Kerri: People with diabetes are told to be careful about working out with high blood sugars. What are the dangers of working out while at an elevated number, and what should an athlete do to combat these risks?

Delaine: A high blood sugar with the presence of ketones indicates a lack of circulating insulin. And without insulin's ability to transport enough glucose into the cells for the increased fuel/energy production during exercise, the body mistakenly attempts to provide more glucose fuel by dumping liver glucose stores … thereby raising blood sugars further. The worsening hyperglycemia and ketones negatively affects acid base balance, throws off electrolytes (such as sodium and potassium), and leads to dehydration. All things that an athlete wishes to avoid! If there is adequate insulin circulating (a meal or correction bolus, for example), that blood sugar should begin to come down. I always advise athletes who experience a high before exercise, to check within the first half-hour to 45 minutes to ensure that the blood sugar is indeed coming down. If blood sugar at that check is higher, discontinue exercise until blood sugars levels are corrected.

Kerri: What would you pack in your diabetes supply bag if you were off to do some extreme sports?

Delaine: Preparation is the key to success with diabetes in extreme sports. I'd be sure to have my meter, plenty of test strips, and extra supplies: insulin and syringes, pens, infusion sets and pump supplies for pumpers, extra batteries, glucose tabs and sport fuel foods, and E-caps (electrolyte replacement, especially if endurance exercise or in heat/humidity).

Thanks, Delaine, for your insight! If you want to talk about exercise and blood sugar management with other people living with diabetes, visit the dLife Support Forum and get involved!

Delaine Wright, MS, RCEP, CDE is an ACSM Registered Clinical Exercise Physiologist and Certified Diabetes Educator, living with type 1 diabetes herself since 1983. She is a Director and online Coach with Fit4D and is a diabetes educator at South County Hospital in Rhode Island.

About Fit4D™: Fit4D™ is an innovative service providing personalized nutrition and fitness guidance to people with diabetes. A team of diabetes specialists, including nurses, registered dieticians, exercise physiologists and trainers, helps members start or improve an exercise and/or nutrition program. Fit4D™ coaches provide the support and motivation only available from a personal coach who empowers members to achieve the sense of well-being that comes from being in control. Services are delivered in the US and Canada through live on-online classes and 1:1 individualized coaching. For more information about Fit4D, visit


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Last Modified Date: October 23, 2013

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by Carey Potash
Charlie’s 12-year anniversary with type 1 just passed and I still know nothing about this diabetes and why it hates us so much. As if to remind us that it was its anniversary, diabetes unleashed hell on Friday. Charlie was stranded well over 400 for hours and even tipped the scale at 580. Susanne pulled Charlie out of school and started what became a wartime exercise in futility. It was one of the worst blood sugar days we’ve had in years. ...