Type 1 Diabetes and The Importance of Exercise

Table of Contents

What is Type 1 Diabetes?

Type One Diabetes (T1D) is an autoimmune condition in which the body’s immune system attacks insulin-producing beta cells in the pancreas. This results in little to no insulin production, making blood sugar regulation difficult. Unlike Type Two Diabetes, T1D is not linked to lifestyle factors and typically develops in childhood or early adulthood.

Impacts of Type 1 Diabetes on Daily Life

Living with T1D requires constant monitoring of blood glucose levels, insulin management, and dietary considerations. Exercise can be beneficial but also introduces challenges, as it affects blood sugar levels in different ways depending on intensity and duration.

The Importance of Exercise for Type 1 Diabetes

How Exercise Affects Blood Glucose Levels

• Aerobic exercise (walking, running, cycling) lowers blood glucose levels by increasing insulin sensitivity and glucose uptake by muscles.

• Anaerobic exercise (strength training, sprinting) can temporarily increase blood glucose levels due to the release of stress hormones like adrenaline.

• The risk of hypoglycemia (low blood sugar) is higher during and after exercise, while hyperglycemia (high blood sugar) can occur if insulin is mismanaged.

Physical and Mental Benefits of Exercise

• Improved insulin sensitivity, reducing insulin requirements.

• Better cardiovascular health, lowering the risk of complications like heart disease.

• Enhanced muscle strength and endurance for overall health and injury prevention.

• Mental health benefits, including reduced stress, improved mood, and better sleep.

Creating a Type 1 Diabetes Workout Plan

Assessing Your Current Fitness Level

Before starting a new exercise routine, consult with your healthcare provider or diabetes educator to assess your fitness level and how exercise might affect your blood sugar levels and insulin needs.

Setting Realistic Fitness Goals

• Aim for 150 minutes of moderate aerobic activity per week, such as walking, cycling, or swimming.

• Include 2-3 strength training sessions per week to maintain muscle mass and metabolic health.

• Set small, achievable goals based on your fitness level and glucose response to exercise.

Choosing the Right Types of Exercises

• Aerobic (Cardio) Exercise: Running, swimming, brisk walking, cycling.

• Strength Training: Resistance bands, bodyweight exercises, weightlifting.

• Flexibility and Balance: Yoga, Pilates, stretching.

• High-Intensity Interval Training (HIIT): Short bursts of high-energy movements; requires close monitoring of glucose fluctuations.

Safety Considerations for Exercise

Monitoring Blood Sugar Levels Before and After Exercise

• Check blood glucose before starting exercise:

• If below 5.5 mmol/L, have a small snack to prevent hypoglycemia.

• If above 15 mmol/L, check for ketones and avoid exercise if ketones are present.

• Monitor glucose every 30-60 minutes during prolonged activity.

• Check blood sugar post-exercise, as levels can drop for hours after workouts.

Recognising Warning Signs During Exercise

• Hypoglycemia (Low Blood Sugar) Symptoms: Shakiness, dizziness, sweating, confusion, weakness.

• Solution: Stop exercise, consume 15-20g of fast-acting carbohydrates (e.g., glucose tablets, juice, honey).

• Hyperglycemia (High Blood Sugar) Symptoms: Excessive thirst, nausea, rapid breathing.

• Solution: Hydrate and check for ketones. If ketones are present, avoid exercise and seek medical advice.

Success Stories and Tips

Real-Life Experiences from Individuals with T1D

Many athletes and fitness enthusiasts with T1D successfully manage their condition through careful monitoring and tailored exercise plans. Consistency, proper fueling, and insulin adjustments are key to maintaining stable blood sugar levels during workouts.

Expert Tips for Managing Exercise and Type One Diabetes

• Keep fast-acting carbohydrates (glucose gels, juice) nearby.

• Hydrate adequately, as dehydration can impact blood sugar control.

• Use a continuous glucose monitor (CGM) to track glucose trends in real time.

• Adjust insulin dosage before and after workouts based on patterns observed over time.

• Wear a medical alert bracelet in case of emergencies.

Resources and Support

Recommended Apps and Wearable Technology

• Dexcom G6 / FreeStyle Libre: Continuous glucose monitoring systems.

• MySugr: Diabetes tracking and exercise log app.

• Strava / Fitbit / Apple Health: Helps monitor physical activity and adjust workouts.

Helpful Professional Organisations for Further Guidance

• Diabetes Australia – Provides support, resources, and advocacy.

• JDRF Australia – Research and support for people with Type One Diabetes.

• Australian Diabetes Society – Professional education and clinical guidelines.

Zyto Exercise Physiology Diabetes Programming Considerations: 

Training Protocol for Type 1 Diabetes (T1DM)

Frequency

• 3–5 days/week minimum

• Mix of aerobic + resistance for optimal results.

Aerobic Training

• Intensity: Moderate (40–60% VO2max or RPE 12–13) progressing to vigorous if tolerated

• Type: Walking, cycling, rower, pool (for neuropathy/joint issues)

• Duration: 150 min/week → aim for 30 min/day, 5 days/week

• Progression: Interval training if safe (e.g. 2 min moderate, 1 min vigorous)

Resistance Training

• Frequency: 2–3x/week (non-consecutive days)

• Volume: 2–3 sets of 8–12 reps per exercise

• Type: Compound lifts (squats, rows, presses), bodyweight, cables

• Progression: Start with machines if balance is impaired → free weights

Neuropathy/Retinopathy Considerations

• Avoid high-impact/jarring exercises

• Limit Valsalva and high-intensity if proliferative retinopathy is present

Timing Around Medication

• Train 1–2 hours post-meal to reduce hypo risk

• Monitor BGL before and after session

• Keep fast-acting carbs on hand

Case Study From Our Clinic

(details changed for anonymity, but the key info remains)

Peter, 58, walked into our clinic like a man heading to court.

He was diabetic, overweight, and deeply offended that his GP told him to “get moving.” He looked at the dumbbells like they’d personally wronged him. First words out of his mouth?

“I hate the gym. This is a waste of time.”

Perfect.

We gave Peter the Metabolic Health Program — not a bootcamp, not a lecture — just three clear sessions a week:

• 2x resistance days (chair squats, rows, deadlifts with a kettlebell he named “Karen”)

• 1x aerobic (aka “just walk, mate”)

We even scheduled his sessions after lunch so his blood sugar didn’t tank and his attitude didn’t spike.

By week 3, Peter still hated the gym — but now he hated it while showing up early.

By week 6, he was smashing goblet squats with 10kg and arguing with the EP about adding “that ski machine thing” into his cardio. We watched him go from 103kg to 96.5kg, HbA1c from 7.6% to 6.3%, and most importantly — from “I’m too tired” to “I walked the grandkids to school and didn’t even puff.”

The best part?

He now refers to the gym as “my place of pain and progress.”

We’ll take it.

Conclusion

Exercise is a powerful tool for managing Type One Diabetes, but it requires strategic planning and glucose monitoring. By choosing the right exercises, tracking blood sugar levels, and making adjustments as needed, individuals with T1D can stay active safely and improve their overall health. Always consult a healthcare provider before making significant changes to your fitness routine.