Starting Exercise with Type 1 Diabetes

One of my intentions for 2017 is to start exercising. I am 50 years old, 20-30 lbs overweight, and my endo has strongly suggested I do something. My exercise regimen will have to fit around my work hours (8AM-5PM) and commute (45 minutes). Most likely after work. The sort of work I do, dealing with diabetes events (hypoglycemia) would be challenging.

From what I have read in this JDRF article, Don’t Sweat It! Exercise and Type 1 Diabetes, exercise and T1 management can be challenging.

It seems to me that the safe way to start is to join a gym that has a diabetes educator or trainer with Type 1 diabetes expertise on staff. I need a LOT of handholding.

Exercise typically lowers my BG and recently my BG have been erratic.

Any idea on how to approach searching for help?

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My T1D son (12 years old) does a lot of exercise, 10-20 hours per week depending upon the week, some of it intensive swimming practices. We are still new at this, but we have experimented quite a lot with exercise in the past 6 months. We have also researched this in the literatue, and read the Sherry Colberg book.

What we have found - for us, may or may not work with you:

  • As long as you test regularly, there is no need for special trainer or educator. For us, regularly means every 30-40 minutes for a average workout, every 20 minutes for an intensive workout
  • There is a “best” range of glucose for performance. My son performs best in the 120-160 range. He does not perform well when he is at 100.
  • underdosing the last meal does NOT help for exercise. The “surface” glucose number (like a surface charge for a battery) drops precipitously when you start working out (confirmed by literature)
  • you don’t want a lot of Insulin On Board. Best have at least 2 hours since your last meal, if possible 3.
  • The way we do it: 30 minutes before practice we bring his glucose to 150-175. Then we replenish it as needed all through. In a soccer practice, he tests every 30-40 minutes, and takes about 15 g of sugar every 30-40 minutes. In a swim practice, he needs to test every 20 minutes, and will typically need exactly 15g every 20 minutes.
  • we taper off at the end of the practice so that he does not end up high (but be aware that at least he continues to go lower after the end of exercise).
  • right after the practice, he takes 12 oz of whole milk (recommended by study), sometimes eats too depending on intensity of workout, etc. He typically doses as well.
  • Before a match or a meet: we eat a high carb, medium protein, low fat meal 3.5 hours before the match/meet, then hydrate very high about 2 hours before.

My son typically keeps on going lower after exercise, fairly typical. When he is in high exercise mode, his insulin needs (TDD) are about half of what they are if is not exercising at all: we were able to figure this out during the Xmas vacations:-) So beware the fact that your basal needs and/or bolus needs may change.

Feel free to message me if you want to chat directly on the phone.

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I haven’t watched it yet, but last night we had a interview w Christel Oerum of the FitBlog

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Do you use a pump? If you do, reducing your basal right before you begin would be a safety measure to try.

What type of exercise are you planning? They type of exercise and length of exercise will affect how much you drop. But very intense exercise can actually make your BG rise instead of drop.

One of the safety measures that I use is to try to exercise when I have little insulin on board, insulin left over from my previous meal. I try to exercise with no food or insulin still in my system, just basal insulin. That helps to keep my BG more steady than it would be with insulin and food still working. So I try to wait 4 hours after a meal before I exercise.

Having a few things available to help with a drop would be important. Go to the sports store and look for from some exercise gels. Look for ones that contain 15 grams of simple sugar.

Start slow and measure your BG often to get an idea of changes you need to make. It is different for everyone, so you need to find a formula that works for you. Take notes about your BG and you will see the adjustments you have to make.

It isn’t too hard, but it takes patience to find a good system that works. I encourage you to keep it up.

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@Christel_Oerum has a very usefull exercise log sheet to help track how food and boluses affect BG during and after exercise.


How about starting with a non aerobic exercise like Pilates? Find a recommended instructor and walk her/him through your BG concerns - this type of program focuses on core strength and stretching and is usually not the kind of activity that would cause a quick low. You could also add a few mini walks as you have break times during the work day - every 10 or 15 mini workout results in a cumulative benefit. Think of these daily activities as a part of your routine and you are much more likely to continue doing them…I was 90lbs overweight and a few years older than you are now when I took my first Pilates class and to my surprise I was able to keep up with the class.

it really depends on what type of exercise you’re looking to primarily do. If you want to pursue real strength training there is little substitute for a real gym with way more setup and equipment than you can possibly manage at home. If you are just hoping to get some cardio in and lose some pounds it’s not a bad option to just get a piece of workout equipment if you have room such as a treadmill, rowing machine, elliptical, or whatever fits your needs (treadmill is by far the most effective home fitness machine IMO but higher impact than is fun for some and a decent one is expensive). Or just go for a brisk walk/ jog around the neighborhood-- some people seem to enjoy that but for whatever reason I prefer the treadmill

As for managing blood sugars along the way, just like anything else as you get more experience with exercise you’ll start knowing what to expect and how to work around it. it’s manageable.

