Disclaimer – This blog post is my own opinion and from my personal experience. No advice or guidance from this post should be considered without the support of your healthcare professional.
With it being #DiabetesWeek 2017, and with one of the themes being #KnowDiabetes , I thought it would be appropriate to share some tips about what I know from my experience of exercise and type 1 diabetes.
This week is all about sharing our experiences to benefit others so I’m hoping that by communicating the importance of these 5 key areas to the way I approach my sport, it may help someone out there who’s struggling to manage their exercise with their diabetes, or it may even encourage someone else to give it a try!
So here is my Top 5:
1. Testing
Testing is obviously vital to keeping diabetes under control but it becomes even more important when you’re trying to exercise. By increasing the number of checks you do before, during and after your exercise, the more likely you are to catch potential hypos or hypers which may creep up on you as a result of the exercise you’ve undertaken.
Tip – I test as often as I can, because ultimately I want to be able to enjoy my exercise and avoid any complications, so if I can spot a trend in my blood glucose early enough and use the appropriate treatment to correct it, I’m more likely to have fun. It’s vital to ensure you remain in a safe range to allow you to perform to the best of your ability; remain safe and most importantly, enjoy it!
2. Treatments
It’s so important to be well prepared with your treatments. Since I was a teenager I’ve carried around dextrose tablets in my pocket regardless of whether I’m playing sport or not in case I was hit with a hypo. It’s not just about hypos though as hypers can occur around exercise, so being able to administer insulin should your levels increase is also a vitally important treatment. You have to be careful you don’t overdo either a hypo or hyper treatment as you don’t want to move towards the other extremity, but ensuring you have your treatments easily accessible to you will hopefully make any precarious situations easier to avoid.
Tip – My go to hypo treatment is Lucozade sport as it’s an isotonic drink which ensures uptake is quicker, whilst it’s not as glucose rich as a can of coke, ensuring I don’t over treat my hypo and run with high glucose levels (Half a bottle normally sorts things out pretty quickly!). Whilst my hyper treatment is normally dependent on how high my levels are and the intensity of exercise, so it’s good to have an understanding of the expected outcome for your glucose levels as a result of the type of exercise. You can then use your insulin dose appropriately.
3. Routine / Preparation
“Fail to prepare, prepare to Fail!” This famous quote is never more apparent than with Diabetes control around sport. If you think you can just turn up, throw your bag down and have a swig of water before you start running around you’re so wrong and you will undoubtedly, in my opinion, suffer regularly with hypos and hypers during exercise.
Tip – For many years I’ve been preparing for games the night before, through the consumption of carbohydrate rich food and trying my best to keep my levels stable. I then would undertake the same morning breakfast and lunch on every single game day to ensure my levels were as predictable as possible to help with managing the game. I’ve used beans on toast as a regular meal prior to a game and tried to ensure my insulin was taken 2.5 – 3 hours prior to a game kicking off, to avoid insulin peaks. Everyone will be different and approaches will need to change for the timing of exercise but the key is to find a routine which you’ve found successful in getting your glucose levels within range, which allows you to enjoy the exercise and get the best from your body.
4. Post Exercise Nutrition/Preparation
The hours after a period of exercise, can cause you trouble. You’ve enjoyed a 2 hour session in the gym or a game of football and your levels were absolutely fine throughout it but you’ve now been hit with a hypo 3 hours later! The General rule is the longer the exercise or more intense it is, the more likely this is to happen (Very general!), so you need to take steps in order to avoid it happening.
Tip – You should eat a carbohydrate and protein fuelled meal post exercise, whilst reducing your normal carbohydrate ratio for dosing to help counteract this drop, but by how much should be your decision. It’s a phenomenon known to most sporty diabetics which if you prepare for and seek advice should alleviate the concern around post-exercise and night time hypos.
5. Mindset
I can’t stress this one enough. You can’t and won’t get your blood glucose levels right every single time you exercise, so please don’t think any of us do! Be prepared for it to go wrong and treat it, but don’t get disheartened by your inability to get it right 100% of the time. Identify the reasons why you think it might have gone wrong, learn from the mistakes and ensure the next time you come to exercise you’ve adapted. Exercise can add so much value to your life that it would be a shame to give up or reduce the number of times you do it, because it went wrong with your levels a few times. Remain positive and seek help! There’s no doubting that exercise is an important factor in diabetes control and has huge health benefits.
