Strategies for Safer Physical Activity for People Living With Type 1 Diabetes

The many benefits of physical activity

People living with type 1 diabetes who engage in physical activity on a regular basis are more likely to reach their target blood sugar levels, improve their blood pressure and better manage their weight than those who have a sedentary lifestyle. Physical activity also helps reduce the total amount of insulin used in a day, not to mention the added benefits it brings to well-being, sleep quality and social integration. 

It is recommended for people with type 1 diabetes to do 150 minutes of moderate physical activity (e.g., cardio training) weekly, including two to three sessions of resistance (muscular) training.

Not enough physical activity for people living with type 1 diabetes

Despite all the benefits physical activity provides, most people with type 1 diabetes don’t do enough of it. It seems that the risk of hypoglycemia, which can be increased for up to 48 hours after physical activity, could explain why so many prefer to abstain. On top of this risk specific to them, type 1 diabetes patients also experience the same kind of barriers to being active as people who don’t have diabetes: lack of time, no access to sports facilities, adverse weather conditions, etc. But the fear of hypoglycemia and a lack of knowledge on how to avoid it remain the most significant hurdles to engaging in physical activity.

The influence of technology

A study involving over 500 participants with type 1 diabetes examined whether technology, such as continuous glucose monitoring (CGM) devices and insulin pumps, influenced the way participants prepared for physical activity.

Participants were asked to fill out an online survey, and their answers revealed what strategies they adopted to avoid hypoglycemia depending on whether they were using any technological medical aids (insulin pump, CGM).

Here are the strategies that were observed:

• Reaching a safe blood sugar level before physical activity (generally between 7 and 10 mmol/L)
• Adjusting long-acting (or basal) insulin before physical activity
• Using less rapid-acting insulin before and after physical activity
• Ingesting carbs before physical activity 
• Ingesting carbs during physical activity
• Ingesting carbs after physical activity

The study showed that most participants adopted at least one strategy, meaning they were well aware of the risk of hypoglycemia associated with physical activity.

It was also observed that users of technological devices are more likely to make sure they reach a safe blood sugar level before exercising and adjust their long-acting (or basal) insulin. Therefore, it seems technology may help you better prepare and apply strategies for a safer active lifestyle.

If you are living with type 1 diabetes, you can help improve researchers’ understanding of safe exercise strategies, just like the study did, by joining the BETTER registry. Help advance scientific knowledge!

Register at www.type1better.com.

References:

• Pinsker, J. E., Kraus, A., Gianferante, D., Schoenberg, B. E., Singh, S. K., Ortiz, H., et al. (2016). Techniques for Exercise Preparation and Management in Adults with Type 1 Diabetes. Can J Diabetes, 40(6), 503-508. doi:10.1016/j.jcjd.2016.04.010
• Riddell, M. C., Gallen, I. W., Smart, C. E., Taplin, C. E., Adolfsson, P., Lumb, A. N., et al. (2017). Exercise management in type 1 diabetes: a consensus statement. The Lancet Diabetes & Endocrinology, 5(5), 377-390. doi:10.1016/s2213-8587(17)30014-1