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More than 60 healthcare professionals from around Australia descended upon Canberra recently to participate in the JDRF Type 1 Diabetes Performance in Exercise and Knowledge (PEAK) program.

Keynote speakers included Australian type 1 diabetes (T1D) experts Professor Tim Jones, Dr Carmel Smart, Professor Liz Davis, Professor Paul Fournier and Professor Stephen Twigg as well as international expert, Dr Ian Gallen, consultant physician and endocrinologist at Royal Berkshire Hospital, Reading, UK.

PEAK is a new fixture on the healthcare professional calendar and aims to provide delegates with the most current findings on managing exercise and T1D. This means they can then pass these insights on to the people with type 1 diabetes they consult with every day.

Walking as exercise

What were some of the key findings from PEAK for people with type 1 diabetes?

Aerobic exercise and type 1 diabetes can go hand-in-hand! This type of exercise is usually continuous, of light-to-moderate intensity and includes activities like running, walking, biking or tennis. Although exercising with T1D can present some challenges in blood glucose level (BGL) management, you can overcome these obstacles with the right education—and a solid game plan.

  • Exercise can deliver improvements in insulin sensitivity and, potentially, in HbA1c.
  • Don’t start exercising if you are hypoglycaemic or have ketones in your blood and urine.
  • After exercise, muscles and liver glycogen levels need to be replenished with carbohydrates. However, insulin sensitivity is elevated for about 24 hours post-activity, so you may need to lower your insulin levels—particularly overnight.
  • When combined with eating after exercise, low insulin levels can lead to high BGLs.
  • Aerobic exercise will cause your BGLs to drop during and after activity, so reducing your basal insulin and/or adding carbs will likely be necessary to avoid hypoglycaemia.
  • Changes in basal insulin delivery by pump can take up to an hour to have an effect. Exercise itself can cause basal insulin absorption rates to rise.
  • Continuous glucose monitors (CGMs) or regular BGL testing are critical to help pre-emptively minimise highs and lows.
  • Eating carbohydrates will provide fuel during exercise and help keep BGLs in a safe range.

We recommend that you consult your HCP before making any changes to your insulin or exercise regime.

For more on the exercise research and recommendations presented at PEAK, this blog article outlines the source report in more detail.

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