Sports & Exercise

Whether you’re a Division 1 athlete, play in a club sport, or just like hitting the treadmill at the gym, it’s great that you’re trying to fit exercise into your busy schedule. We know that diabetes adds a whole additional dimension to staying fit, so check out the resources below to supplement what you already know - and learn some things you may not!


Integrated Diabetes Services  Answers courtesy of Jennifer Smith (T1D since she was a kid!), CDE/RD for IDS.

I’m about to exercise, but I just checked my blood sugar and it’s low. What is the best thing to do?

Treat the low BG and wait 30 minutes to ensure the low has come up. Take a 15g carb snack if you still plan to work-out once the BG level has returned to normal, and keep a simple carb source with you to treat low during the work-out if necessary. Gatorade or a sweetened sports drink can work very well here. If you plan to workout longer than 45-60 minutes you may need an additional 15g carb snack to ensure BG doesn’t drop again.

What about if it’s high? 

If BG is higher than 250 at the start of a work-out it’s important to test for ketones.  If you work-out with moderate to high ketones, BG can climb higher and it can be dangerous. If no ketones are present, then the nature of the exercise will typically drop BG. Do not take a correction bolus of insulin for high BG before a workout – the exercise will enable this insulin to work faster and harder and it’s more likely to have a low BG during or immediately following the workout.  

What is the perfect blood sugar range to be in before I work out?  

Optimal BG for performance is between 120-180. BG less than 120 can lead to low BG during the workout unless insulin is adjusted accordingly. 


How often do you recommend working out to maximize blood sugar control? 

It is optimal to include daily exercise to maximize BG control.  If time doesn’t permit, then aim for at least every other day. The roll-over effect of exercise can be felt and seen in BG control for a 24 hour window after an exercise session, so it’s beneficial to try to get in at least 4 days of exercise/week. It can also be helpful to keep workout at about the same time daily to help determine what adjustments need to be made to keep BG stable. 

What are the best kinds of workouts?

The best kind of workout is really whatever you like to do. It could be kick-boxing for one person, or cycling for another person. You should pick something you enjoy doing so that you will be more likely to stick with it long term. If you typically mix a work-out with various types of activities such as weights/resistance and cardio, then the structure of the workout can make a difference in during and post work-out BG levels. It’s optimal to start a mixed exercise session with weights or resistance (which commonly bring BG levels up) and end the session with cardio (which brings BG levels down). Control during and after the exercise session can be more even with less lows following this pattern.


If I am eating before, after, or during a workout, what are the best foods to eat?

Food eaten before a workout is usually consumed to ensure the BG doesn’t drop during the workout. This means the snack should be consumed at least 30 minutes before starting to exercise. This allows the body to break the snack down and begin digestion which ensures it will be in your blood stream helping to keep BG stable during the workout. A good pre-workout snack would be something with mixed nutrients such as an apple with peanut butter or hummus with crackers.Food eaten during a workout is usually for those who are endurance athletes and need to take in food to keep muscles fueled. If this is the case, there are a lot of different options – from quick carb sources like gels or chews to slower digesting foods like energy bars.  If you are eating during a workout because you have a low BG, then a quick carb source is the best to ensure it gets into your system to bring BG back up quickly – this would be something like glucose tablets, sweetened sports drinks or even dried fruit. Food eaten after a workout depends on the type of workout. More cardio based activities require a meal following the workout that is a mix of nutrients such as protein/carbs and fats – all of which provide different benefits in the aftermath of exercise.  A weight or resistance based exercise may require a more protein based “snack”, but shouldn’t be entirely void of carbohydrates either. 
Typical 1 hour exercise sessions don’t usually require a snack directly afterward as long as BG is stable. You should try to eat a meal in the next 2 hours to re-fuel your system and help with restoring lost energy to muscle as well as aid with muscle growth. Those who participate in endurance exercise (lasting longer than 90 minutes) usually will benefit from a small snack after the long workout to replenish muscle energy stores. A meal should follow this in the next 2-3 hours and consist of a mix of carbs/protein and fat.


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