EXCERCISE

Why should you excercise?
Exercise is good for you. It makes you feel good, it reduces your risk of heart disease and stroke - it can even be fun!

Having type 1 diabetes means that you must take certain precautions to enable you to exercise safely and successfully. This is necessary because exercise can cause your blood sugar to fall or rise depending on your control at the time.

Before beginning any exercise program you should check that you are fit to do it. Special care is necessary if you have complications of diabetes such as foot problems, eye disease, kidney disease, high blood pressure or heart disease. If you have any of these problems please discuss your exercise program with either a Doctor or Diabetes Specialist Nurse.

These guidelines are to help you manage your diabetes during exercise, and to prevent problems such as hypo's in the night. They are however, a general guide, and you may need more specific help and advice.

Avoiding Hypoglycaemia
Exercise makes you sensitive to insulin and therefore hypo's can occur during exercise and up to 48 hours afterwards. There are several steps you can take to avoid it.

• Test your blood sugar regularly before, during and after exercise. Delay exercise if your blood sugar is less than 5.5mmor-1. Take extra sugary food and test again in 20 minutes.
• Inject your insulin in a site away from an exercising muscle e.g. the abdomen.
• You will probably need to reduce your dose of insulin before exercising. How much you reduce it by will depend on how long you are exercising for. For example for 30 - 60 minutes of swimming or football, you should reduce your insulin by 30% - 50%. This is a general guide and you will learn, by careful testing and recording of results, how to adjust your insulin for different types of exercise.
• Remember that exercise can cause your blood sugar to fall for up to 48 hours afterwards. To avoid hypo's during the night you may need to reduce your evening insulin dose by 30% - 50%.
• Avoid exercising when your insulin is working at its' strongest. If you don't know when this is ask your Diabetes Specialist Nurse or Doctor.
• You may need to take extra sugary food before, during and after exercise. You should also eat an extra large bedtime snack of starchy food. Examples of these foods can be found in the second column. You can get more detailed dietary advice from your dietitian.

Avoiding High Blood Sugars and Ketones
Exercising with poor diabetic control can cause your blood sugars to rise even higher. The following steps should be taken to avoid making your control worse.

• Test your blood sugar and test your urine for ketones before exercising.
• If your blood sugar is higher than 14mmol-1 and you have ketones, or if your blood sugar is higher than 17mmol-1 even if you do not have ketones, it is wise to delay exercising as your blood sugar is likely to rise, and you may produce more ketones.