so the trick is to learn how to adjust food and insulin around each of your workouts.

How to Adjust Your Insulin Intake

Key things to consider when exercising include the type of exercise you plan to do, the action and timing of your insulin and your carbohydrate intake. The overall goal is to begin your workout with your blood sugar in safe range.

When managing blood sugar and adjusting insulin prior to exercise, be mindful of the intensity and duration of your exercise. Adjusting your insulin dose is just like any other component of type 1 diabetes management. Getting it right requires practice — and a conversation with your health care provider can help too!

What About the Timing of my Workout?

Sometimes you don’t have complete control over when you work out. But if you are participating in a competitive sport and/or if you have a sporting event, the kick-off time is set. Be prepared to reduce your insulin prior to game time, bearing in mind playing time and intensity. The amount by which you reduce your insulin dose depends on those factors.

The time of day may also have an impact. Exercising in the late evening after dinner may increase the risk of hypoglycemia overnight, but you can reduce this risk by lowering your evening insulin. If your workout fits best in the evening, make a plan with your endocrinologist or diabetes team to do this safely.

Different Kinds of Exercise and How They Affect Type 1 Diabetes

The way physical activity affects blood sugar changes from person to person, and from exercise to exercise. 

What Should I Eat Before my Workout?

Even when you time your workout perfectly with your insulin, you may need to eat extra carbohydrates to prevent lows. Everyone’s carbohydrate requirements for exercise are unique. Checking your blood sugar before, during and after exercise will help you develop your own plan.

And don’t forget to stay hydrated with water! It’s also a good idea to have hypoglycemic (low blood sugar) treatment, like glucose tabs or juice on hand during exercise.

After Exercise

The effects of exercise don’t stop just because the physical activity or exercise is over. Delayed onset hypoglycemia can occur, dropping your blood sugar in the 6 to 15 hours after exercise. This is something to take into account when estimating your insulin dose before and immediately after exercise. Test your blood sugar before, and then every few hours after exercise, and record what exercise you do and what food you eat in your blood sugar record book or an app. This will make it easier to see trends and will also assist you and your diabetes team in developing good diabetes management strategies.

If your blood sugar levels continue to fall after exercise, you may need to decrease your insulin doses before and after exercise. The amount by which you reduce your insulin will depend on your blood sugar trend. Your endocrinologist or diabetes team will be able to give you advice about insulin adjustment.

Check out this video of T1D athlete Sophie Schunk and continue reading about T1D and exercise.