4-6-2 Reducing Hypoglycaemia During Exercise
Practical insulin and fueling strategies to prevent low blood glucose in sport
Physical activity increases insulin sensitivity and muscle glucose uptake, which can lead to hypoglycaemia in people living with type 1 diabetes. The risk depends on insulin on board, exercise intensity, duration, and timing. The following strategies help reduce low blood glucose during and after exercise.
Reduce Pre-Exercise Bolus by 50–70%
Pre-Exercise Carbohydrate Intake
Repeated Small Carbohydrate Doses During Exercise
Reduce Basal Insulin by 50–80%
Set Higher Temporary Glucose Target (Closed-Loop Users)
Reduce Post-Exercise Basal by 20% for 6 Hours
Avoid Unnecessary Pump Suspension
Use Short Sprints During Aerobic Exercise
Caffeine Before Exercise
• Risk depends on insulin on board
• Aerobic exercise increases hypoglycaemia risk
• Repeated lows reduce counterregulatory response
• Keep an activity and glucose diary
• Individual testing is essential
Related Articles
2-3-1 What is Hypo and How to Manage It?
Recognising low blood sugar and staying safe during physical activity
2-3-3 Severe Hypoglycaemia
Recognising, preventing, and responding to dangerous low blood glucose during physical activity
1-3 High Blood Glucose Levels: A Step-by-Step Quick Guide
Safe actions to control high blood sugar during sport and daily activity
2-3-2 Hypo Unawareness in Type 1 Diabetes
When low blood sugar happens without warning signs
5-1-2 Glycemic impact
Understanding glycaemic index, carbohydrate timing, and fuel strategies in type 1 diabetes
