Question 1

What blood glucose should someone with type 1 diabetes have before exercise?

Accepted Answer

Around 7 to 10 mmol/L is a common starting range for aerobic exercise, individualised with the diabetes team. Below 5 mmol/L, take 10 to 20 g of carbohydrate and delay until glucose is above 5 mmol/L. Above 15 mmol/L, check blood ketones first.

Question 2

When should someone with type 1 diabetes not exercise?

Accepted Answer

Exercise should be avoided if blood ketones are 1.5 mmol/L or more, or after a severe hypoglycaemic episode in the previous 24 hours. Ketones of 0.6 to 1.4 mmol/L should be addressed before exercising.

Question 3

Does exercise cause hypoglycaemia in type 2 diabetes?

Accepted Answer

Mainly in people taking insulin or a sulfonylurea such as gliclazide, whose doses may need adjusting. Metformin alone does not typically cause hypoglycaemia, so a person on metformin alone does not usually need carbohydrate before exercising.

Question 4

How long after exercise can hypoglycaemia happen?

Accepted Answer

The risk stays raised for up to 24 hours, with most episodes 6 to 15 hours afterwards. Evening or prolonged sessions carry the highest risk overnight, so monitoring, extra carbohydrate and a reduced overnight insulin dose may be needed.

Exercise in Diabetes

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