Type 1 Diabetes: Exercise Often Raises Blood Glucose In Type 1 Diabetes
Regular physical activity and exercise are recommended for the general population for overall improved health. However, exercise of moderate intensity increases the risk of hypoglycemia during and following exertion in those with type 1 diabetes mellitus (T1DM). Accordingly, exercise guidelines for T1DM focus on prevention of exercise-induced hypoglycemia. The risk of hypoglycemia may discourage some with T1DM from exercising. Children and youth may be embarrassed by the temporary reduction in coordination and physical performance associated with hypoglycemia and by the fear of letting teammates down while playing. Some parents may discourage their children from normal participation in physical activity and from playing competitive sports because of concern about severe hypoglycemia. However, this fear may reduce a child’s physical activity, which may lead to reduced overall health, reduced enjoyment from exercise, and restricted confidence in meeting the demands imposed by living with a chronic health condition like diabetes. As a result, long-term exercise habits as well as personal growth and psycho-social development may be blunted. Concern with hypoglycemia from exercise is probably even more heightened in those with hypoglycemia unawareness, or the absence of symptoms during hypoglycemia. However, some of these concerns might be allayed by the realization that vigorous exercise tends to raise blood sugars rather than lower it. The fact that vigorous exercise tends to raise blood sugar appears to be relatively unknown to many with T1DM. However, the effect has been confirmed in a number of studies. These studies have identified an exercise threshold that elicits this response. The threshold exercise intensity occurs at or above 80% of a person’s maximum exercis Continue reading >>
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Exercise
Exercise is an important part of your general health, but it also helps you to maintain good type 1 diabetes management Adjusting food and insulin around exercise can be tricky, as different types of exercise can have a different effect on you. You’ll need to find the right plan that works for you before, during and after exercise. It’s best to speak to your healthcare team about this. Before you exercise Having too much active insulin before you exercise can cause a hypo, as it reduces the amount of glucose the liver can add to blood. Exercising with too little insulin stimulates glucose production from the liver, which can cause a hyper. So you may need to reduce your insulin before you exercise, depending on what you’re doing and how long you’re doing it for. Speak to your healthcare team to get help to create the right plan for you. Carbohydrate intake before exercise Whether you need to eat carbohydrate immediately before exercise will depend on your blood glucose level, the type of exercise you plan to do, its duration and its intensity. Everyone’s carbohydrate requirements for exercise are different so checking your blood glucose before, during and after exercise will help you develop your own plan. During exercise In general, sustained and moderate exercise (like hiking) will result in a slow drop in blood glucose levels. Intense, sprint-like exercise that really gets your heart pumping (like a game of football or netball) might cause your blood glucose level to rise. This is because your body releases high levels of adrenalin that trigger your liver to break down stored glucose and release it into your bloodstream. It will be exaggerated if your insulin levels are too low at the time of exercise. Carbohydrate intake during exercise If you are exercisi Continue reading >>
Exercise Guidelines
Find exercise guidelines for your type: In this section, you will find: Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Diabetes and Exercise, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information. Continue reading >>
Guidelines On Safe Exercise For People With Type 1 Diabetes
Exercising safely with type 1 diabetes can be quite a challenge. A paper from JDRF funded experts has acknowledged these challenges and published useful exercise guidelines for type 1 diabetes patients and providers. These JDRF experts are part of an international team of 21 researchers and clinicians led by York University Professor Michael Riddell. The paper, called “Exercise management in type 1 diabetes: a consensus statement” which has been published in The Lancet Diabetes & Endocrinology provides guidelines on how to exercise safely and effectively with type 1 diabetes. Aaron Kowalski, Ph.D., JDRF Chief Mission Officer and report contributor said in a press release, “Exercise has tremendous benefits for people with T1D, but it can be hard to predict how it will affect their blood glucose and how they feel during and following physical activity,” and that “The lack of reliable information on how to exercise safely has created obstacles for people with T1D who want to maintain a healthy lifestyle. These consensus guidelines, as well as JDRF’s new PEAK program, are breaking down those barriers.” The T1D PEAK program (Performance in Exercise and Knowledge) is an initiative by JDRF to help educate people with type 1 as well as their caregivers and healthcare providers on how to exercise safely. Riddell, the lead author speaks to some of these benefits and barriers of exercise, “Regular exercise can help individuals with diabetes to achieve their blood lipid, body composition, fitness and blood sugar goals, but for people living with type 1 diabetes, the fear of hypoglycemia, loss of glycemic control, and inadequate knowledge around exercise management are major barriers,” In order to create the guidelines, Riddell and team reviewed observational studi Continue reading >>
Exercise, Hypoglycemia, And Type 1 Diabetes
Go to: Physical Activity, Glucose Physiology, and Hypoglycemia Blood glucose concentration at any given time point is a reflection of the net balance between the rates of glucose appearance (Ra) into and disappearance (Rd) from the circulation. Therefore, when blood glucose concentrations are rising (immediate postprandial state), by definition, Ra (glucose appearing from the meal+rates of endogenous glucose production [EGP]) must exceed Rd (glucose uptake into tissues such as liver, muscle, and fat cells). Likewise, when blood glucose concentrations are falling, by definition, Rd (glucose uptake) must exceed Ra (either from a meal and/or EGP). It is well established that exercise increases muscle glucose uptake through insulin-dependent and insulin-independent mechanisms and that EGP must increase to meet the increased metabolic demands of the exercising muscle to prevent hypoglycemia.1–4 These changes in glucose fluxes (Table 1) are facilitated by changes in (1) hormonal concentrations (i.e., falling insulin and rising glucagon and catecholamine levels during exercise5), (2) blood flow to exercising muscles,6 and (3) adaptations to intracellular pathways that facilitate glucose uptake.7–10 The rise in EGP during exercise was observed to be due to increases in both gluconeogenesis and glycogenolysis in a series of elegant experiments in intact and pancreatectomized dogs.3,11–13 We have recently demonstrated14 that in recreationally active healthy individuals without diabetes, a 60-min bout of moderate-intensity exercise (50% of maximal oxygen uptake) 2 h after a mixed meal increased EGP eightfold, which was facilitated by a doubling of plasma glucagon concentrations. In this study, despite the fact that plasma insulin concentrations rapidly declined to fasting le Continue reading >>
- You CAN beat diabetes! Strict diet, exercise and drugs helps reverse type 2 diabetes
- The how, what, and why of exercise and type-2 diabetes
- Get off your backside! It's madness for the NHS to spend millions fighting type 2 diabetes when the simple cure is exercise, says DR MICHAEL MOSLEY, who reversed HIS own diabetes
Start Working Out With T1d
WRITTEN BY: Christel Oerum Editor’s Note: Christel is a blogger, personal trainer, diabetes advocate, fitness bikini champion and fitness personality. She has been living with Type 1 diabetes since 1997. Most of us like the idea of exercising and being active. We know that it’s good for us and that we probably should turn it up a notch, but there is so much information out there on what to do, when to do it, fancy new diets, etc., that it’s hard to know what to believe. When you then throw in Type 1 diabetes, it may feel like information overload and I unfortunately do see people just give up sometimes. It’s simply too much and there’s too little guidance on what to do and how to successfully exercise with diabetes. In this post, I’ll try to give you the tools you need to get started on a safe and effective workout routine. Set realistic goals Goal setting is one of the most overlooked, but in my opinion most important, factors in successfully starting a workout regime, whether you have Type 1 diabetes or not. Just wanting to be healthy and fit is a noble goal, but it’s not specific enough to keep you motivated and give you a clear path to success. I always ask my clients to spend the time necessary to think about what you really want and write down very specific short and long-term goals. The key word here is to be realistic. A long-term goal might be to run a marathon while a short-term goal might be a 5K. It could be improving your strength by X%, do 10 pushups, be able to walk around the block without being winded, lose X pounds, or whatever is important and motivating for you. There are no bad health goals, only too vague ones. When you have a clear goal, you can start working towards it, measure your progress, and make changes to your plan if you hav Continue reading >>
How To Counsel Type 1 Diabetes Patients Who Exercise?
How to Counsel Type 1 Diabetes Patients Who Exercise? This feature requires the newest version of Flash. You can download it here . Anne L. Peters, MD: Hi. I'm Dr Anne Peters. I am here today with Dr Bruce Bode to talk about exercise as part of the treatment for diabetes. Let's start the discussion. You and I both take care of lots of athletes. How do you teach someone how to take care of a person who is taking insulin? Bruce W. Bode, MD: As you know, exercise is an insulin sensitizer; it makes insulin work better. In type 2 diabetes, you always want to get your patients to walk because it improves insulin action. In type 1 diabetes, they don't make insulin, so they need to take insulin to survive. You have to balance the insulin with their food intake. When they exercise, you're going to need less insulin because they will have improved insulin action and sensitivity. For people with type 1 diabetes who want to exercise, and especially those who want to get into extreme exercise like running a marathon, you have to help them and guide them. You have to balance the insulin with glucose levels. You have to have the right amount of insulin and match it with carbohydrates as best as you can. The rule of thumb is that you always start exercise when your glucose level is above 90 mg/dL and preferably don't start exercise if your glucose level is above 250 mg/dL because that means you are relatively insulin-deficient. If you are starting at 90 mg/dL, you might want to take 10-20 g of carbohydrate before you start, even juice or something. Then, the key is that you need to monitor the glucose in response. If somebody is doing aerobic exercise like running or walking, and over time they start to fall, that means that they have too much insulin on board. You have to cover that Continue reading >>
- Get off your backside! It's madness for the NHS to spend millions fighting type 2 diabetes when the simple cure is exercise, says DR MICHAEL MOSLEY, who reversed HIS own diabetes
- This Diabetes Month, Don’t Forget About the Importance of Exercise for People with Type 1 Diabetes
- You CAN beat diabetes! Strict diet, exercise and drugs helps reverse type 2 diabetes
First-ever Guidelines On Safe Exercising With Type 1 Diabetes!
