Exercising safely with Type 1 Diabetes

Exercising safely with type 1 diabetes


Regular participation in physical activity is recommended for Type 1 diabetics because the health benefits of a physically active lifestyle play an important role in their treatment. Unfortunately exercise also increases the risk of hypoglycaemia for insulin dependent diabetics. Consequently, diabetics are often reluctant to engage in regular exercise.


Our research in collaboration with the Sport Science, Exercise and Health Department at the University of Western Australia focuses on what are the best ways for patients with Type 1 Diabetes to exercise safely. Our long term aims are to develop clinical guidelines, to provide better advice for patients with the disease, and other resources to educate patients on how to prevent hypos during and after exercise.




So far we have made some novel discoveries in the field of exercise and diabetes, some of which have been incorporated into clinical practice guidelines including the 'NHRMC National Evidence-Based Clinical Care Guidelines for Type 1 Diabetes for Children, Adolescents and Adults'.  We have shown that performing a short sprint before or after moderate intensity exercise is useful for preventing or delaying hypoglycaemia caused due to exercise and that incorporating short sprints during moderate-intensity exercise decreases the risk of risk of hypoglycaemia. 


Our studies have also shown that the relationship between exercise intensity and carbohydrate requirements are not linear and the amount of carbohydrate required at basal insulin levels may be less than current recommendations, since there are many factors which effect blood glucose levels during exercise.


We are now undertaking separate studies to investigate the different factors which effect blood glucose levels during exercise. We are also performing a series of in-clinic and outpatient studies to address key 'gaps' in current exercise guidelines.

Here are some of the studies we are currently undertaking:



Exercise intensity and carbohydrate trial


We know that the amount of carbohydrates to prevent hypoglycaemia differs with different intensities of exercise, under basal insulin conditions in those withType 1 Diabetes. We now want to see if this pattern is effected by higher insulin levels - similar to the effect of exercising soon after having bolused for food. The study involves people with Type 1 Diabetes aged between 15 - 30 years.  This is an in-clinic study and involves a fitness test and four testing sessions with exercise at different intensities for 40 minutes per session.


2 Bike  exercise2


Above: Participants in some of our exercise trials 


For further information about this trial contact Vinutha B Shetty on 9340 7882 or Vinutha.shetty@health.wa.gov.au



Intravenous to oral carbohydrate trial


Previously our group has found the amount of intravenous glucose required to prevent hypoglycaemia varies with different intensities of exercise in Type 1 diabetics. However these findings were based on intravenous glucose infused during the studies performed in our laboratory. In this next phase of research we're aiming to determine the equivalent oral glucose amount required to prevent hypoglycaemia while avoiding marked hyperglycaemia during moderate intensity exercise.


Type 1 diabetics aged between 15 - 30 years will be recruited to this in-clinic study. It will involve a fitness test and six testing sessions with exercise at two different intensities for 40 minutes per session. The outcomes of this study will provide important information about carbohydrate supplementation as a strategy for minimising the risk of hypoglycaemia during exercise for Type 1 diabetics.


3 Swiming 4 Kids Running


For further information about this trial contact Vinutha B Shetty on 9340 7882 or Vinutha.shetty@health.wa.gov.au



Effect of exercise modality study


There is evidence that engaging in very short (four-second) sprints during exercise can lower the rate at which blood glucose levels fall and reduce the risk of hypoglycaemia when compared to normal exercise (without short sprints). This study aims to investigate blood glucose responses to moderate intensity exercise compared to the impact of moderate intensity exercise combined with multiple short sprints with and without carbohydrates beforehand. Our aim is to find the best way to exercise to avoid hypoglycaemia in people with Type 1 Diabetes.
This is an in-clinic study and involves a fitness test and four testing sessions. Testing sessions will involve exercise for 40 minutes with sprints, during and at the end of exercise, in some of the sessions. Participants will be given a carbohydrate drink to consume before two of these sessions.
We are looking for people aged between 14 - 35 who have had Type 1 Diabetes for more than a year to participate in this study.  

For further information about this trial please contact Wayne Soon on 9340 8742 or wayne.soon@research.uwa.edu.au 



Sprint trial


Not all forms of exercise increase the risk of hypoglycaemia. From our own work and that of others there is evidence that engaging in high intensity sprint efforts can help to prevent a fall in blood glucose levels. This may potentially be a strategy for those who want to exercise without the fear of experiencing a hypoglycaemic event. This also means that if used appropriately exercise may also be useful for preventing hypoglycaemia rather than causing it.


The 'Sprint Trial' is an 'at home experiment' that will investigate the effect of incorporating these short sprint efforts into moderate intensity exercise on individual blood glucose responses. Participants will be fitted with both a continuous blood glucose monitor (Dexcom) and an activity/heart rate monitor (Actiheart, shown in the pictures below). This study will help us to further develop exercise guidelines for people with Type 1 Diabetes.


6 Heart Rate Meter      7 Sensor


Above: The actiheart (left, heart rate monitor) and Dexcom system (right, continuous glucose monitor) to be used in the sprint trial. 


If you are interested in participating in the Sprint Trial or would like more information about the study, please contact Tarini Chetty on 9340 3319 or Tarini.chetty@health.wa.gov.au