Exercise management guidelines for Type 1 diabetes
Everyone benefits from exercise, including those who at the risk of diabetes or have diabetes.
Regular exercise can help people with diabetes control their blood sugar levels and manage their blood lipid and body composition, while improving their overall fitness.
Management of different forms of exercise is particularly difficult for patients with Type 1 diabetes including for their healthcare providers.
But for people with Type 1 diabetes there isn’t any adequate knowledge around exercise management and its effect on blood sugar levels which triggers the fear of hypoglycaemia (when blood sugar decreases to below normal levels) and loss of glycaemic control.
Type 1 diabetes is a challenging condition on many levels and requires management of various physiological and behavioural processes.
While regular exercise is important for people with Type 1 diabetes, the management of the different forms of exercise is difficult for the individual and the heath-care provider, due to the fluctuations that take place in the blood sugar levels during exercise.
Recently, an international team of researchers and clinicians published a set of guidelines for exercise management to help people with Type 1 diabetes avoid fluctuation in blood sugar level while exercising. The guidelines also include glucose targets for safe and effective exercise and nutritional and insulin dose adjustments required to prevent exercise related blood sugar fluctuations.
The researchers noted that people with Type 1 diabetes tend to be as inactive as the general population and a large number of individuals are obese or overweight as they do not maintain a healthy body mass or achieve the minimum amount of moderate to vigorous aerobic activity (150 minutes per week) required for optimum health. This is in contrast to Type 1 diabetics who were relatively slim and active a few decades ago.
People with Type 1 diabetes have to monitor their blood sugar levels before, during and after exercise. Over a period of two years, researchers reviewed observational studies and clinical trials on exercise management amongst people with Type 1 diabetes.
The report states that regular exercise helps paediatric patients with Type 1 reduce cardiovascular disease and decrease the average blood glucose levels (glycated haemoglobin), while improving overall well-being.
In adults with Type 1, both eye disease and kidney disease is less common in those who exercise regularly. The report also suggests that adults with Type 1 have a better chance of achieving the target levels of glycated haemoglobin, blood pressure levels and a healthier Body Mass Index (BMI) when compared to inactive patients.
According to the report aerobic exercises like jogging, walking and light cycling can reduce glycaemia while anaerobic exercises like sprinting, heavy lifting and playing interval sports like hockey can temporarily raise glucose levels.
Both forms of exercise can lead to hypoglycaemia (severe low blood sugar) in late recovery, usually when patients are sleeping.
It is thus important to understand the changes that take place in the physiology and its influence on glycaemic levels during different forms of exercise and sports to ensure that safe and effective glycaemic management strategies are employed. These guidelines provide patients with Type 1 diabetes and their healthcare professionals a parameter to avoid various barriers for exercise and help patients achieve the many benefits that exercise offers.
Previous studies have shown that exercise suppresses inflammation which is particularly helpful to patients with inflammatory diseases such as diabetes. But it is wise to consult your health care provider to formulate an exercise plan for you especially if you have Type 1 diabetes. This new guideline provides the much needed parameters to plan effective exercise regimes and glycaemic management strategies for Type 1 diabetes.
Source: The Lancet Diabetes & Endocrinology
