Exercise Guidelines for Type 1 Diabetes Management

A Comprehensive Guide for Safe and Effective Physical Activity

Endocrinology

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Last updated: Mar 24, 2025

Introduction

Physical activity is a crucial component of Type 1 diabetes management. This guide outlines safe exercise practices while maintaining optimal blood glucose control.

Pre-Exercise Guidelines

Blood Glucose Monitoring

  • Check blood glucose 30 minutes before exercise
  • Target range: 126-180 mg/dL (7-10 mmol/L)
  • If <126 mg/dL: Consume 15-30g carbohydrates
  • If >250 mg/dL: Check ketones and postpone if positive

Insulin Adjustments

  • Reduce bolus insulin by 25-75% for meals before exercise
  • Consider reducing basal insulin for long duration activities
  • Discuss specific adjustments with your endocrinologist

Exercise Types and Recommendations

Aerobic Exercise

  • Start with 20-30 minutes, 3-4 times weekly
  • Examples:
    • Brisk walking
    • Swimming
    • Cycling
    • Light jogging

Resistance Training

  • 2-3 sessions per week
  • Focus on major muscle groups
  • Start with body weight exercises
  • Progress to light weights with proper form

During Exercise Monitoring

Signs to Watch For

  • Hypoglycemia symptoms
  • Excessive fatigue
  • Irregular heartbeat
  • Shortness of breath

Safety Measures

  • Keep fast-acting glucose nearby
  • Exercise with a partner when possible
  • Wear medical ID
  • Carry your glucose meter

Post-Exercise Care

Monitoring Schedule

  • Check glucose immediately after exercise
  • Recheck 2-3 hours post-exercise
  • Monitor before bed if evening exercise

Recovery Nutrition

  • Consume protein and carbohydrates within 30 minutes
  • Stay hydrated
  • Monitor for delayed hypoglycemia

Special Considerations

High-Risk Activities

  • Swimming
  • Mountain climbing
  • Extended hiking
  • Contact sports

Additional Precautions

  • Avoid exercise during insulin peak times
  • Check feet for injuries after activity
  • Maintain proper hydration
  • Adjust treatment plan seasonally

Emergency Protocols

  • Keep glucagon accessible
  • Know your emergency contacts
  • Document exercise responses
  • Review safety plan regularly

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