Fear of hypoglycaemia (‘hypos’, blood glucose level <4mmol/L) and particularly severe hypoglycaemia (blood glucose <4 and needing help from someone else to treat it)
Children and young people with type 1 diabetes who take regular exercise are less likely to have severe hypos.
If you do very vigorous exercise, there is a higher risk of hypos later on but these can be avoided by changing how much insulin you give and what you eat, as well as keeping a close eye on your glucose levels.
Tips you may wish to share
- When exercising, especially if this is not something you have done very much of before, check your blood glucose before exercising and every 30 minutes whilst you are doing it. If you exercise regularly, you are more likely to have stable blood glucose levels.
• Aim for your blood glucose levels to be between 5-10 mmol/L before starting exercise. If they are less than 5, you may need some quick acting glucose (such as a sports drink) to boost your levels up. If doing a vigorous/prolonged activity, a quick acting glucose item will not be enough-eat a longer acting carbohydrate snack such as a banana or oat biscuit.
• If you know that you tend to go low when doing exercise, you may need to give less quick acting insulin with the meal beforehand and/or reduce the background insulin rate on your pump if you use one.
• Hypos can happen several hours after exercising, depending on the type of exercise done, so keep an eye on your blood glucose levels once the activity has finished, particularly if you are doing it for the first time. You can reduce the risk of delayed hypos be reducing the amount of insulin you give with meals after exercising and/or reducing the amount of background insulin (either long acting insulin or pump basal rate, depending on which insulin regimen you use).
• Establishing a good routine for management of your diabetes whilst exercising often requires a bit of time at the beginning and a diary will be helpful to show your diabetes team so they can help
References
1. Quirk H, Blake H, Tennyson R et al. Physical activity interventions in children and young people with Type 1 diabetes mellitus: a systematic review with meta-analysis. Diabetes Med 2014;31(10):1163-73
2. Yardley J, Mollard R, MacIntosh A, et. Al Vigorous intensity exercise for glycaemic control in patients with type 1 diabetes. Can J Diabetes 2013;37(6):427-32
3. Ridell MC, Iscoe KE Physical activity, sport, and paediatric diabetes. Pediatr Diabetes 2006;7(1):60-70