I am 54 and absolutely hate going to the gym. But walking with my dog is huge for me. I HAVE TO DO IT. Don’t get me wrong, I have been to the gym. But I just cannot stay motivated. So I understand. Walking really is a slow way to get weight off, but every little bit helps. I’ve been diabetic for 45 years. I’ve struggled with weight for about that long. As long as I am walking the dog I tend to stay on track.

I’m on a pump. I always check my sugar before I leave. Depending on my sugar level I will either suspend before walking or lower my basil on my pump. If you’re not on a pump just be prepared. I always have my “stuff” in my little backpack purse. I don’t get any symptoms when going low. So I’m always prepared with something to bring my sugar up if needed. If I have to stop and check while walking I do it. Depending on how far or where I’m at I am always super vigilant because as you know going low is horrible.

Lastly, I am currently waiting for my diabetic alert dog to be fully trained (2 years only 10 months to go). It may be an idea because it is a great way to have the dog at work with you (take it for walks during lunch) and to stay safe. Mine will alert me every time my sugar goes below 80. And it will be with me EVERYWHERE I go.

Just a bunch of random ideas. I don’t run, I don’t go to a gym. I walk. This is what I do to keep my weight under control. I hope it helps a little. I know we are all different. :slight_smile:


i would tend to agree with debra about the walking thing. if you havent been physically active, its a nice gentle way of getting active. it costs nothing and as long as its not baltic where you live, you can do it whenever you want.

also what others have said, having little or no insulin in your system always helps to stay steady.

i do lots of sport and really enjoy it. diabetes is a pain and when i first got it, i was so nervous about going low in an exercise class or while running in a mountain race or whatever. testing and being prepared with glucose will help ease your fears and little by little youll get to know how your body responds to different types of exercise.

good luck!


Walking has been my main exercise for the last five years. I walk almost every day and put in about 100 miles per month. I’m of the opinion that exercise will not be the primary way to lose weight, but it helps. I live with a service dog and he accompanies me 99% of the time. Developing the habit around dog walks is a great idea because the dog needs access to the outside for relieving and since you’re already out the door it’s easy to add a block or two, or six!

I find using a FitBit step-tracker helps me stay motivated. I’ve walked 1231 miles in the last 12 months. The bracelet fitbit will wirelessly upload to the tracking program on my computer.

You can walk wherever you are. I used to walk every day at lunch-time when I worked. The steps add up. Once I started using the tracker, I did things like parking in the distant reaches of the store parking lot and adding steps to my daily count. These things do add up.

If you add hills to your course you can immediately tax your cardio-vascular system more. It’s all up to you.

I moved to an urban environment last year and sold my car. Walking is an integral part of my every day.


I have a little different experience, but my approach may be useful. I was not over weight, ran regularly and had recently completed a marathon before being hospitalized with type 1. I asked the Dr. how this would affect my exercise and the response was “well, sonny, you may just have to give that up”.
I’m older now (67) and there was no info available then (1995) so I started by testing my BG, then running around the block (about 3/4 mile I suppose) tested again. Ran again, tested again…rinse and repeat…
Next day I started adding distance until I got to 6 miles. All the time keeping my beginning BG at above 160 and not running soon after insulin shots. We’re all different so I expect that your results will be too. Just get started ( 0500 in the morning is a great time to begin).
Since that time, I’ve run 15 marathons, a bunch of other races, backpacked all over the NW and had a great time of it. You will too, I’m sure. Most importantly; Get Started.


Funny how an arbitrary limit imposed by an authority figure can serve to motivate some of us. I’m glad you didn’t roll over and accept that limitation.:runner:

For me, I always get into trouble if I exercise strenuously enough while I have an active bolus going on (usually within 2-2.5 hours). Not sure why-- my wild guess would be the exercise moves the insulin into my blood stream faster (shrug); but at any rate, I have a treadmill at home and usually try to jog 3 times a week. Nothing epic-- currently I’m alternating 5 minutes walking and 10-15 minutes running, up to 3 miles total. I’ve found both pre- and post-T1D that exercise has to be convenient and at least semi-enjoyable, so I usually have TV/movie queued up while I jog. Other than just being careful with the bolus, I really haven’t seen much of a difference with having diabetes. I usually keep my go-to candy with me just in case… Starbursts! (1 Starburst is good for me to raise blood sugar about 15 mg/dL-- that would be my other piece of advice, do a little experimenting and have something nearby that you can be strategic with, as it’s easy to go berserk when low!). Good luck, you can do it!!

