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Everyone should do some form of physical exercise if they are to keep healthy. A body in good general condition can withstand hardships better. However, exercise must be enjoyable and should not be something one is forced into. Some like sports while others prefer to sit quietly with books, the television or a computer. We must adjust the insulin treatment to the individual, not the other way around.

Everyone should be encouraged to take part in some form of regular physical activity, even if it is only riding a bicycle to and from work or school, and people with diabetes are no exception to this. Regular physical exercise can help lower cardiovascular risk factors (overweight, hypertension, high blood lipids) in adults and adolescents with Type 1 diabetes. In contrast, the pronounced lack of exercise and muscular activity in some teenagers seems to contribute to an increased insulin resistance, a tendency to be overweight and a deterioration in blood glucose control. When your muscles are working, the store of glucose in the muscles (muscle glycogen, approximately 400 g in an adult person) is used first. After this, glucose from the liver and fatty acids (breakdown products from fat) are used as fuel.

Exercise lowers the blood glucose level by increasing glucose uptake into the muscle cells without increasing the amount of insulin needed. This is because more glucose is consumed by your muscles during exercise. After exercise, the muscles will have increased insulin sensitivity for 1-2 days, leading to an increased risk of hypoglycaemia up to 24 hours after exercise. This means that exercise 3-4 times a week will result in increased insulin sensitivity even between the training sessions, and the total insulin dose can probably be lowered. Sometimes the increased insulin sensitivity does not begin until 4-6 hours after the exercise and may occur during the night if you exercise in the evening.

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