Exercise and diabetes
- Exercise and hypoglycaemia
- Foods to prevent hypoglycaemia
- Food for continuing exercise
- Insulin adjustment and exercise
- Exercise and high blood glucose
The student with diabetes should be encouraged to exercise because it:
- improves fitness and well-being
- encourages a lifelong healthy lifestyle
- builds self-esteem, confidence and team-work
- improves the action of insulin and enhances blood glucose control.
Exercise and hypoglycaemia
Exercising muscles use more glucose for energy. This may cause the blood glucose to fall during, immediately after or, in the case of prolonged or intensive exercise, several hours afterwards. To prevent hypoglycaemia, extra carbohydrate needs to be eaten before exercise begins. If the exercise is intensive and sustained, extra carbohydrate may be needed for each half hour of exercise. If the sport has been particularly vigorous or lengthy, extra food may be needed after the sport as well.
Foods to prevent hypoglycaemia
In preparing for exercise, two options exist. Slowly absorbed carbohydrate foods, which need time for digestion and absorption, could be eaten half an hour before the exercise or quickly absorbed foods can be given immediately before exercise.
| Slowly absorbed carbohydrate foods |
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This extra snack needs to be eaten half an hour before exercise begins. This may be one of the following:
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Quickly absorbed carbohydrate foods |
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A glucose or sugar-based food can be given just as exercise is about to start. Examples include:
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Food for continuing exercise
In general, the equivalent of half a piece of bread or half piece of fruit needs to be eaten for every half hour of exercise. If a student has had a very strenuous day of exercise (eg, an all-day walk or a tennis competition), extra carbohydrate food will be also be required after the exercise. This may even be needed before bed time to avoid a delayed hypo occurring during the night.
Insulin adjustment and exercise
For scheduled intensive exercise (eg, swimming training, football) the dose of insulin which acts at that time of the day may also need to be reduced, in addition to eating extra carbohydrate food in order to further reduce the risk of hypoglycaemia. Parents or guardians need to discuss arrangements for sport with their child’s doctor and the member of staff responsible for sports.
Exercise and high blood glucose
Exercise is not recommended during periods of poor diabetes control when blood glucose levels are high. It may cause them to become even more elevated. Parents or guardians will advise the school if exercise should not be undertaken.
Special precautions for exercise
- Food or drinks for the treatment of hypoglycaemia need to be available at the place of physical activity and sport and not at some distance.
- Students with diabetes need additional supervision during exercise. Younger students may also need to have meals supervised, especially before exercise.
- Sports uniforms or clothing should have a pocket to allow a student with diabetes to carry emergency hypo food (eg, jelly beans).
- Any sport in which a hypo would cause a risk to either the student or someone called upon to help, should be modified or only be considered after careful planning and always occur under strict supervision.
- Water sports need very careful planning and supervision because a hypo increases the risk of drowning and some features of hypoglycaemia may be masked by cooler body temperatures experienced during water-based activity.