Understanding Activity and Exercise : University College London Hospitals NHS Foundation Trust

Being active is important for health. We all need to do regular activity as a part of a healthy lifestyle. This information is to help young people with diabetes understand a bit more about physical activity and exercise.

Movement is good for everyone.

Being active is good for:

Heart Health	Bone Health	Sleep	Fitness	Insulin Sensitivity	Wellbeing

For someone living with diabetes being active can affect your glucose levels. Different types of activity can have different impacts. Understanding a bit more about exercise intensity can help you to manage your glucose levels.

Physical activity is any movement produced by the muscles of the body that requires energy. It is part of daily life, for example walking to school or shops, helping the with housework or gardening, playing.

Exercise is planned, structured physical activity with the goal of improving or maintaining fitness or strength or developing a sports skill.

5–18 year olds are advised to do 60 minutes of moderate to vigorous intensity activity every day. 30 minutes a day of this activity should be outside of school

What does that mean?

Moderate to vigorous activity is any activity that gets your heart beating faster and makes you feel slightly breathless.

You can use something called the Rate of Perceived Exertion (RPE scale) or Borg Scale to figure out your exercise intensity.

0	Sitting, lying down, no activity
1	Very, very easy light activity, breathing doesn't change, very easy to talk and move
2-3	Light activity, breathing a bit faster but still easy to talk whilst being active
4-6	Moderate activity, breathing is faster but you can still talk and hold conversation with some effort
7-8	Vigorous activity, breathing is harder and so is talking
9	Very vigorous activity – hard work to keep going or talk at the same time
10	Maximum effort – can't talk and keep going, just keeping going is difficult

To meet the activity guidelines, try and do activities that would score between 4 and 10 every day.

The recommendations also say that you should do some activities that help to strengthen bones and muscles.

What does that mean?

Bone strengthening activities include walking, running, playing sports like football, hockey, netball and rugby, where you are on your feet. Resistance exercises using body weight, resistance bands or weights all help to build and strengthen muscles. For example, push-ups, squats, sit ups.

Exercise intensity is how hard we are working when we are being active. If you have type 1 diabetes, we know that different types of activity will have different impacts on glucose levels.

We divide physical activity into 3 types, based on the main energy systems used.

Aerobic	Mixed	Anaerobic

Usually lowers glucose levels	Glucose levels may rise, fall or be stable	Glucose levels usually rise
Walking, jogging, cycling, fitness training	Team sports football, rugby, netball, hockey. Some individual sports like tennis, gymnastics.	Sprint based sports, competition, strength and power sports

Sometimes the same activity will have a different impact depending on how hard you are working. For example, a football training session may lower your glucose levels, but a football match may push them up.

You can use the RPE scale to help identify what may happen to your glucose levels Aerobic activity which lowers your glucose levels is usually between 2 and 8 Anaerobic activity which pushes glucose levels up is usually between 7 and 10.

An activity diary can help you to understand how any regular exercise or training affects your glucose levels. If you know about how your glucose levels respond to different activities, you can take steps to prevent low or high glucose levels.

When an activity is new, always treat it as if it will lower your glucose levels until you learn what happens.

Use the information on the website to guide you with insulin adjustments and exercise snacks to help manage glucose levels. If you need help or advice, ask for an appointment in the exercise and diabetes clinic.

Moving more helps to keep glucose levels in range. Short bursts of activity (10–20 minutes) across the day can help keep glucose levels in range without causing hypos. Regular short bursts of activity should not need extra snacks.

When we move, we increase the amount of glucose that moves into the active muscles. Twenty minutes of gentle movement will lower glucose levels by about 2mmol/L if insulin has been given in the last 2–3 hours.

If you need ideas for ways to be more active as a family, the links below may help.

For children and young people and family’s: