If a person has diabetes, it is important that they get enough exercise. Physical activity can help control blood sugar levels and lower an individual’s risk of developing complications from their diabetes, such as heart disease and nerve damage.

Regular exercise is essential for overall health. According to the Centers for Disease Control and Prevention (CDC), people should aim for at least 150 minutes of moderate-intensity physical activity each week.

This remains true for individuals with type 1 diabetes, a condition that hinders the body’s ability to produce the hormone insulin. This can lead to high blood glucose levels, which people need to manage with a combination of medications and lifestyle, including diet and physical activity. Unlike type 2 diabetes, type 1 diabetes is irreversible and requires lifelong management.

Exercise can impact a person’s blood sugar levels and cause people with diabetes to experience very low blood sugar. Several studies suggest that this is why many individuals with the condition may not want to participate in as much physical activity as experts recommend.

Not getting enough exercise can lead to several health concerns. Despite the potential effects of exercise on blood sugar levels, it is possible for people with diabetes to safely manage blood sugar levels while still maintaining an active lifestyle.

Read on to learn how to exercise safely with type 1 diabetes, which exercises to choose, and how to manage blood sugar levels.

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People with type 1 diabetes need to exercise regularly to help manage their condition. The benefits of frequent exercise apply to everyone, including those with diabetes, and they include:

  • maintaining a moderate weight
  • reducing stress and improving mood
  • increasing energy levels
  • helping joints and flexibility
  • improving cholesterol levels
  • reducing blood pressure

Anyone with type 1 diabetes who is new to exercise or who has not regularly exercised for some time should get medical clearance from their doctor first, according to American College of Sports Medicine guidelines.

It may help to speak with healthcare professionals so that they can help devise an appropriate physical activity plan.

The Centers for Disease Control and Prevention (CDC) recommend types of activity that meet the criteria for moderate-intensity physical activity, including:

  • badminton
  • cycling
  • dancing
  • doing housework
  • mowing the lawn
  • playing sports
  • rowing
  • swimming
  • tennis
  • walking briskly

These kinds of exercise are suitable for most people, including those with type 1 diabetes.

Individuals who have not been active recently or have never been active should start slowly and gradually build up the intensity and duration of their workouts over time.

Anyone who has not regularly exercised for some time should take rest days between workouts if necessary, depending on the intensity and duration of the physical activity.

According to the CDC, people with diabetes should be particularly mindful of certain factors, such as:

  • drinking enough fluids to avoid dehydration
  • checking blood sugar levels before exercising
  • wearing appropriate fitting shoes and cotton socks appropriate for the exercise
  • measuring blood glucose levels after exercising
  • checking feet for blisters or sores and noting if they take longer than 2 days to start to heal
  • ensuring they have a snack or glucose tablets available in case blood sugar levels drop too low

If a person has high blood sugar before they exercise, they should check their blood or urine for ketones.

If ketones are present, the American Diabetes Association (ADA) recommends avoiding vigorous activity.

If people exercise when they have high ketone levels, they risk developing ketoacidosis, a life threatening complication of diabetes that requires immediate medical attention.

Depending on the type and duration of workouts, a person may notice that their blood glucose levels rise (hyperglycemia) or drop (hypoglycemia).

Exercise lowers blood sugar, both acutely and over time, in two distinct yet equally important ways: by increasing insulin sensitivity and by allowing glucose to enter cells without insulin.

According to the ADA, this means that a person’s muscles can use available insulin to take up glucose both during and after a workout.

Additionally, physical activity helps cells burn glucose for energy as the muscles contract. Being active allows glucose to leave the bloodstream and enter cells that require energy, resulting in a drop in blood glucose, regardless of whether insulin is available.

High-intensity exercise can increase the levels of hormones, such as epinephrine and glucagon, in the body, which can then increase blood glucose levels, according to an older study from 2009. Doctors call high blood glucose hyperglycemia.

To prevent this, if a person has high blood sugar before they exercise, they should measure their levels more often during exercise. Adequate hydration can prevent the concentration of sugar in the blood from becoming too high.

If individuals have high blood sugar after exercise, they should measure their ketone levels. If these ketone levels are high, they should speak with their doctor. It is crucial to avoid physical activity when ketone levels are high to prevent life threatening ketoacidosis.

Doctors call low blood sugar hypoglycemia, which some may experience after working out. It is important to ensure that people always have a source of carbohydrates on hand, so they are ready to treat hypoglycemia immediately.

Blood glucose levels can drop for up to 24 hours after a person has completed their workout, so people should take care to monitor their levels.

If individuals have recurring issues with low blood sugar after working out, they should speak with a doctor. They may need to adjust their insulin intake to prevent them from developing low blood sugar levels.

If a person notices they are becoming hypoglycemic, either while working out or afterward, they should immediately consume a carbohydrate-rich snack.

Experts define hypoglycemia as a reading of under 70 milligrams per deciliter (mg/dl). The CDC recommends people raise their blood sugar levels with the “15–15 rule” by eating 15 grams (g) of carbs and checking blood sugar levels after 15 minutes. They should then repeat these two steps until the blood sugar levels return to their usual range.

Fast-acting carbohydrates suitable for treating low blood sugar include:

  • 1 tbsp of sugar, honey, or syrup
  • half a cup of juice or sugary soda
  • 3–4 glucose tablets
  • one sachet of glucose gel
  • candy, such as jelly beans, gummy bears, or hard candy, depending on the serving size

People should always read the labels of foods they consume when treating hypoglycemia. They need to check the grams of carbohydrates per serving and make sure they do not contain high levels of other macronutrients such as fiber, fat, and protein. These can slow the absorption and effect of carbohydrates on blood sugar levels.

To treat hypoglycemia, people should look for foods that contain only carbohydrates in their simplest form, which is sugar. However, this advice only applies when consuming food to treat hypoglycemia and is inappropriate nutrition advice for regular eating.

Without treatment, hypoglycemia can become more serious.

Severely low blood sugar levels are untreatable using the 15–15 rule, and injectable glucagon is the best way to address severe hypoglycemia.

Additionally, glucagon emergency kits are available on prescription, and a person may wish to teach others they exercise with on using them in emergencies. This is because when someone is severely hypoglycemic, they may lose consciousness and be unable to administer the kit themselves.

People with type 1 diabetes should always check their blood glucose levels before working out.

If a person’s blood sugar is lower than 100 mg/dl before exercising, they should eat a small snack, which should be rich in carbohydrates and contain around 15 g of carbs.

The following snacks contain around 15 g of carbs per serving size:

  • 1 cup of melon
  • 1 very small banana or half a large banana
  • 1 orange
  • half a cup of sweet potato
  • half a cup of oatmeal
  • 8 animal crackers
  • 3 graham crackers
  • 2 rice cakes
  • 1 granola bar
  • 6 saltine crackers
  • 13 potato chips
  • 1 small apple
  • half a cup of unsweetened applesauce

If a person exercises over an extended period, their blood sugar levels will likely drop during their workout.

With this in mind, people should regularly check their blood glucose levels and take snack breaks if necessary.

Experts recommend consuming additional carbohydrates after every 30–60 minutes of exercise.

Exercising with type 1 diabetes does not have to be difficult.

With some extra precautions, people with the condition can maintain an active lifestyle, leading to a lower risk of complications and health conditions.

However, it is important that individuals with type 1 diabetes monitor their blood sugar levels during and after workouts to ensure they stay at safe levels.