By Carla Cox, PhD, RDN, CDCES, CSSD
Regular physical activity is a cornerstone of health. Yet with all the known benefits and its impact on overall health, most adolescents do not meet the recommended 60 minutes of activity daily. Teens with diabetes have even more challenges than the suggested lack of time and motivation. These barriers include maintaining stable glucose values during and post exercise and fear of hypoglycemia.
As we counsel young people with type 1 diabetes, physical activity patterns are often overlooked as an important recommendation for health. With a focus on glucose management and dosing for carbohydrates, assessing physical activity and making recommendations can fall down the list of topics discussed.
There are excellent consensus papers that provide guidelines for exercise in children and adolescents that will help set the framework for the discussion. Generally, the concern is risk of hypoglycemia during and post exercise, which remains the biggest challenge even with the automated insulin delivery systems.
Impact of Strength Training in Young Adults
It has been recognized that in adults with type 1 diabetes, strength training prior to aerobic exercise improves glucose stability and reduces the risk of hypoglycemia. So the question becomes, is that true for adolescents with type 1 diabetes? And could that have the potential to reduce one of the perceived barriers to regular physical activity for this group of individuals.
In recent research by Sarnblad et. al., this question was examined. It was a small study of 8 active males with type 1 diabetes. The subjects performed four experimental sessions of a control, resistance and continuous exercise. The outcomes demonstrated that although aerobic exercise resulted in lowering of glucose, resistance exercise resulted in stable glucose following the activity. In such a small study, can we take the information and put it into practice, or must we wait for more data?
Although the sample size was small, it is consistent with larger studies on adults with type 1 diabetes. Results demonstrate:
- Resistance exercise prior to aerobic exercise in those concerned about hypoglycemia has no harmful implications and may help to sustain glucose within target range.
- This advice can be incorporated into the other recommendations that include: setting a higher glucose target 60-90 minutes prior to activity and recommendations for carbohydrate ingestion prior to and during activity.
- The concept that resistance activity reduces the risk of hypoglycemia.
It is a win/win recommendation and can be included in our general exercise guidelines as we wait for verification with more studies.
For more information on diabetes in young adults, visit DiabetesEducator.org/Pediatrics.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
Copyright is owned or held by the Association of Diabetes Care & Education Specialists and all rights are reserved. Permission is granted, at no cost and without need for further request, to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered, and proper attribution is made to the Association of Diabetes Care & Education Specialists.
HEALTHCARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or healthcare provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit DiabetesEducator.org/Find.