Julie Cunningham, MPH, RDN, CDCES, IBCLC
The benefits of exercise are undeniable. But when it comes to diabetes and exercise, those with the condition may have to put in a little extra effort to get a good workout and reap the rewards. Light to moderate activity causes the body to burn carbohydrates for fuel and muscles to use sugar for energy, typically leading to a drop in glucose levels. However, intense exercise can actually trigger an increase in blood sugar levels due to the release of stress hormones.
As a person living with diabetes, this means a trip to the gym should be planned in advance. You need to be prepared for a potential low after your workout and bring along extra carbs that can keep your blood sugar stable until your next meal.
Thankfully, there are a number of strategies that can help you play it safe with diabetes and exercise! Use these four tips to keep your blood sugar balanced next time you schedule a sweat session.
1. Check your blood sugar levels before, during and after your workout
As mentioned, blood sugar levels usually decrease during exercise but can rise during an intense workout. For these reasons, it's important to stay aware of your glucose level.
A continuous glucose monitor (CGM) can help you check your blood sugar with little interruption to your workout. One of the best features of a CGM is that it predicts low and high blood sugars ahead of time, based on how quickly your blood sugar is changing. When your device alerts you to let you know of an upcoming high or low, you can grab a quick snack or adjust your insulin dose and get right back to your workout.
If you don't have a CGM, it's wise to bring your glucometer with you to the gym and keep it handy in case you need to do a quick sugar check. If you experience any signs or symptoms of low blood sugar during your workout — such as feeling dizzy, weak or shaky — check your glucose level. Treat any blood sugar reading of less than 70 mg/dL right away.
If your blood sugar rises during a more demanding workout, it will typically begin to drop about 30 minutes later as you continue to exercise. Over time, you will come to know your body's typical response to exercise. This will help you predict how many carbohydrates you need to eat before your workout and what kind of changes you need to make to your insulin dose.
2. Be prepared for highs and lows
It's a good idea to take some rapid-acting carbohydrates with you to the gym in case of hypoglycemia. Some portable carbohydrate options are juice boxes, glucose tabs and glucose gel. If you use an insulin pump, talk with your healthcare team about using a temporary basal setting during exercise. This can minimize the need for extra carbohydrates before and after your workouts, and it can also decrease your risk of low blood sugar.
Preparing for lows is only half the battle — you'll need to be prepared for high blood sugar as well. Be sure to bring adequate insulin with you to your workout. An insulin pump can come in handy in this situation; it can be programmed to temporarily deliver insulin at a higher rate if you know that your blood sugar runs high during exercise.
3. Start slow and work your way up
If it's been a while since you hit the gym, be sure to give yourself some time to get back into a routine! It's best to start with a walking program and increase the intensity of your exercise from there. Consider using a professional to help you plan a workout program, and look for a personal trainer or exercise physiologist who has experience with diabetes and exercise.
Or maybe you'd like to give yoga or tai chi a try. These mind-body exercises give you a great workout while lowering your stress levels, and lower stress levels lead to lower blood sugar.
4. Refuel your body with healthy carbohydrates
After your workout, make sure that your blood sugar is in your target range. Keep an eye on your blood glucose level for several hours. Depending on the intensity of your exercise, your blood sugar may run low as your body works to restore energy that was depleted from your muscles during exercise.
This is not usually a time to go low-carb; your body has used up its carbohydrate reserves and needs to replenish its stores. If you need a good post-workout snack, consider a combination of carbs and protein, such as peanut butter and crackers or unsweetened Greek yogurt and fruit.
When it comes to diabetes and exercise, staying safe takes some planning, but the rewards are worth it! Not only can you increase your strength and stamina, but you may also decrease your risk of heart disease — one of the more common complications of diabetes.
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