Sarah Loftus was diagnosed with type 1 diabetes (T1D) at 26. Now 28, she uses an Omnipod 5 pump paired with a Dexcom G7 continuous glucose monitor (CGM).
Sarah shared her experience of using an AID system (insulin pump with a CGM) as part of our guide to exercise and T1D.
How do you find using an AID system?
Honestly it feels like I’ve got a T1D fairy godmother who takes away half of the hard work that comes with managing T1D, especially around exercise. The closed-loop system takes heaps of the mental load of T1D away.
It’s given me more confidence, not only in training, but in everything that comes with T1D: eating, sleeping, socialising, working, travelling. I feel safer and less worried because of it.
Before using an AID system, I had to micromanage every decision around food, insulin and movement. It was, to put it simply, very difficult and very draining.
AID isn’t for everyone, though. I always want to emphasise that it’s about finding what works for you.
In my experience with the Omnipod, the algorithm didn’t take long to adjust – within a week, it knew my patterns. However, the system can’t take into account the multitude of factors that we know affect T1D (things like travel, sickness, hormones, etc.), so it doesn’t take away the human element of managing T1D, which, in my opinion, is what makes us incredibly and uniquely resilient.
Using an AID system doesn’t make things perfect. If we’re being honest, I don’t think there’s such a thing as perfection in T1D, or anything really – but it does make things a lot more manageable, safe and reassuring.
What main sports or exercise do you do now?
My current routine includes a mix of running, weightlifting, swimming and daily walks.
I usually do three weight sessions, two runs and two swims every week – a mix of sessions on my own and with friends, as I’ve found training with people to be a lot more enjoyable since being diagnosed with T1D.
I have two rest days a week, as I’ve found I need a lot more rest and sleep since being diagnosed with T1D. My body takes longer to recover from strain, which doesn’t just come from exercise but also shows up in work, socialising and sickness.
In the years since my T1D diagnosis, I’ve also done netball, Hyrox and cycling.
How does exercise affect your BGLs?
The different types of exercise that I do affect my BGLs in very different ways.
I usually see a slight rise during and after weightlifting, as opposed to running and swimming, where they stay relatively steady but often start dropping near the middle to end.
I’ve realised there’s no one-size-fits-all approach to exercising with T1D, or doing anything with T1D, tbh! The same workout can affect me differently depending on stress, sleep, food, hormones and all the other factors we know can contribute.
I also walk a lot. I don’t count it as my ‘training’ but I tend to average 12–15,000 steps per day, which always tends to bring my BGLs down.
Overall, exercise is really beneficial for my BGLs, as it helps keep them relatively steady and within range.
What do you to get ready before exercising?
I always check my levels before I start any exercise to make sure I’m in a comfortable range and adjust accordingly.
I like to exercise when my BGLs are between 5 mmol/L and 10 mmol/L. If my BGLs are below 5 mmol/L, I’ll have half a banana or some coconut water as a snack.
I try to avoid exercising with any insulin on board (IOB) or if my levels are above 15 mmol/L, as exercising with IOB usually results in hypoglycaemia for me.
However, all of the above isn’t always possible when you’ve got a routine and plans, so it’s more of a loose ideal and I end up adjusting accordingly during the workout.
My levels are often quite stable before and during exercise, it’s usually after that I need to be more conscious.
For walking, I do the same as my training sessions and just make sure my BGLs are safe. If they drop whilst I’m out, I usually just go to the supermarket, get a coconut water, and then sit outside and wait for them to return to a safe level.
How do you manage your T1D while working out?
I always have hypo treatment nearby. My go-to is coconut water, Glucochews, or HypoDuo, which I very kindly got sent by the founders.
Honestly, other than that, I prefer to switch off from managing T1D and focus on my training. It’s always been a sort of meditation for me; it’s the only time I truly forget everything else going on.
I have my alerts on, and I actually keep my ‘low alert’ at 5 mmol/L, so I know my AID will notify me if my BGLs are dropping. Having it set slightly higher means I can take action before I go too low.
Using an AID system does help a lot, because it automatically adjusts insulin delivery based on my glucose trends, so I don’t have to constantly stop, check and make manual decisions, which has made a huge difference to my training.