I’d start with walking. I got in the habit of walking from one office to another during the day. You can work in a walk during lunch or even a walk after work if your company doesn’t have a campus; you also might miss a bit of rush hour taking a walk after work.

Once you kick it up. You can start with yoga or pilates. Then you can ease yourself into aerobic exercise. Make sure you align with your doc on your insulin adjustments and check before, during, and after your workouts!

I just started going back to the gym. They’ve got some great devices out there. I have an Apple iWatch and it’s great for a quick way to check my Dexcom reading, heart rate, and simply keeping track of my health data.

Lots of great tips! Good luck!

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10-20 hours per week woudl be a LOT of exercise for me. I work 40 hours a week excluding lunch. Toss in 7.5 hours of commuting, 1 hour/day for studying (I’m in IT, if you’re not constantly learning you’re falling behind), and time with my wife and kids and and … yeah. 10 hours/week is a lot.

For me, the average time for exercise is 45minute - 1 hour. What would you recommend there?

I have also observed, that intense exercise in the morning means a severe hypo sometime later in the day while at work, usually before/during a client meeting. I need my brain to earn a living. This is becoming quite challening for me.

I don’t know what that means.

So … exercise in the morning before breakfast?

How do you do that? Glucose gels?

Seems like everyone has a more flexible schedule than me. Week days 4 hours after breakfast is 10AM, 4 hours after lunch is 3:30PM. I’m at work getting client work done. 4 hours after dinner is 10PM. Exercising after that far after a meal is not possible.

Would before (breakfast/dinner) meal exercise be better?

I bought an exercise bike and have started using that. The BG does drop at inconvient moments (like the middle of a client presentation or while trying to solve a techical problem that requires focus while on a deadline) a few hours after exercise.

I bought the bike because 1) spring in New Jersey is rain, rain, rain. 2) summers in New Jersey = heat stroke, 3) winter is cold and I intensely dislike cold and 5AM = pitch black.

I am hoping it wll help. I have no solution for the hypo except for glucose gels and I have started to gag just at the thought of downing another one.

I have yet to figure it out, but refuse to give up my favorite activity of swimming. I found I was always going high a few hours later as I was off my pump. It makes sense, but not very helpful. Lately, I have been planning on a swim and take a shot of lantus in the morning, set my basal on 0 until that evening 12 hours after the shot and am back on the pump. This seems to work much better. Its all about the planning though. I wish I could be more spontaneous. I just bought a bicycle and my husband and I have been bike riding after supper. This is a new challenge, but so worth it. The one good thing is the extra goodies I get to eat.

I do almost all of mine before dinner.

Before breakfast is tricky because when you wake up you might have somewhat difficult BG numbers to contend with - high or low. Also you have not had any food for 12 hours so your body won’t have as much fuel. And you have been asleep so you haven’t been able to adjust basal numbers leading up to the exercise.

Before dinner is ideal because you have had several hours since lunch, no IOB, and you have hours to get your BG nice and flat. If you are on a pump, you can cut your basal down for a few hours to make it right for exercise.

The additional benefit of doing it before dinner is that you get to refuel soon after the exercise with dinner. Refueling within 30 minutes of exercise helps restore muscle glycogen much quicker. If you want to exercise everyday, this is important.

Of course, all of that depends on what type you are going to do - strength, cardio, endurance, the intensity, etc.

Try these. They are a very high sugar version of Gatorade. Four ounces has 23 grams. I think it’s easier than gels. Gatorade Prime (the drink, not the gels!)

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I doubt that! Many of us are professionals here as well. I constantly have to make choices about my schedule in order to maximize time with the family, ability to get work done, and time for things like exercise. For me, exercise is a priority since it is a critical part of being healthy. It is also the most useful tool I have to manage my Blood Glucose right now (since I’ve got some weird thing going on with super-slow onset T1).

The easiest way for me to make the time is to do it either early in the morning (fasting, after I get up) or late at night (after my kid goes to sleep). Neither is ideal, timewise, but those times are the best I can manage. I get three heavy weight workouts a week in (about 1-1.5 hours on average), and I ride my bike or walk to work every day (which gets me another hour or so of cardio in). I do some longer rides (2 hours) on the weekends, and will start doing more of that soon as I’m thinking of training for a triathlon.

Being diabetic has definitely made life more complicated. I have to do planning of meals, exercise, and schedule in a way I didn’t have to worry about a couple years ago. But that’s just the way it is now…