I used to hate exercising. It made my blood glucose difficult to control: one moment my levels would be rising rapidly, and then they would plummet. When I played beach volleyball, it was extremely frustrating to have to stop games so I could scarf down a candy bar or give myself insulin. It was physically and mentally draining. As Ginger Vieira mentions in her article, “5 Tips for Exercise with Type 1,” working out with type 1 diabetes can be difficult–but, with self-study and a little bit more effort, you can learn how to workout efficiently and safely. Over the last few years, I have been studying my body, seeing how it reacts to different types of exercises, workout times, and pre-workout foods. Now, I am the type of person who wakes up excited to exercise. Crazy, right?
Ginger’s first tip is to “understand what exercise you are doing.” Different exercises use fuel in different ways, and this impacts blood glucose levels. For example, when I bike or run, my blood sugar levels will suddenly plummet. As Ginger says, your body uses glucose for fuel during cardiovascular or aerobic exercises. Sometimes I will start my workout at 300 and end it at 60. Before an intense cardio day, I make sure my blood glucose levels are a little bit higher (but not too much, around 160). I also make sure not to give insulin too close to when I workout. On the other hand, strength training makes my blood glucose rise, so I try to make sure my levels are a bit lower (around 120) before I do any sort of weight lifting. This falls under Ginger’s second tip, which is to “control as many variables as possible.” Starting the workout with in-range blood sugar is the best way to ensure a safe workout. I highly recommend wearing a Continuous Glucose Monitor while working out, so you do not have to stop your workout to check your blood glucose levels.
When you get low blood sugar before, during, or after a workout, the food you use to treat it is very important. As Ginger mentions in tip number three, eating a peanut butter sandwich will raise your blood sugar at a much slower rate than a glucose tablet because the fat in the peanut butter slows down the digestion rate. If you’re like me, then you get pretty frustrated when your blood glucose levels are not rising fast enough after a low. I always have a packet of fruit snacks next to me while I workout, so I can eat them quickly if my blood glucose levels drop.
In tip number four, Ginger recommends having a notebook where you can write notes about what does and does not work for your body during exercise. You can write down your blood glucose levels before and after the workout, what type of exercises you did, and how you felt. I am not quite organized enough for this, so I try to remember what routine works best for me. For example, I know that I cannot drink coffee before a workout, because it makes my blood glucose levels rise quickly.
I used to workout a few hours after breakfast, and I ended up always going low because my insulin sensitivity would increase during my exercise, and my insulin dosage from breakfast would peak at the same time. Then, I started working out first thing in the morning, and I did not have that problem anymore. Ginger’s final tip is to “try exercising first thing in the morning, on an empty stomach.” This has helped me considerably in keeping my blood sugars in an appropriate range. However, I also sometimes struggle from the dawn phenomenon (if you’re unfamiliar, this is when your blood glucose levels rise abnormally in the very early morning), so sometimes my blood glucose is high in the morning, and I still have to give a small amount of insulin before exercising.
Working out with type 1 is all about maintaining a delicate balance. It’s important to listen to your body: sometimes working out extremely hard can feel very similar to having low blood sugar. However, type 1 is in no way a limit to athletic ability: some of the most famous athletes are type 1 diabetics. So, lace up those shoes and grab those earphones: it’s time to move.
This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “5 Tips for Exercise with Type 1.”