Table 7.

Suggested strategies based on pre-exercise blood glucose levels

Pre-exercise blood glucose levels	Carbohydrate intake or other actions
<90 mg/dL	Consume 15–30 g of fast-absorbing carbohydrates prior to the start of exercise, depending on the level of exercise: This may not be necessary for exercises of less than 30 minutes, or high-intensity exercises such as weight training or interval training.
	Additional carbohydrate intake is required for prolonged moderate-intensity exercise (depending on blood glucose levels, consume an additional 0.5–1 g of carbohydrate per kg body weight every hour of exercise).
90–150 mg/dL	Start consuming carbohydrates at the beginning of most exercise (0.5–1 g of carbohydrates per kg body weight every hour of exercise), depending on the type of exercise or insulin activity level.
150–250 mg/dL	Delay carbohydrate consumption until blood glucose decreases below 150 mg/dL, after starting an exercise.
250–350 mg/dL	Test for ketones and stop the exercise if a medium to high amount of ketones is detected.
	Start with low- to moderate-intensity exercise. Since high-intensity exercise can lead to hyperglycemia, these exercises should be delayed until blood glucose falls below 250 mg/dL.
≥350 mg/dL	Test for ketones and stop the exercise if a medium to high amount of ketones is detected.
	If no ketones are detected, adjust the pre-exercise insulin dosage (generally to about 50%) based on insulin activity level.
	Start with low- to moderate-intensity exercise and avoid strenuous exercise until blood glucose levels fall.