As a person with type 1 diabetes who exercises regularly, I can tell you it's pretty much of a guessing game. I have some strategies that I use to keep my glucose in range for my spin class, aerobics, kick box, hiking and other workouts, but they are far from fool-proof -- and I've yet to find any really solid advice on BG management during these sweat-fests. So I for one am really intrigued to see the first-ever official guidelines on managing exercise with T1D published in The Lancet journal last week as a 14-page report titled “Exercise management in type 1 diabetes: a consensus statement.” This comes on the heels of the ADA's sweeping 2017 Standards of Diabetes Care, which we just reviewed yesterday. The new info-packed paper honing in on exercise was compiled by an international team of 21 researchers and clinicians, including some familiar names like JDRF's Artificial Pancreas lead Aaron Kowalski, and Drs. Bruce Bode of Atlanta Diabetes Associates, Anne Peters of USC Keck School of Medicine, and Lori Laffel of Joslin Diabetes Center. It offers "guidelines on glucose targets for safe and effective exercising with T1D, as well as nutritional and insulin dose adjustments to prevent exercise-related fluctuations in blood sugar." So what did these experts come up with? Well, let me just say that it's a comprehensive and informative paper -- explaining everything from the physiology of diabetes and exercise and the body's differing metabolic responses to aerobic vs. anaerobic activity, to sports energy drinks and the relative benefits of a low-carb, high-fat (LCHF) diet. Disclaimers, and a Green Light The authors are careful to make a few important disclaimers, first and foremost that one-size recommendations do not fit all, so strategies should be built around exer Continue reading >>
A Promising New Exercise Solution For Type 1 Diabetes
Exercise is good, but for type 1 diabetics, it can be very, very bad. Spontaneous exercise in particular can drive blood sugar to dangerously low levels. However, wearable electronic devices are putting increasingly detailed metabolic information within easy reach of the general public. The study discussed here considers how that technology can help give type 1 diabetics the freedom that non-diabetics take for granted. Blood Sugar Complications In type 1 diabetes, the patient’s pancreas produces little or no insulin. Without a natural supply of the hormone responsible for mediating blood sugar concentrations, a type 1 diabetic depends on regular insulin injections instead. "Diabetes management involves carefully balancing insulin injections and carbohydrate consumption to maintain a blood sugar level in between these two extremes." Excessive blood sugar increases the risk of diabetic complications, including retinal and peripheral nerve damage, which can lead to blindness and the loss of digits, respectively. Low blood sugar is equally dangerous, potentially causing dizziness, confusion, and unconsciousness. Diabetes management involves carefully balancing insulin injections and carbohydrate consumption to maintain a blood sugar level in between these two extremes. Exercise and Glucose Exercise can play an important role in maintaining this balance. It burns glucose and improves insulin sensitivity. Moreover, diabetics derive the same exercise-related improvements in mental wellbeing and cardiovascular health that non-diabetics do. Unfortunately, exercise also poses unique risks for diabetics. The glucose burned during exercise may not be replenished quickly enough, leading to hypoglycemia and its associated risks. The longer the exercise duration, the greater the ris Continue reading >>
Physical Activity And Type 1 Diabetes
Sheri R. Colberg , PhD, FACSM,1 Remmert Laan , BA, MBA,2 Eyal Dassau , PhD,3 and David Kerr , MBChB, MD, FRCPE2 1Human Movement Sciences Department, Old Dominion University, Norfolk, VA, USA 2William Sansum Diabetes Center, Santa Barbara, CA, USA 3Department of Chemical Engineering, University of California, Santa Barbara, CA, USA Sheri R. Colberg, PhD, FACSM, Human Movement Sciences Department, Old Dominion University, Norfolk, VA 23529, USA. Email: [email protected] Copyright 2015 Diabetes Technology Society This article has been cited by other articles in PMC. While being physically active bestows many health benefits on individuals with type 1 diabetes, their overall blood glucose control is not enhanced without an effective balance of insulin dosing and food intake to maintain euglycemia before, during, and after exercise of all types. At present, a number of technological advances are already available to insulin users who desire to be physically active with optimal blood glucose control, although a number of limitations to those devices remain. In addition to continued improvements to existing technologies and introduction of new ones, finding ways to integrate all of the available data to optimize blood glucose control and performance during and following exercise will likely involve development of smart calculators, enhanced closed-loop systems that are able to use additional inputs and learn, and social aspects that allow devices to meet the needs of the users. Keywords: exercise, technology, insulin, artificial pancreas, physical activity, type 1 diabetes Physical activity (PA) for people of all ages living with type 1 diabetes (T1D) is associated with many well-established health benefits, including improved cardiovascular fitness, better bone-health and enh Continue reading >>
Type 1 Diabetes And Exercise
Exercise is an absolutely vital part of type 1 diabetes treatment. Staying fit and active throughout your life has many benefits, but the biggest one for people with diabetes is this: it helps you control diabetes and prevent long-term complications. Exercise makes it easier to control your blood glucose (blood sugar) level. Exercise benefits people with type 1 because it increases your insulin sensitivity. In other words, after exercise, your body doesn't need as much insulin to process carbohydrates. If your child has type 1 diabetes, making sure he or she gets enough exercise is not only a great way to help manage his or her diabetes but also instill healthy habits from an early age. To learn more about how to safely incorporate exercise into your child's routine, read our article about physical activity for children with type 1 diabetes. Exercise can also help people with type 1 diabetes avoid long-term complications, especially heart problems. As you can read about this in our article on type 1 diabetes complications, people with diabetes are susceptible to developing blocked arteries (arteriosclerosis), which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesterol—and that helps you avoid arteriosclerosis. Additionally, there are all the traditional benefits of exercise: Lower blood pressure Better control of weight Leaner, stronger muscles Stronger bones More energy One person who certainly understands the benefits of exercise in managing type 1 diabetes is Jay Cutler, quarterback for the Chicago Bears. He was diagnosed with type 1 diabetes in 2008, but the disease hasn't interfered with his football career. To learn more, read our article about Jay Cutler's experience with type 1 diabete Continue reading >>
- You CAN beat diabetes! Strict diet, exercise and drugs helps reverse type 2 diabetes
- The how, what, and why of exercise and type-2 diabetes
- Get off your backside! It's madness for the NHS to spend millions fighting type 2 diabetes when the simple cure is exercise, says DR MICHAEL MOSLEY, who reversed HIS own diabetes
Type 1 Diabetes And Exercise
During activity, injected or pumped insulin cannot be 'shut off' like the body's own insulin, so too much glucose is taken up by both muscle contractions and the high levels of insulin, says Sheri R. Colberg, Ph.D., professor of exercise science at Old Dominion University in Norfolk, Virginia. To avoid hypoglycemia when doing physical activity, monitor your blood sugar before and after exercise. Here are some other guidelines from Colberg and the American Diabetes Association: Eat a small carbohydrate-containing snack before exercising if your blood glucose is 100 mg/dl or lower. Wait about 10 to 15 minutes before starting your activity. Eat a snack if you plan to exercise for more than 60 minutes, plan to do a more intense workout than usual, or if the weather is warmer or cooler than usual. Always carry a small snack that's high in sugar or carbohydrate. The average 150-pound adult needs 20 grams of carbohydrate for every half-hour of moderate exercise. Some snack choices include sports drinks and gels and easily absorbed carbohydrate sources, such as jelly beans and energy bars. Watch for symptoms of hypoglycemia during exercise. If you feel weak, lightheaded, cold, or clammy, stop and check your blood glucose. If it's low, treat it with a pure source of glucose, such as glucose tablets or gel. Become familiar with the ways different activities affect your blood sugar levels. Measure blood sugar before and after exercise. Keep a written record of what the activity was, how long you did the activity, what you ate, and blood glucose levels before and after. Over time, you'll better understand how activity affects your blood sugar levels and insulin doses. For insulin pump users, lower basal insulin if you're planning more than 90 minutes of activity. Shorter bouts of e Continue reading >>
- You CAN beat diabetes! Strict diet, exercise and drugs helps reverse type 2 diabetes
- The how, what, and why of exercise and type-2 diabetes
- Get off your backside! It's madness for the NHS to spend millions fighting type 2 diabetes when the simple cure is exercise, says DR MICHAEL MOSLEY, who reversed HIS own diabetes
Don’t Sweat It! Exercise And Type 1 Diabetes
