Sport and exercise

Where can patients with diabetes get reliable information about self managing their insulin or oral hypoglycaemia agents when exercising or playing sport?

Sport and exercise pose particular challenges for patients with diabetes as the increased metabolism of glucose and the elevated insulin sensitivity associated with exercise can lead to reduced blood glucose levels and an increased risk of hypoglycaemia.

A website called www.runsweet.com and a book called The Diabetic Athlete (ISBM 0736032711) are good sources of advice.

What advice should people with insulin treated diabetes be given prior to sport or exercising?

They should be warned that their blood glucose level may fall after exercise and they may be at increased risk of hypoglcyaemia during and afterwards.

They should be counselled to make a pre-emptive reduction in insulin dose prior to commencing exercise, keeping some rapidly-absorbable glucose with them and to check their blood glucose more frequently than usual after the exercise.

If the exercise is prolonged (e.g. long distance running) the patient should consider checking their BM during the exercise as well.

Does this advice also pertain to those with T2DM treated only with OHAs?

There is an increased risk of hypoglycaemia after exercise in those treated with sulphonylureas and these individuals should be advised to be more alert to warning symptoms, to check their BM after exercise and to keep a rapidly absorbable glucose source with them while exercising.

Is lowering of blood glucose the only recognised effect of exercise on those with diabetes?

No, some individuals with T1DM notice a paradoxical rise in blood glucose during or after exercise and this again emphasises the importance of blood glucose monitoring during/after exercise. These people only discover if this is their normal response to a given exercise by experience.

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