Gear, weather, water and existing complications

This page covers the practical side of staying active: keeping your devices on and reading correctly, how the environment changes your glucose, and what — if anything — changes when you already live with complications. The short version on complications: very little.

Gear that has to survive the session

Where the sensor goes

At least an inch (about 2.5 cm) from an infusion site. Away from impact zones in contact sport, and off the lower back for anyone rolling or tumbling — wrestling, judo, gymnastics.

Keeping it stuck on

Sweat, heat and water all defeat adhesive. Clean and fully dry the skin, then use a barrier wipe or an overlay patch.

False lows from pressure

Tight compression clothing, or lying on the sensor, can produce readings that are simply wrong. Odd overnight dips after training are often this.

Taking the pump off

Disconnecting is fine for swimming, water sports or contact sports. But past about 90 minutes off, you need a plan to replace the missed insulin, or you may come back high with ketones climbing.

In young children, the named hazard is simply forgetting to reconnect afterwards. Set a phone alarm.

Some competitions don't allow devices to be worn. Check the rules in advance rather than at the start line.

Heat, cold, altitude and water

Cold slows insulin down — and it breaks meters. A glucose meter kept below freezing may refuse to read, or read wrongly. A sensor is the better choice for winter sport, which matters in a Québec winter: think skating, skiing and snowshoeing.

Altitude. Meters can read inaccurately high up, appetite drops, and energy use rises. Thin air also makes for poor decisions, so make your plan on the ground.

Diving with type 1 needs its own specialist protocol and is not something to improvise.

The consensus statement singles out four settings as unsafe after any recent low: alpine skiing, climbing, trekking alone and open water.

If you already have complications

The consensus position comes first: the benefits of being active outweigh the risks of being sedentary, and people with complications still gain plenty from gentle activity at very little risk. Few real restrictions exist. These are the ones that do.

• Eyes. With advanced retinopathy, very heavy lifting, straining and head-down positions need clearing with an eye specialist first.
• Feet and nerves. Numb feet don't report blisters. Wear proper footwear, and look at your feet after every session — not just when something hurts.
• Kidneys. Exercise does not make kidney disease worse, despite a temporary rise in protein in the urine afterwards. Activity may actually slow it down.

Over 40 and planning something very hard or very long? Diabetes Canada suggests a check-up first, including eyes, feet and heart.

Don't over-medicalise a walk

The American Diabetes Association pushes back on over-screening. For people with type 1 at any age, the only common exercise-related adverse event is hypoglycemia. Screening makes sense before something very demanding; it shouldn't stand between anyone and a decision to go for a walk.