Type 1 Diabetes and Running: Finding the Balance

Whether you have been an avid runner your entire life or a couch potato contemplating the crazy pastime of running, a type 1 diabetes diagnosis doesn’t have to hold you back.

And, of course, one thing you’ll never hear a runner say after a run is, I wish I hadn’t done that. However, if you have T1D, you might hear it—if they aren’t prepared. Before running with T1D, run down our checklist to ensure you’re up for the charge.

Here are seven helpful tips about running with type 1 diabetes.

The Top 7 Things to Know about Running with Type 1 Diabetes Before You Begin

1. Check with your doctor first.

 If you wear an insulin pump, your healthcare team may suggest adjusting your exercise settings. Also, it’s best to have a physical to check your blood panels and ensure you’re in prime condition before getting the green light. Chances are you’ll experience a physical, mental, and emotional boost with running—all great reasons to start without delay.

2. Running improves the body’s absorption of insulin. 

Besides building muscle, maintaining body weight and improving aerobic activity to keep your heart healthy, running increases insulin sensitivity, meaning your cells respond to insulin better.

The American Diabetes Association explains that the body’s muscle cells are better equipped to use insulin during and after a workout. When the muscles contract, your cells use glucose for energy, whether insulin is available or not.

3. T1Ds should check their blood sugar before, during and after running.

Everyone with type 1 diabetes is different. From the amount of insulin they need for food and exercise to how their body handles stress. This is why knowing how your blood glucose responds to movement is important. Your body may react differently to different sports at different times of the day.

Understanding the patterns can prevent hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Also, if you’re not wearing a continuous glucose monitor (CGM), checking levels every 30 minutes is essential.

Pro Tip: The risk of hypoglycemia remains up to 24 hours after an intense workout.

4. How to Combat Lows During a Run. 

The National Institutes of Health report that increasing glucose consumption (food) and decreasing insulin for exercise are often recommended to maintain safe blood glucose levels. Blood sugar levels can fall quickly during activity, and as you exercise, falling glucose levels may intensify through the workout. This is why catching and treating lows is vital before they drop too substantially. The runner should stop running until the blood sugar rises to normal levels before running again.

For this reason, you should never run without glucose tablets, gels, or juice. The NIH also stresses that as CGMs prevent hypoglycemic episodes during physical activity, it’s important to note that glucose levels might be slightly lower than displayed on your CGM.

Get to Know Your Body and Know the Symptoms of Low Blood Sugar, which include, but are not limited to:

• Feeling weak
• Dizzy
• Light-headed
• Shaky
• Hungry
• Confused
• Sweating‍

‍Pro Tip: Low blood sugar may be harder to identify and correct while exercising.

5. How to fuel up before a run. 

Running burns calories and blood glucose, so it’s important to eat first—though when, what and how much is key. Eating a heavy meal right before might give you a stomach ache, so like swimming, try waiting a bit before hitting the pavement. It’s best to see through trial and error. Remember, what works for one T1D is not best for all. Listen to your body and find a good balance.

When to Eat?

It’s good to not only eat a light snack before a run but after as well. Your body needs fuel before and afterward—for its recovery. Runner’s World suggests that T1Ds eat a small combination of protein, carbohydrate, and fat. A quick digesting, nutrient-filled snack is ideal.

What to Eat?

Some snack/meal ideas include:

• Toast with peanut butter
• Bagel with turkey
• Egg white omelet with toast
• A Cliff protein bar
• A banana with a few nuts
• Sports drinks, Glucose gel, glucose tablets
• Crackers
• Dried Fruit
• Oatmeal with fruit
• Grilled chicken or baked potato

Also, if you run later in the day, your meal should include fat, protein and long-lasting carbohydrates a few hours before a run.

6. Adjust glucose levels before, during and after running. 

Again, you should always consult your physician for your personal exercise plan and what levels to set, but most experts recommend that your glucose levels be slightly higher pre-workout, around 126-180 mg/dL. If your glucose levels are lower than 126 mg/dL, the individual should consume 10-20 grams of fast-acting carbohydrates.

Pre Workout

Also, note that your blood sugar should be in the safe range before running.

If your blood glucose is less than 100 mg/dl — your blood sugar level might be too low. If glucose levels exceed 90 mg/dL, even more carbohydrates are advised, around 30-40 grams.

Around 126 – 250 mg/dL —is the safest range to begin.

If you’re over 250 mg/dL — you should bring your glucose levels down before beginning.

Post Workout

If your blood glucose levels are 100 or lower post-workout, having a small 15-20 carb snack (without insulin dosing) might be a good idea to avoid a low blood sugar episode.

Pro Tip: Stay hydrated; even mild dehydration can affect your blood glucose levels.

7. Carry T1D identification. 

If you run alone, you should wear some kind of identification in case of an emergency. Have your medical information ready, your emergency contact information on hand, and always let someone know where you’re going and when you’re expected to return. It’s best to run with a buddy when you can.

Be Safe and Strong

Type 1 diabetes challenges every aspect of your life but shouldn’t hinder what you can and cannot do. However, the fear of hypoglycemic episodes is real. Listen to your body, work through issues with your healthcare team and find a workout that works for you. Don’t give up—educate yourself; technology like CGMs are incredible life-saving tools if you can access them.

And if you need inspiration, look at all the T1D professional athletes who battle through it daily! Check out Eric Tozer, who made history by becoming the first T1D to complete the World Marathon Challenge by running seven marathons on seven continents in seven days!