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Finding the right balance between exercise, food, and insulin



Justine Bode Lyons, Team Novo Nordisk medical team

Finding the right balance between exercise, food, and insulin can be challenging and part of my job is to assist riders with decisions during training and racing.

As a nurse and certified educator, I provide diabetes self-management education to Team Novo Nordisk athletes and encourage self-monitoring of blood glucose.



One of our main goals at Team Novo Nordisk, a global all-diabetes sports team of cyclists, triathletes and runners, spearheaded by the world's first all-diabetes professional cycling team, is to help our athletes learn how to keep their blood glucose (or sugar) levels in an ideal range during exercise.



All athletes on the men's professional cycling team wear continuous glucose monitors and I look for patterns in these data and their blood glucose data.  Based on this information, I recommend adjustments to their nutritional and insulin regimens.  Additionally, when I am on-site at a race or a training camp, I record the riders' blood glucose levels before, during, and after races and advise them on insulin adjustments and nutrition.

Below are some recommendations regarding mealtimes for our riders and other people managing diabetes whilst living an active lifestyle:

  • Self-monitoring of blood glucose before, during, and after exercise can help fine-tune insulin needs at mealtimes and prevent or treat blood glucose levels that are out of range.
  • Maintaining a log of blood glucose data along with insulin doses, carbohydrates consumed (in grams), and type of exercise can show trends in glucose during various exercise conditions.
  • Athletes and those who regularly exercise should carry fast-acting carbohydrates at all times and be prepared to treat "lows" (i.e., hypoglycaemia).  Alternatively, if blood glucose is above target prior to exercise, a correction dose of insulin may be needed.
  • Exercise increases insulin sensitivity and on longer training days, there is a greater risk of hypoglycaemia. Athletes or those undertaking longer exercise sessions (e.g., long distance running) should consume additional carbohydrates during endurance exercise.  The amount of carbohydrates needed varies per individual.
  • For short, intense exercise sessions, additional carbohydrate or insulin adjustment may be unnecessary, as blood glucose can actually rise during this type of exercise.  If blood glucose levels rise too high, this is called hyperglycaemia and can cause short-terms symptoms.
  • Endurance athletes should consume a recovery meal within one hour after exercise to replenish muscle and liver glycogen stores.  This is also a critical time to properly hydrate and replace electrlytes.
  • Overnight blood glucose levels should be monitored following exercise.  To prevent nocturnal hypoglycaemia after exercise, a bedtime snack or reduction in basal insulin may be needed.



This page is intended for members of the UK public
UK/WB/0916/0053(1) November 2016

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