And what do you do after exercising?
For most of my sessions, I train in the morning, so I’ll always have brekkie afterwards. I find a balance of carbohydrates, fat and protein fuels me best (with a coffee, of course).
There are two days where I train in the middle of the day and evening, so I just plan lunch and dinner straight after those sessions to ensure I have fuel going in, which keeps my BGLs relatively steady.
I find it easier to manage my BGLs short-term after training sessions, but it’s the long-term that can be difficult.
On Wednesdays, I have track night with my friends, which means I’m doing intense intervals and then going to sleep not long after. I find it’s the overnight BGLs that I have to be conscious of.
Activity Mode is a great hack for post-training, as you can keep it on for a period after exercise to prevent BGLs from dropping.
Again, it’s all trial and error. I have found that my algorithm has learnt my BGLs quite well, thankfully.
The key is ensuring I eat very soon after a session and then keep a close eye on my BGLs for the next few hours.
Do you have any advice for people with T1D who want to start exercising or do more of it?
My absolute number one advice is definitely to do it! Exercise is so great for your body and mind, whether you have T1D or not.
I’m so thankful to my parents for getting me into sport at such a young age, and also thankful to myself for mixing it up throughout my life to ensure I’m trying new things, not getting complacent, and learning to train for me, not my appearance.
When I was diagnosed with T1D, it came out of nowhere. I had been sick for six months prior to the day. My number one question was obviously, “how will it affect my training?”
It wasn’t a case of adjusting my training to T1D. It was about understanding how to manage T1D during my training. Since being more involved in the T1D community through advocacy and events, I’ve realised that a lot of people with T1D are nervous to start training or do more of it. That makes me quite sad.
There are so many benefits in exercising. It helps your mind, body, longevity, bone health, T1D, and more. I would love everyone to give it a go, in whatever way that may look for them. It’s not about copying what other people are doing or doing something because you think you ‘should’. Exercise is all about trying new things and figuring out what you enjoy, what makes you feel good, maybe meeting new people. T1D is just a part of all that.
I would recommend starting small. Try one or two sessions a week, whether that’s going to the gym, doing yoga at home, trying a dance class, or playing tennis with friends. There are so many ways to exercise and so many avenues to get into it. It’s not just the common ones, e.g. running, gymming, cycling and swimming.
As always with T1D, be patient with yourself and give yourself grace. It takes time, for yourself and your T1D. You need to learn what you enjoy doing and how your body will adjust to that. It might not be easy or straightforward, but once you get into a routine, it will absolutely be worth it.
You can keep notes of what exercise you did and how your BGLs were before, during and after. Look for patterns in that and don’t be afraid to experiment. As with every time you leave the house, always carry hypo treatments with you. Whether you need them or not, it provides mental relief knowing you have something on hand no matter what.
Any other tips to share?
Using an AID system, whether you’re exercising or not, is just another experiment of living with T1D. It is exactly like your first night with T1D, holiday with T1D, or meal at a restaurant with T1D. It’s all new, unpredictable, and scary.
I feel incredibly grateful for the support system that I have, and I just hope everyone who has T1D has the same. It’s a really important aspect of management, whether you’re exercising, using an AID system, or neither.
My ultimate reminder would be that whether your BGLs are high, low, or in range, it doesn’t mean you’re doing something wrong. You have to figure out what works for you and your body, with the help of exercise and AID.
This means that sometimes your BGLs will be out of range, and that is okay, as long as you also know how to adjust accordingly to prevent any serious or long-term issues.
With the right support, tools, and time, you can find an approach that works for you. Just be patient, kind, and gracious with yourself. Exercise is absolutely still possible with T1D, and it can be one of the most empowering parts of living with it.
At least for me anyway, using an AID system 24/7 has meant that living with T1D is a lot easier than it was before I started using a pump. I speak to lots of people online who ask about my experience with Omnipod specifically, because that’s the pump I use. I always remind them that it’s worth at least trying an AID system to see how you may adjust.
Some people love them, and some people don’t, but you never know until you try!
