Diabetes and outdoor activities: Making the most of days out

Diabetes and outdoor activities: Making the most of days out

Staying physically active is key for your health and wellbeing if you have diabetes [1], and outdoor activities are a great way to stay fit while having fun [2]. 

However, engaging in physical activity or simply being outside for longer may require extra precautions if you have type 1 diabetes [1, 3]. For example, you may have to adjust your insulin dose or other medication you’re taking [1, 3]. You’ll also need to wear appropriate footwear [1], plan your meals, and stay hydrated while you’re out and about [3]. 

But just because you have diabetes, it doesn’t mean that you need to stop exercising or miss out on fun — you just need to be a bit more careful. 

In this article, we cover some of the precautions you may need to take when engaging in outdoor activities with diabetes. We also review diabetes-friendly activities and give some top tips to help you make the most of your day out.

Understanding how diabetes can impact outdoor pursuits

Diabetes can affect physical activity and outdoor pursuits in several ways. 

First of all, it’s worth noting that physical activity is not just exercise [1, 3]. Physical activity includes any activity that involves you moving around and spending energy [1, 3]. This includes planned exercise, such as going to the gym, but also daily activities like cleaning the house, gardening or running after the bus [3]. 

How does physical activity affect blood glucose levels?

Different types of activities will have different effects on your blood glucose levels [3]. 

For example, aerobic exercise like swimming, cycling or running may lower your blood glucose levels [3]. 

On the other hand, anaerobic exercise (like sprinting or powerlifting) may increase your blood glucose [1, 3]. 

How outside temperature can impact your blood glucose

Being outside can sometimes expose you to very high or very low temperatures, which can impact your blood glucose [4, 5]. High temperatures can change how your body uses insulin, for example, and sunburn can raise blood glucose [4]. Being dehydrated may also raise blood glucose [1, 4].

On the flip side, being outside in cold temperatures may cause your blood glucose to shoot up due to the stress that cold temperatures place on the body, triggering a chain reaction of hormones [5].

Precautions to take when engaging in physical activity

Like any physical activity, outdoor pursuits that spend your energy will sometimes require adjusting your treatment, particularly if you have type 1 diabetes [1, 3]. 

For example, if you have type 1 diabetes and you take up gardening, hiking, or playing a fun sport with your friends, you need to make sure your blood glucose stays within your target range by adjusting insulin or carbohydrate intake [3]. To ensure this, you’ll need to test your blood glucose more often than normal [3]. 

Not taking precautions during exercise may cause hypoglycaemia episodes (very low blood glucose) or hyperglycaemia (very high blood glucose) in people with type 1 diabetes and to a lesser extent, in people with type 2 diabetes [1].

Outdoor activities and diabetes complications

If you have developed certain complications from diabetes, you may wish to avoid certain outdoor activities [1]. For example, if you have cataracts, the American Diabetes Association (ADA) recommends you avoid outdoor cycling, as it may be dangerous due to reduced vision [1]. 

The ADA further recommends you avoid exercising outdoors on very hot or very humid days if you’re older and have diabetes to avoid heat-related illness [1]. For the same reason, the ADA recommends avoiding outdoor exercise if you have [1]:

• Autonomic neuropathy (nerve damage that affects your internal organs)
• Cardiovascular complications 
• Lung disease

The benefits of outdoor activities for managing your diabetes 

The benefits of outdoor activities for managing your diabetes

Outdoor activities like playing sports with your friends, gardening, climbing, or playing frisbee in the park can be a great way to stay fit and reap the benefits of physical activity while having fun [2]. 

Physical activity has a plethora of benefits for people with diabetes, including [1]:

• Improved insulin sensitivity and lower insulin resistance
• Lower risk of diabetes complications [3]
• Better cardiac function
• Better lung function
• Stronger immunity
• Lower blood glucose levels (for people with type 2 diabetes)
• Lower blood pressure 
• Lower levels of ‘bad’ cholesterol and triglycerides

Additionally, exercise improves physical strength, muscle mass, bone density and mental health for all adults [1]. 

