Type 1 diabetes and sport

Diabetes and sport

Exercise and movement are beneficial for both physical and mental health. However, exercising with type 1 diabetes can be challenging.

Still, it’s important—because exercising with diabetes offers many benefits. It helps reduce fluctuations in blood sugar levels and lowers the risk of other conditions associated with type 1 diabetes.

GoOD TO KNOW:

Being physically active is beneficial for your overall health and plays a vital role in managing blood glucose levels effectively.

Exercise affects blood glucose levels. It’s important to take this into account.

Various recommendations can help make exercising with type 1 diabetes easier.

During and after physical activity, blood glucose levels can drop. It’s important to minimize this as much as possible.

Type 1 diabetes does not prevent individuals from pursuing professional sports. Many elite athletes have shown that with the right medical support and training, it is entirely possible to compete at the highest level.

Benefits of exercise

Physical activity helps keep your body healthy and fit. It supports your physical well-being and has a positive impact on your mood. Regular exercise can improve your ability to cope with stress and contributes to maintaining a healthy weight balance.

Benefits of Exercise for People with Type 1 Diabetes

For individuals with type 1 diabetes, physical activity is especially important. It offers two major health benefits:

More stable blood glucose levels. Exercise improves insulin sensitivity, allowing cells to absorb insulin more effectively. This often means you need less insulin when you’re physically active. With lower insulin levels, it becomes easier to manage blood glucose. Regular movement also supports healthy weight management.
Reduced risk of complications. Staying active lowers the risk of diabetes-related complications, such as cardiovascular issues. Regular exercise helps keep your heart and blood vessels in better condition.
Positive impact on HbA1c and Time in Range. Consistent physical activity can lead to improved long-term glucose control, reflected in better HbA1c values and more time spent within your target glucose range.

What to pay attention to?

When you move, your body uses more energy—even during light activities like walking or cycling. Your muscle cells require extra glucose, which they draw directly from the bloodstream. In this process, little to no insulin is needed.

However, when you engage in more intense exercise, your blood circulates faster. This accelerates the absorption of insulin you’ve recently administered, making it act more quickly and more strongly. That’s why it’s important to consider how physical activity affects your blood glucose levels and insulin response.

Watch Out for Low Blood Sugar

During exercise, muscle cells use extra glucose. Physical activity also makes insulin work faster. This means your blood glucose can drop quickly in a short period of time. That’s why it’s important to be cautious about low blood sugar when you exercise. Carefully assess how much insulin your body needs at that moment.

However, having too little insulin in your system isn’t ideal either. It can cause your glucose levels to rise too sharply. High blood glucose during exercise can be uncomfortable—and in some cases, even dangerous for your body.

Exercising with Diabetes Is Personal

The impact of physical activity on glucose levels varies from person to person. It can also differ depending on the day or time you exercise. The type of sport and the duration of your activity play a significant role.

Enjoying exercise with type 1 diabetes is often a journey of trial and error. What works one time may not work the next.

The professionals at Diabeter are happy to help with questions about exercising with type 1 diabetes. Together with you, they explore safe and enjoyable ways for you or your child to stay active—because we understand that physical activity is an essential part of a healthy lifestyle with diabetes.

Different Types of Sports

The type of sport you engage in influences how physical activity affects your blood glucose levels. Sports can generally be divided into three categories:

Endurance Sports (Aerobic): These involve sustained, moderate-intensity activity. Examples include running, cycling, swimming, and ice skating. These types of sports often cause blood glucose levels to drop.
Mixed Sports: A combination of endurance and strength training, where intensity varies throughout the activity. Examples include team sports like basketball, football, and volleyball. Blood glucose levels may rise or fall depending on how intense the activity is.
Strength Sports (Anaerobic): These involve short bursts of high-intensity effort. Examples include sprinting and weight training. These sports often lead to an increase in blood glucose levels.

Active Insulin in the Body

With type 1 diabetes, insulin is administered using a pen or pump. During exercise, insulin in the body can act faster and more intensely. This is often referred to as “insulin on board” or active insulin. Once insulin is in your system, you can’t remove it.

If there’s too much insulin in your body, the risk of hypoglycemia during exercise increases.

Some people exercise for longer periods—more than two hours—without administering insulin. For example, by disconnecting their insulin pump or skipping doses during activity. This can cause blood glucose levels to rise rapidly due to the absence of active insulin.

Short-acting insulin typically works for 2 to 3 hours. Without insulin, your body cannot transport glucose from the bloodstream into the cells.

Tips for exercising with diabetes

These recommendations from Diabeter can help make physical activity with type 1 diabetes safer and more enjoyable:

Adjust insulin levels before, during, and after exercise. The amount of insulin needed varies from person to person. Your diabetes care team at Diabeter can provide personalized guidance.
Always check your blood glucose before exercising. Your glucose level before starting is crucial. Exercising with low blood glucose can be dangerous—it's important to treat a hypo first. If your glucose level is too high (above 20 mmol/L), exercise may not be beneficial. Your muscles may fatigue quickly, and the health benefits are limited.
Inform others about type 1 diabetes. If you or your child are exercising with others, it’s important that teammates, coaches, or trainers understand type 1 diabetes. This helps create a supportive environment and ensures safer, more comfortable participation.

Preventing hypos during exercise

Blood glucose levels can drop quickly during physical activity—and often continue to fall even after you’ve finished exercising. This drop can last for hours, sometimes even into the next day. That’s because the glucose stored in your muscles and liver gets depleted, and your body replenishes it by drawing glucose from the bloodstream.

That’s why it’s important to monitor your blood glucose regularly after exercise—ideally every 1 to 2 hours. You’ll likely need less insulin than usual, but the exact amount varies from person to person. Your diabetes care team can provide personalized advice on how much insulin you need after exercising.

Top-level sport and diabetes

You might think: top-level sport and diabetes — that must be impossible! But there are plenty of elite athletes with type 1 diabetes who prove it can be done.

Valerie Magis, top hockey player: “I want to be a role model for people with diabetes who also want to reach the top.”

Synchronized swimmers Noortje and Bregje de Brouwer won a bronze medal at the 2024 Olympic Games.