The benefits of exercise are wide ranging. Regular physical activity can help people manage their weight, sleep better, reduce the risk of some diseases, including type 2 diabetes (T2D) and heart disease, and improve overall quality of life—among other proven benefits. People with type 1 diabetes (T1D) can gain the same benefits from exercise as anyone else. Yet studies show that many people with T1D do not engage in regular physical activity owing to a fear of hypoglycemia, or dangerously low blood-glucose levels. Exercise scientists and athletes with T1D alike say that people with T1D can exercise safely and effectively. It’s a matter of observing how your body responds to exercise, learning to balance insulin, food, and physical activity, and using research-supported strategies to minimize the risk of hypoglycemia during and after exercise. Managing hypoglycemia associated with exercise Sheri Colberg-Ochs, Ph.D., professor of exercise science at Old Dominion University in Norfolk, VA, has both professional and personal interests in understanding the risks and benefits of exercise for people with T1D. As an exercise physiologist, Dr. Colberg-Ochs studies the relationship of exercise to diabetes and lifestyle management. She has also lived with T1D for 44 years, while staying fit and active. Dr. Colberg-Ochs notes that the risk of hypoglycemia during and after exercise can be managed. “There’s not a tried and true method that works for everyone. It’s very individual, based on the type of activity and your normal diabetes regimen,” she says, “but you can certainly reduce the frequency of hypoglycemia that’s associated with being physically active.” The risk of hypoglycemia is affected by the type, duration, and intensity of physical activity. Aerobic a Continue reading >>
Exercise In People With Type 1 Diabetes
Exercise is recommended for everyone with diabetes. In people with type 1 diabetes exercise provides many benefits—improved cardiovascular health, a psychological lift, stronger bones, stronger muscles and more restful sleep. It evens aids in weight loss and improved insulin sensitivity. In fact, there have been studies that demonstrate that people with type 1 who exercise have lower mortality rates. But one thing it hasn’t been proven to do is decrease A1C levels. When people with type 2 diabetes engaged in regular exercise, their A1C levels drop. The research looking at exercise benefits in terms of glucose control for people with type 1 isn’t as sanguine. The reason there isn’t always a positive impact on A1C has to do with the ever present risk of hypoglycemia and hyperglycemia whenever a person with type 1 diabetes exercises. Both exercise-related hypo- and hyperglycemia occur in people with type 1 diabetes because the physiology of exercise works a bit differently. When we exercise we need more glucose to fuel our muscles. So in people without diabetes, glucagon is activated and causes the liver and muscles to breakdown glycogen in a process called glycogenolysis . At the same time, the liver starts to replenish its glucose stores from amino acid backbones through gluconeogenesis, so it can have backup glucose for extended periods of activity. Concurrently the level of insulin declines, weighing the hormonal milieu away from energy storage to energy generation. In people with type 1 diabetes, insulin levels, injected exogenously, don’t decline. This blunts glucogenolysis and continues to enhance glucose uptake by the muscles. While the muscles need glucose, too-rapid consumption depletes the glucose in the blood stream. If production of glucose by the li Continue reading >>
5 Tips For Exercise With Type 1
A diabetes life coach shares her secrets for good blood glucose control while working out. Throughout July, we’re featuring excerpts from Ginger Vieira’s new book, Dealing with Diabetes Burnout. In this final edited excerpt from the book, the longtime life coach and diabetes advocate shares the lessons she’s learned from years of exercise with Type 1 diabetes. There is no doubt that exercising with diabetes is about one million times more challenging than exercising without diabetes, particularly if you take insulin. Low blood sugars and high blood sugars are major party-poopers in the middle of a walk, yoga, spinning class, tai chi, or strength-training. I’m here to tell you that it can be done and you can enjoy exercise, but it takes a little work, a little more effort, and a bunch of self-study. sponsor When I personally started to become really active and committed to exercising regularly, I was working really hard to balance my blood sugar during things like Ashtanga yoga, strength-training, and various forms of cardio like power-walking and the stairmaster. And it wasn’t easy, but at the very same time I was learning with the help of my trainer, Andrew, about what was literally going on in my body during different types of exercise. Learning about this basic science, taking a deep breath, and viewing my body as a science experiment is the only reason I am able to exercise happily and confidently today. Read “25 Facts to Know About Exercise and Type 1 Diabetes.” Here are five lessons I’ve learned on balancing blood sugars during exercise: 1. Understand What Type of Exercise You’re Doing Jogging and strength-training will both have very different impacts on your blood sugar, even though your heart rate may rise during both. Cardiovascular or aerobi Continue reading >>
