T1D management for athletes is unique to the individual and depends on many variables including the sport, athlete’s health needs, length and duration of training, upcoming competitions, etc. The primary risks of physical activity for the T1D athlete are essentially two:
- Hypoglycemia (blood sugar is too low)
To prepare for hypoglycemia, keep at least 15-20g of fast-acting carbohydrates on hand at all times. Also note that the risk for hypoglycemia is higher if you skip a meal or exercise strenuously or for a long duration. Aerobic exercise, such as jogging, tends to drive blood glucose down.
- Hyperglycemia (blood sugar is too high)
Certain high-intensity or anaerobic exercises, such as weight lifting, can increase blood glucose. The bottom line is that you need to listen to your body, check your blood glucose often, and look for patterns to help you adjust routines.
Before your activity
Allowing yourself time to fuel up with enough carbohydrates is hugely important—you need stored glucose to burn! Athletes with T1D might find themselves increasing the amount of finger pricks they need prior to an event. Tim Atkins, an athlete with T1D, suggests going for insulin levels “as normal as possible in the 2-4 hours before exercise. Blood sugars can then be raised in the 30 minutes before exercise with energy gels or drinks.” Look for a routine and when you find one that works, stick as close to it as possible!
During your activity
It’s important to pay close attention to your body so you can manage blood glucose changes quickly. Always have the following on-hand:
- Diabetes supplies (glucose meter, insulin, syringes and spare pump supplies)
- Fast-acting sugar (sports drink/glucose tablets)
Because every athlete is different, there is no one answer for how to manage your diabetes while participating in an athletic activity. Below are a few factors to consider when developing your plan:
- Intensity – Higher-intensity workouts burn glycogen stores more quickly.
- Aerobic versus anaerobic – Aerobic activity (jogging etc.) tends to lower blood glucose while anaerobic activity (lifting weights etc.) can raise them.
- Length of activity – Carbohydrates should be replenished every 30 minutes.
- Temperature – In hotter temperatures, athletes use glycogen stores more quickly. Prepare by packing fast-acting sugars like sports drinks and glucose tablets. Always stay well hydrated!
After your activity
It’s important to replenish glycogen stores post-activity. The effects of exercise can be felt for upwards of 24 hours. Hydration is crucial. Consuming “slow” carbohydrates, those with fat and/or protein, is also key.
Every athlete with T1D is different. What works for someone else might not work for you. Frustratingly, what works best for you one day might not work as well the next. Paying close attention to your body and your insulin needs demands more effort, but do your best to consult with doctors and to take the occasional step back to look for patterns, while analyzing what’s working and what isn’t.
Through safe trial and error, become familiar with your body’s response to your preferred modes of exercise. Try to keep records of insulin dosing and carbohydrate intake to see what keeps your blood glucose in range. Take the time to step back occasionally to see what’s working and what isn’t.
Read Christel Oerum’s Start Working Out with T1D.