Tip – There are so many great resources and people with knowledge to support in the #GBdoc on Twitter, The Diabetes Football Community is something I provide support on, whilst runsweet.com or forums like diabetes.co.uk can support and guide you if you need it. Social support can be invaluable in encouragement and guidance surrounding exercise.
I hope that the areas I’ve covered will provide some insight, support and reassurance to those of you who read it. They are just from my experiences though and should always be considered alongside the support of your healthcare professional.
#KnowDiabetes #FightDiabetes #DiabetesWeek 2017
Thanks for putting this out, it was a really good read and helpful.
My 9 year old daughter is a dancer and competes a fair bit, I’m really struggling at the minute to keep her sugars in single figure. She wears a pump and even putting on a temp basal, she is coming out high. Normally on comp day I struggle to keep her sugar levels up but last weekend I struggled to keep them under 25 🤔😩
As a parent I find it hard as I don’t like to see her battle high sugars as she is a different child, very grumpy.. A personal question, when your sugars are high, how do you feel? My daughter is so aggressive it’s untrue and I just wondered if it’s her or because of her high sugars??
Thanks once again for finding time to write this, it was a really good read
Hi Vanessa. Thank you for reading the post firstly. 😊. Was a pleasure to write from my perspective and I’m really pleased you enjoyed reading it.
To answer your question, yes I get irritable and grumpy when my sugar levels are high because you genuinely feel pretty rubbish and sluggish! Speaking to other type 1 diabetics this is quite a common way to feel, so she’s definitely not alone! Mood swings are associated with the extremities of the condition i.e. Hypo or hyperglycaemia.
Have you talked about her emotions on competition day? Does she get nervous or really excited because adrenaline can shoot levels up, and this has happened to me in big games. During training it’s less prevalent because you’re calmer about the situation and less bothered. I know Scott Allan (pro footballer) has to have insulin before he gets on the pitch to counteract the rise.
Just try to keep positive as you’ll work it out. It’s always been trial and error and things do go wrong, just keep plugging away.
If you have any questions you know where I am!
Chris
TDFC
Truly it is the high sugars that can turn a normally placid person into a grizzly bear 😉 Also whilst sport can drive the sugar levels down be aware of the body’s stress reponse (‘Fight or Flight) so in the case of competitive sport she may be nervous which triggers this response and the associated extra fuel stores the body thinks it needs to fight or flee so her sugars rise.
T1 for 22 years.
Great post! I will be forwarding this to my son who is a very sporty 16 yr old. You write in such a clear way and with a wealth of experience behind you! I love how you don’t say that you must do this or that! I’ve found some sites to be a wee bit too dictatorial! As you stress: everyone is different! Maureen
Thank you for your kind words Maureen! 😁. I try to write from a realistic point of view which encompasses much of the theory to. Diabetes is always a moving feast which you have to adapt and learn to control. Things are always changing but if you have the techniques to tackle it you’ll be fine.
Also if your son wants any tips myself or noel would be very happy to answer any of his questions.
Chris 😊.
Cheers Chris! We’ve had two big rugby games this week- adrenalin sure does kick in and push those numbers up during a game. Can I ask you if you do a BGL check during a game and your levels are high, do you keep going? I’m asking this as my son can be 8 mmols before a game, shoot up to 17 in the middle then come crashing down into hypoland two hours later. I let him play with those higher levels as I’m thinking it’s the adrenalin and the more intense and competitive the game is, the higher those mid game levels go! We adjust his post game slow acting late night insulin to catch the lows and that seems to work. Hope that all makes sense. I’d just love to hear what you do. My son uses insulin pens, not a pump and doesn’t want a CGM. All his choice. Thanks, Maureen
I test before the warm up, after it, then prior to the game. I test then again at half time and post game. If I experienced a 17mmols I would correct that, as it has a detrimental effect on my performance being that high (lose a yard of pace, loss of energy). I like to run closer to normal ranges and then counter for those post game hypos by dropping insulin levels and eating a carb loaded meal. I’m also a pen user and have only just started using the libre. Hope that’s helpful.
Chris