Plan a session
Think ICE - insulin, carbohydrate, exercise - before you start. Then follow the three steps: before, during and after. This is the page to come back to every time.
Start with the tool
GlucoseGo - is now a good time?
Tell it your glucose, your trend arrow and how long you plan to move. It tells you your risk of going low and what to do - in under a minute.
Example
The three-letter check
Think ICE: insulin, carbohydrate, exercise
These are the three things you can change. Ask yourself about each one before you start, and you will avoid most problems before they happen.
Insulin
How much insulin is still working?
Insulin lowers your glucose. If you have a lot still working when you start, a fall is much more likely. Think about when you last gave a dose.
Carbohydrate
Do I need carbs before or during this?
Carbs are your main fuel. For longer or harder sessions you may need to top up with fast carbs like glucose tablets.
Exercise
What am I doing, and for how long?
Steady, hard and mixed exercise all affect your glucose differently. Knowing which you are about to do changes your plan.
Step 1
Before you start
Check your glucose and your trend arrow. Where you begin makes a big difference to how the session goes. Aim to start between 7 and 10 mmol/L.
Below 5 mmol/L
Too low to start. Have 15 to 20 g of fast carbs and wait until you are above 5.
7 to 10 mmol/L
A good place to start for most exercise. Keep some carbs with you.
Above 14 mmol/L
Check for ketones first. If they are raised, do not exercise - speak to your diabetes team.
Watch your arrows. A falling arrow means your glucose will keep dropping once you start moving. The direction matters more than the number on its own.
Step 2
While you are moving
Check your glucose every 20 to 30 minutes. How many carbs you need each hour depends on how hard you are working.
The sprint trick. If your glucose is falling, a ten-second all-out sprint can help steady it. Your body releases stored glucose to fuel the effort.
Step 3
Afterwards
Your body keeps refilling its glucose stores for up to a day and a half after exercise. That means a low can happen much later - including while you are asleep.
Eat carbs with your next meal. Do not skip it.
You may need less insulin with that meal, and less overnight. Your diabetes team can help you find the right amount.
If you exercised in the afternoon or evening, check your glucose before bed. A small snack can stop an overnight low.
Fuel, safety and special cases
More detail, when you want it
You do not need these to get started. Open the one you need.
Fuel and foodWhat to eat, when, and how much.
- Fast carbs (glucose tablets, jelly babies, juice) work within minutes - use them during exercise or to treat a low
- Slower carbs (bread, pasta, porridge) release glucose over a longer time - better before a long session
- Too little and you run out of fuel; too much and your glucose climbs higher than you want
Staying safeWhen not to exercise, and what to carry.
- Do not exercise with raised ketones, chest pain, or if you feel unwell - speak to your team
- Always carry fast carbs and a way to check your glucose
- Tell the people you are with that you have Type 1, and where your hypo treatment is
Special situationsPregnancy, diving, skiing, altitude and travel.
- These need a plan made with your diabetes team, not a general rule
- Cold and altitude can change how your sensor reads and how your body responds
- Long trips need extra supplies, a backup meter, and time-zone planning for your insulin
If the simple plan is not workingAdvanced options to try next.
- Change how much you reduce your mealtime insulin, in small steps
- Adjust your background insulin for the day of a big session
- Keep a record over several sessions before making bigger changes - and share it with your team
Carbs for my activityWork out the carbs you need each hour for 30 different activities.
Find what you are doing. The first number is the carbs you need for each kilogram you weigh, every hour. Put your weight in below and the last column works it out for you.
Walking
Running
Cycling
Swimming
Team sport
Racquet sport and golf
Skiing
Dancing
Around the house
Do not take it all at once. Spread it through the session - split it into three and have some at the start, some part way through and some near the end. Example: Ben cycles for an hour at 18 miles per hour and weighs 75 kg. That is 150 g, so he has 50 g at the start, 50 g at 20 minutes and 50 g at 40 minutes.
Carbs from how hard it feelsThe Borg scale - use this when your activity is not in the list above.
Score how hard the effort feels from 6 (sitting still) to 20 (as hard as you can go). Then read across.
Spread these carbs through the session too. Example: Rob works at a score of 13 for an hour and weighs 90 kg. That is 90 g, so he has 30 g at the start, 30 g at 20 minutes and 30 g at 40 minutes.
These numbers are a starting point, not a rule. Check your glucose and change them to fit what you see. Your diabetes team can help.
Your next step
Set up your technology
Whether you use injections, a pump or a closed loop, there are small changes that make exercise easier.