Regular exercise is an important part of good diabetes management as it lowers blood glucose levels and boosts the body’s sensitivity to insulin, countering insulin resistance. What are the Diabetes and Exercise Guidelines for good health management?

Recent research suggests that exercise can even slow or prevent the development of macular degeneration and may benefit other common causes of vision loss, such as glaucoma and diabetic retinopathy.

Balancing Glucose Levels and Exercise

For people with diabetes type 1 it is important to address how to balance blood glucose levels during and after exercise. The blood sugar response can be difficult to predict. Exercise sometimes increases the risk of falling blood sugar levels — known as hypoglycaemia — while other times it can cause blood sugar to rise.

Glucose levels must be closely monitored, since having a “hypo” can lead to dizziness, disorientation, anxiety, etc. This is a major barrier stopping many people with diabetes from incorporating exercise into their daily life.

Many experts recommend that people with type 1 diabetes, who want to maintain an active lifestyle, exercise when their blood glucose levels are normal or modestly elevated, but not when circulating insulin concentrations are raised, such as shortly after a bolus or prandial dose of insulin. Finding the right balance can be challenging.

New Guidelines for Exercise

An international team of experts has laid out the world’s first standard guidance on how people with diabetes can use modern glucose monitoring devices to help them exercise safely.

Due to the complexity of the glucose monitoring systems, both individuals with diabetes and their healthcare professionals, may struggle with interpreting the information they provide. That’s one of the main reasons the guidelines were developed.

Using Data From Glucose Monitoring Technology

The guidelines look at the evidence from glucose monitoring technology and use it as the basis for clear guidance for exercise in adults, children and adolescents with type 1 diabetes.

The guidance covers areas like carbohydrate consumption and safe glucose thresholds. The idea is that it should serve as an initial guidance tool. Guidance for each individual patient can then be tailored based on their needs, in consultation with health professionals.

According to one of the authors, the guidance is a landmark agreement, which could end up making a real difference to people with type 1 diabetes. It will help them obtain the maximum health benefits of exercise, whilst minimizing wide fluctuations in their blood glucose level.

The guidelines include extensive advice and recommendations for exercise preparations, issues to consider during exercise, and steps to be taken post-exercise. For example, the guidelines note that target sensor glucose ranges should be between 7.0 mmol/l and 10.0 mmol/l. For those with an increased risk of hypoglycemia, the levels would be slightly higher.

If sensor glucose levels are elevated, individuals should monitor blood ketone levels, and insulin correction may be performed. The guidance also states that exercise should be suspended if sensor glucose level reaches <3.9 mmol/l. If the levels are below 3.0 mmol/l, exercise should not be restarted.

Conclusion

The recommendations will need to be regularly updated to provide the best and most robust evidence-based recommendations for people with type 1 diabetes. The glucose monitoring technology continues to evolve, which the guidance needs to take into account. But this first edition of the guidelines is already a good start.