For people with type 1 diabetes (T1DM), managing blood glucose levels before, during and after aerobic exercise is a major struggle. Several major professional organizations have published guidelines and recommendations to address various aspects of the struggle. But how those guidelines are understood and implemented by patients has not been widely studied…until now.
Researchers at the University of Arkansas in Little Rock put together an online survey which was posted to social media groups limited to adults with T1DM who run, jog, or walk for exercise. The survey was completed by 102 adults with T1DM and found that:
- 68% reported exercising 4+ days per week
- They averaged 23 miles per week
- 98% reported using continuous glucose monitors
- 75% used insulin pumps
- Self-reported average HbA1c was 7.1%
Despite being under a physician’s care, most respondents felt they had learned about diabetes and exercise on their own:
- 80% learned mostly from “trial and error”
- 46% from social media
- 32% from their medical team
- 28% from online searches
- Some used multiple methods
As for hypoglycemia and exercise, the survey found that:
- 27% reported ongoing fear of hypoglycemia as a significant barrier to exercise
- 36% reported noticing increased glucose variability because of exercise
- 19% reported having hypoglycemia unawareness, which occurs when a person with diabetes does not experience the usual early warning symptoms of low blood sugar (eg, sweating, trembling, butterflies in the stomach, tingling, numbness and rapid pulse)
- 73% reported that they exercised even if they had severe hypoglycemia in the last 24 hours
- 74% did not perform testing for diabetic ketoacidosis even when they had very high and unexplained blood sugar prior to exercise
- 49% reported not wearing diabetes identification during exercise
“This survey demonstrated that many people who live with T1DM, despite being tech-savvy and engaged, passionate about exercise, and seemingly well-controlled based on hemoglobin A1c, are still struggling to exercise safely without high and low blood sugar,” said lead researcher Joseph Henske, MD, of the University of Arkansas for Medical Sciences in Little Rock. “We hope to increase awareness of published guidelines regarding exercising with diabetes and help create better practical educational tools.”
Source: Henske JA, Beach G, Albashaireh A. Real-World Survey of Adherence to Guidelines Regarding Type 1 Diabetes and Aerobic Exercise. Presented June 15 at Endo 2023.
