Women + Exercise: It’s Complicated
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Exercise is often recommended for people with diabetes, though barriers to being physically active aren’t always given enough attention. In this session, a panel of experts at the 2022 American Diabetes Association Scientific Session discuss the role of physical activity in diabetes management and possible solutions to common barriers.
Session: Reaching Everyone—Health Disparities and Sex Differences in Physical Activity
Presentation:The Menstrual Cycle and Beyond: Barriers and Facilitators of Activity in Women with Type 1 Diabetes
Speakers at this ADA Scientific Sessions presentation included: Jane Yardley, PhD (University of Alberta)
Regular exercise is important for overall health. For people living with type 1 diabetes exercise can:
- Lower the risk of heart disease
- Improve longevity
- Maintain healthy body weight
- Prevent the development of diabetes-related complications
- Improve insulin resistance
- Improve overall mood
Amidst all the benefits of physical activity for people living with type 1 diabetes, Dr. Jane Yardley noted women are commonly less active than men. When asked about what prevented them from exercising, women cited a lack of a diabetes-friendly community (understanding of devices and alarms), a fear of hypoglycemia and increased glycemic variability (spikes + drops in blood glucose levels).
During exercise, different forms of fuel are used depending on the type of activity. With aerobic exercise, blood glucose is the second source of fuel, which is why it’s common to experience lows during exercise.
The main hormones regulating the balance of blood glucose is insulin and glucagon, but for people living with type 1 diabetes, this regulation does not function properly and can make managing blood glucose levels difficult during exercise.
What impacts blood glucose during exercise?
“Exercise is complicated” Yardley shared. Factors that can impact blood glucose during exercise include:
- Type of exercise (aerobic, anaerobic)
- Time of exercise (morning, evening)
- Time of last meal (carbohydrate intake)
- Phase of menstrual cycle
Not surprising, past exercise guidelines were developed using studies with young, fit males— leaving much still unknown about how exercise impacts women’s physiology, including women with type 1 diabetes.
The phases of menstrual cycles can definitely impact whether a woman with type 1 diabetes experiences spikes or lows during exercise. Yardley explained that glycogen depletion may depend on the menstrual cycle phase, with a higher hypoglycemia risk during aerobic exercise in the luteal phase.
What should women with type 1 diabetes do to exercise safely?
There is still no data on the impacts of resistance training on women with type 1 diabetes (T1D) going through menopause, but researchers are aware that this gap in knowledge needs to be addressed.
Yardley recommended that providers make women aware that their menstrual cycle can impact their blood glucose levels during exercise and assist women in getting the support that encourages a safe environment for exercise with type 1 diabetes.
The best type of activity for women with type 1? “Whatever you like. Because that’s what you’re going to maintain. Any activity is better than no activity,” Yardley said.