Physical Activity + Type-1 Diabetes

Lindsey Smith, RD, LD

Heading back to school with after school sports practices and games, robotics clubs, and weekend tournaments can be difficult to plan ahead for but see these tips from the McNeely Diabetes Clinic’s Registered Dietitian, Lindsey Smith, to keep activities fun and safe!

People living with diabetes can play sports and be physically active, just like anyone else! In fact, daily physical activity is important for everyone, regardless of diabetes. Being physically active can have many benefits on our health and well being, including:

  • Greater concentration in school
  • Improved self-esteem and confidence
  • Regulation of blood glucose levels
  • Reduced cholesterol/lipid levels and risk of heart disease
  • Decreased stress and improved mood
  • Improved sleep quality


For individuals living with type-1 diabetes, it is very important to balance your insulin doses with the food you eat and the activity you do. With a little planning, physical activity can absolutely be a part of your daily routine!


Plan Ahead

Most physical activity will cause blood glucose to drop and can result in hypoglycemia (low blood sugar, defined as <70 mg/dL). Monitoring your blood glucose before, during, and after activity is crucial in understanding how a specific activity affects you. All activities are not created equal! The type of exercise, intensity, and duration act on an individual basis, and the better you understand how your glucose is affected the better you can control it. Use the table below as a guideline prior to activity:


Exercise of short duration, low to moderate intensity – 60 minutes or less! Walking, bowling, skateboarding, snorkeling, raking leaves, Moto-cross, yoga, Pilates, ice skating, playing with a pet 80-100 15-25 grams carb at the start of activity
Higher than 110 no food necessary

*Test within 30 minutes*

Exercise of moderate intensity – 60 minutes or more! Mostly aerobic.


*Test sometime between 30 and 60 minutes and every half hour after that

Swimming, jogging, golfing, cycling, tennis, volleyball, dancing, Zumba, gymnastics, horseback riding, ultimate Frisbee, elliptical, hiking, rowing, climbing, snow shoeing, skiing 80-100 25-50 grams carb at the start of activity; eat 15 grams per hour after that
110-170 15-25 grams carb per hour to maintain BG
180-300 no additional food
Higher than 300 check for ketones

*Do not exercise if positive*

Exercise of vigorous intensity with bursts of energy and rapid increases in heart rate – 60 minutes or more!


*This is higher intensity aerobic activity. Follow testing protocol above

football, hockey, baseball basketball, soccer, wrestling, strenuous cycling, swimming, circuit training, kick boxing, obstacle course


*may increase sensitivity to insulin later in the day

80-100 25-50 grams carb at the start of activity
110-170 15-25 grams carb
180-300 15 grams carb optional
Higher than 300 check for ketones

*Do not exercise if positive*


Fuel for Activity

To prevent hypoglycemia during and/or after activity, it is important to consume “uncovered” (no insulin given) carbohydrates prior, during and/or after activity if needed. Check out the lists below for carbohydrate snacks that work well with activity!


Before and/or after activity (carbs + protein):

  • Crackers with peanut butter
  • Crackers and cheese
  • Banana with peanut butter
  • Greek yogurt with fruit
  • Whole-grain cereal with milk


During activity (fast-acting carbs):

  • Gatorade or other sports drink
  • Glucose tablets (4 tablets = 16g carb)
  • Juice boxes
  • Fruit snacks
  • Energy gels or chews


Important Reminders!

  • Aim for BG of 120-180 prior to exercise. The goal is to maintain this range using nutrition!
  • Game days, try-outs, and certain team positions can cause stress and stress typically raises BG.
  • Talk with your Dietitian about choosing the right foods to fuel with and creating a specific nutrition plan.