Last but not least, the release of ‘happiness-inducing’ endorphins after a good workout can improve your overall wellbeing and put you in a good mood [3].

The benefits of simply being outside

Being outside makes it more likely that you’ll be physically active and reap the benefits of physical activity [6].

Not only that — research shows that simply being outside holds hidden health benefits, too. For example, studies have suggested that being exposed to nature and green space can [7]:

• Reduce the risk of type 2 diabetes 
• Reduce the risk of cardiovascular disease
• Reduce the risk of premature death 
• Lower stress
• Lower blood pressure
• Improve overall health and wellbeing

Diabetes-friendly outdoor activities

Diabetes-friendly outdoor activities

Most outdoor activities are suitable for people with diabetes as long as they take the necessary precautions [8]. No specific exercise is better than another, and the key is to find something you enjoy [2, 3]. 

That said, here are some ideas for diabetes-friendly outdoor activities to get you started [1, 2, 3]:

• Long walks and hikes
• Brisk walking or jogging
• Rock climbing
• Kayaking
• Playing frisbee in the park
• Playing sports with friends, such as football or netball
• Cycling
• Swimming
• Dog walking 
• Gardening or mowing the lawn
• Running or training for a marathon
• Outdoor yoga or tai-chi

Preparing for outdoor activities when you have diabetes

Here are some tips to help you prepare for outdoor activities. 

Store your supplies safely 

When planning an outdoor activity, it’s a good idea to pack your diabetes supplies and some emergency items just in case [5]

Keep your medicines and supplies away from extreme temperatures [5]. Remember that insulin should be kept at a cool temperature, away from direct heat, but also away from freezing temperatures [4, 5]. Try storing it in a cooler instead, at an optimum temperature [4].

Stay hydrated

Staying hydrated by drinking plenty of water is particularly important for people with diabetes [4]. 

If you have diabetes you’re more likely to dehydrate, and dehydration can raise blood glucose [4]. On top of this, some medications that you may have to take can cause dehydration [4]. If it’s hot outside, drink water even if you’re not thirsty [4].

Pack snacks in case of hypos

As well as staying hydrated, you may want to pack food in case you have a hypo — low blood glucose can be very serious [9].

If your blood glucose levels are low, you may need to eat a small snack containing 15-30 grams of carbohydrates, such as two tablespoons of raisins, half a cup of fruit juice or regular fizzy drink (not diet) [9]. You can also take glucose tablets so your blood glucose levels doesn’t fall too low while you’re out and being physically active [9].

Take good care of your feet

You’ll need to look after your foot health to prevent any diabetes-related foot problems [1]. Here are some tips to take care of your feet while being outdoors:

• Don’t walk barefoot, even if you’re at the beach or pool [4]
• Wear comfortable cotton socks and athletic shoes if you’re going to be physically active [9]
• After an activity, check your feet for blisters, sores, cuts or any signs of skin irritation [9]

To find out more about why looking after your feet is so important, read our article on diabetes and foot health.

Check your blood glucose often and adjust your treatment

Checking your blood glucose before, after, and ideally during exercise is key for keeping your blood glucose within range [3, 9]. 

If your blood glucose is low, you may have to have some carbohydrates before you exercise [3]. If your blood glucose is high, you may need to up your insulin dose [3]. If you’re engaged in intense physical activity for longer, you may have to take a break and have a snack [3]. 

Finally, it’s important to check your blood glucose right after you’ve stopped exercising, but also a few hours after you’ve stopped — your blood glucose may continue to drop slowly after an intense bout of exercise [3]. This may raise the risk of hypoglycaemia, especially at night [1]. You may have to have a bedtime snack or adjust your insulin dose to prevent this [1].

If you’re taking other diabetes medication instead of or in addition to insulin, their dose may also have to be adjusted when you exercise [1]. Speak to your healthcare team about having a plan in place for when you are more physically active [3], or if you need help adjusting your insulin dose [4].

Engaging in outdoor physical activity can yield vast benefits for your health and well-being [1, 2]. Outdoor activities are a great way to stay fit while having fun [2], but make sure you take the necessary precautions if you have diabetes [8].