Strength Training with Diabetes T1

Balancing blood glucose levels during exercise can be a formidable task, particularly when the need to sustain optimal performance collides with the imperative of maintaining stable glucose. Depending on the type, length, and intensity of the training, I adjust my approach regarding insulin, nutrition, and target start and finish glucose value. I find it essential to fine-tune my insulin dosages and carbohydrate intake based on the demands of the exercise. For instance, I may reduce my basal insulin or take additional fast-acting carbohydrates before long and high-intensity workouts to prevent hypoglycemia. Most of the time, I try to perform endurance sports with a minimal active insulin deriving from my last bolus. This does not mean I exercise without insulin as I am using the pens, not an insulin pump, therefore I am never without basal insulin, meaning that there is always some basal active insulin in the body.

After exercise, I focus on replenishing glycogen stores with balanced meals that include protein and moderate carbohydrates. As I mention here, I consume carbohydrates in a smart way, meaning that I plan their consumption around physical activity, on the other days my diet is reduced in carbohydrates.

While I follow a standard method involving careful carb counting and insulin administration, I have developed some practical strategies or 'hacks' that help me manage glucose levels effectively before and after workouts.

These include monitoring my glucose levels more frequently, using a continuous glucose monitor (CGM) for real-time data, and adjusting my insulin or carbohydrate intake in response to any unexpected glucose fluctuations. When I exercise after a meal, I adjust my current insulin to carb ratio from 1:20 grams to 1:30 grams. Moreover, most of the time I reduce my basal insulin the day before if I am expecting an endurance effort the next day. This personalized approach allows me to maintain glucose stability and optimize my performance during various types of exercise.

1. Avoid injecting insulin between two and two and a half hours before exercise
2. Make sure to have a banana or Gluc Up gel with me during the training
3. Combine fast absorption carbs with protein
4. Keep track of nutrition and glucose management

Strength Training

Strength training is considered an anaerobic activity, and it is characterized by heart rate spikes. My training plan involved one or two sessions of strength every week. In my opinion, strength training is usually undervalued and not pursued correctly by women who prioritize cardio training, with the belief that it is more efficient to lose weight.

During my strength workout, I don’t expect to experience low glucose events. If the strength training is a max effort training, the tendency is to experience a blood glucose increase. However, if strength training turns into endurance training with weight, glucose levels could drop steadily. Before strength training, I make sure my starting glucose is in range, not too low >3.9 mml/L (>70 mg/dL) and not too high <13.9 mml/L (<250 mg/dL), to perform heavy lifting safely and focus on technique exercises. Nutritionally, I ensure to eat the right amount of protein intake before and after the workout. Before, during and after exercise I check my glucose to avoid any hypoglycemia or hyperglycemia.

Below I will summarize the integration strategy I adopt if I am about to perform a mixed (aerobic and anaerobic) activity for 1 hour, like an endurance strength training session.

Under 65 mg/dL

Assume 15g of simple and fast carbohydrates

Assume 20g of long-lasting carbohydrates

Between 130-180 mg/dL:

Assume 20g of long-lasting carbohydrates

Above 250 mg/dL:

Do not assume any food