Improving exercise with type 1 diabetes

Protein pre-exercise is the whey

“The study we are wrapping up now looks at consuming protein pre-exercise to prevent hypo during exercise,” he explains.

“In our first lab study we found that whey protein at a dose of 0.5 grams per kilogram of body weight (around 40g or two ‘scoops’ from most commercial protein powders) increases blood glucose by about 4mmol/l over three hours.

“It also increases plasma glucagon about 7-fold. The increase in blood glucose starts to happen about 30 minutes after ingestion.

“When we used that same dose of whey protein 30 minutes before exercise in adults with type 1 diabetes using automated insulin delivery, we found that during 60 minutes of cycling exercise glucose was increased and hypo risk was decreased.”

Participants across more than 80 exercise sessions recorded about a 2mmol/l difference in blood glucose at the end of exercise compared to the control group (who did not consume protein beforehand).

While around 45% of people experienced a hypo in the control group, only 6% of the ‘whey protein group’ experienced a hypo during or post-exercise.

“The study is still underway, so there has been no formal analysis. But we’re excited about the early findings and what it means for people managing type 1.”

An effective option to manage blood glucose levels

Dr Morrison says consuming protein before exercise is another “tool in the toolkit” for people with type 1 diabetes.

It does not replace current recommendations for preventing hypos during exercise (such as limiting the amount of insulin on board or eating carbohydrate), but it is another option which appears to be effective.

“The glucose response to consuming protein is more moderate and sustained compared to consuming carbohydrate, which usually results in a short but large spike in glucose,” he explains.

“This hopefully also means that not too much hyperglycaemia should occur after protein ingestion.

“What we do know from some qualitative data we have collected is that many people with type 1 (up to as many as 30%) are using protein supplements already, but the timing or amount of protein is often not optimised to prevent hypos with exercise. This is what we are hoping to provide with our research efforts.”

Consuming protein is recommended by sports nutrition guidelines for helping recovery and building muscle, but people with type 1 might also be able to use protein for its glycaemic benefits.

A simple change you can make today

You likely already consume protein as part of a balanced diet. Simply opting to consume around 20-40g of whey protein pre-exercise could improve your blood glucose levels during and after that bike ride or weights session.

“One of my favourite things about this research is that it can be implemented into people’s daily lives straight away – they don’t need to wait years for the therapy to become available,” Dr Morrison says.

“In fact, many of our participants tell us that they have started using whey protein in their daily exercise after finishing our trials.

“You can buy whey protein at most health food shops or even at the supermarket.

“We still don’t have all the answers about which doses or timing of whey protein around exercise is most effective.

“We think lower doses, or other protein sources (such as vegetarian options like soy protein) may also be effective – but we don’t have any data on this yet. That’s what we’re working towards.”

Dr Dale Morrison is a post-doctoral researcher with the University of Melbourne and the Diabetes Technology Research Group (DTRG). His research focuses on easing the burdens associated with exercise to improve the daily lives of people with type 1 diabetes.

Next steps

This study is part of a three-stage project funded by The Leona M. and Harry B. Helmsley Charitable Trust to improve exercise outcomes in people with type 1 diabetes.

The next stage will look at consuming protein post-exercise to see how that impacts blood glucose after exercise and overnight.

Another planned project will look at consuming protein before bed to prevent overnight hypoglycaemia. The research is led by the University of Melbourne and St Vincent’s Hospital, with collaborators at Deakin University, John Hunter Children’s Hospital (NSW), and Stanford University (USA).