Exercise is healthy

Exercise is good for everybody and especially for people with diabetes. Some of the benefits are as follows:

  • Exercise can help to manage blood glucose levels

  • Exercise helps to maintain a healthy weight

  • Exercise make you feel happier

You do not necessarily go to the gym. Just walking is really healthy too! Lots of univerisities offer much green area where you can safely go for a long walk.

Ask for help

Do not hesitate to ask for help. You can ask the GP or the specialist diabetes team for advice.

If you do not have a glucose sensor yet, this is the time to ask your doctor for one. They are great for checking your glucose while you are sporting.

Do your research

Different types of research have different effects on blood glucose levels. There are typically immediately effects (starting within minutes) and longer terms effects (lasting hours).

For example, if you go for a run for 20 minutes, your blood glucose will likely start dropping while running. If you go for a two hour walk, your blood glucose will likely start dropping, but because of the intensity can influence your body for 24 hours.

There is a consensus report article by Riddell and colleagues with a set of guidelines for exercise with diabetes published in The Lancet: link to article. You can also find this on the internet as PDF.

In Panel 1 of that article is a set of recommendations, which are as follows:

The carbohydrate intakes shown here aim to stabilise glycaemia at the start of exercise. Blood glucose at the start of exercise must also be viewed within a wider context. Factors to consider include directional trends in glucose and insulin concentrations, patient safety, and individual patient preferences based on experience. Carbohydrate intake will need to be higher if circulating insulin concentrations are high at the onset of exercise.

Starting glycaemia below target (<5 mmol/L; <90 mg/dL)

  • Ingest 10–20 g of glucose before starting exercise.

  • Delay exercise until blood glucose is more than 5 mmol/L (>90 mg/dL) and monitor closely for hypoglycaemia.

Starting glycaemia near target (5–6·9 mmol/L; 90–124 mg/dL)

  • Ingest 10 g of glucose before starting aerobic exercise.

  • Anaerobic exercise and high intensity interval training sessions can be started.

Starting glycaemia at target levels (7–10 mmol/L; 126–180 mg/dL)

  • Aerobic exercise can be started.

  • Anaerobic exercise and high intensity interval training sessions can be started, but glucose concentrations could rise.

Starting glycaemia slightly above target (10·1–15·0 mmol/L; 182–270 mg/dL)

  • Aerobic exercise can be started.

  • Anaerobic exercise can be started, but glucose concentrations could rise.

Starting glycaemia above target (>15 mmol/L; >270 mg/dL)

  • If the hyperglycaemia is unexplained (not associated with a recent meal), check blood ketones. If blood ketones are modestly elevated (up to 1·4 mmol/L), exercise should be restricted to a light intensity for only a brief duration (<30 min) and a small corrective insulin dose might be needed before starting exercise. If blood ketones are elevated (≥1·5 mmol/L), exercise is contraindicated and glucose management should be initiated rapidly as per the advice of the health-care professional team.

  • Mild to moderate aerobic exercise can be started if blood ketones are low (<0·6 mmol/L) or the urine ketone dipstick is less than 2+ (or <4·0 mmol/L). Blood glucose concentrations should be monitored during exercise to help detect whether glucose concentrations increase further. Intense exercise should be initiated only with caution as it could promote further hyperglycaemia.

Try it out

Ultimately, you need to learn how to combine your exercise with your medication and your food. Use your glucose sensor to check your exercise regularly, that is exactly what they are for.