Seven Tips for Cycling With Diabetes

Regular exercise[1] is an essential part of diabetes management. It helps lower A1C[2], promotes heart health[3], lowers weight[4], and fights against insulin resistance[5]. Exercising even releases endorphins, those feel-good chemicals in the brain. Whether you have type 1[6] or type 2[7], exercise should be a regular part of your life. And while there are many options out there, one is clearly (in my humble opinion) superior: cycling!

I love cycling! Sailing down the open road, wind in my face, legs pumping, passing by jogger after jogger — it’s pure heaven! Of course, I’m a bit obsessed. I even run my own blog dedicated solely to cycling with diabetes:[8]. I ride almost everyday, and can think of no better way to spend a free Saturday than riding through the countryside for 60, 70 or 80 miles. For the winter months, I have a smart trainer so I never have to miss a day on the bike. I actually own sun sleeves, unapologetically wear the full spandex kit, and can name 10 cycling toys I’d run out and buy today if I only had the trust fund to afford it.

Yes, cycling is a great exercise choice! But if you’re new to cycling, there are a few things you should know before you dive in. And so I present to you these seven tips for cycling with diabetes, to help you get the full benefit of this wonderful pastime!

Seven tips for cycling with diabetes

1. Be aware that blood glucose doesn’t always go down with exercise

Conventional wisdom tells us that exercise leads to hypoglycemia[9]. The idea is pretty simple — your muscles need more energy, the glucose in your blood is consumed, and your blood glucose level drops. But this is only part of the story. Sometimes, exercising can actually lead to elevated blood sugars[10].

You see, aerobic activity leads to falling blood glucose levels. But if you push into what we call anaerobic activity, blood glucose can actually rise (and very quickly!). When you push into anaerobic level exertion (basically all-out effort, the kind you can’t sustain for more than a few minutes at a time), the liver sends out stored glycogen[11], which is very potent stuff designed to surge the system with glucose. On top of that, the body sends out stress hormones such as adrenaline and cortisol to help your system further elevate blood sugar. It does this because your body assumes you’re pushing all-out to get away from danger. The end result can be a reading of 250 when you’re expecting 60!

The best way to avoid this is to use a heart-rate monitor. Your anaerobic zone will correlate to a specific heart-rate zone, and taking care to avoid lingering in this zone for all but the briefest bursts of effort can help eliminate this unwanted glucose surge. Calculating your HR zones is easy — a quick Google search[12] will show you how.

2. Have more glucose than you think you need

You should never be on the bike without ample glucose[13]! You are often on your own, in the countryside, or on paths that take you away from the city. You don’t necessarily have easy access to stores, other people or help. AND you’re more likely to go low. Not having glucose can be downright deadly! My golden rule is to figure how much glucose I think I might need, and then take double that amount with me.

3. Choose the right saddle

Saddle choice is important for anyone planning to cycle. You’re going to be spending a lot of hours on it, so it better provide the right kind of support. But it’s even more important for people with diabetes. Traditional saddles put pressure on the perineum, the soft tissue between the legs. There is a nerve bundle that runs through this area that is responsible for bladder function[14] and sexual health[15]. Both of these are potential areas of complications for us, so we better avoid damaging that nerve bundle! I almost had to stop cycling when my previous saddle was causing issues for me. Luckily, I found a great saddle that has allowed me to ride with no pressure. Look for saddles with a center channel that runs the full length of the saddle, or noseless saddles. The saddle I use (and love) is from ISM[16] — they specialize in making saddles that eliminate this soft tissue pressure.

4. Listen to your body

Believe it or not, exercising can run your immune system down. That’s right, exercising can actually make you sick. I learned this the hard way last year. I had been cycling a lot that summer. I was losing weight, my leg muscles actually had some definition, and I was feeling pretty good about myself! Then around September I started getting a mild cough. I ignored it, and I continued cycling. Well, that started a two-month battle with a nasty cold that my immune system just could not shake off. My doctor told me that my intense exercise, coupled with the associated weight loss, might have actually weakened my immune system’s ability to fight off that cold. And of course I did no service to myself by pushing through the initial symptoms like I did. Since then, I have learned to listen to my body, and when it’s telling me to slow down, I slow down! It’s much better to lose a week on the bike then to spend two months sick.

5. Always have a cool-down period

Just as anaerobic exercise can lead to an unexpected elevation in blood glucose, it’s not unusual to experience a post-exercise surge in blood glucose[17]. This phenomenon is particularly true for folks like me who are still using injections and can’t go to a temporarily lower basal rate. Here’s what happens: While you’re exercising, your blood glucose can drop (unless you hit too much of that anaerobic zone we talked about earlier). This means you need to ingest glucose, and while you’re cycling your metabolism is moving at a faster clip, so you’ll tend to need more than usual to bounce you back up. This is fine as long as you’re exercising, but once you stop, your metabolism returns to normal and your muscles are no longer mopping up that extra glucose you ingested. The result can be a surge. Now, this surge isn’t as severe as the anaerobic effect, but it can still be a solid 30–60 point bump. Avoiding this surge entirely is almost impossible in my experience, but there is one thing you can do to lessen the effect of it: have a cool-down period. Take it very easy the last 10–15 minutes of your ride, and try to transition out of your aerobic zone and back into your normal HR zone. Making this transition gradual can really help lessen the severity of the post-exercise surge.

6. Hydrate[18]

This applies to any cyclist, but the effects of dehydration can be more severe for those of us with diabetes than in the general population. Severe dehydration can lead to elevated blood glucose, and even moderate dehydration can throw us blood glucose curveballs. I always take a hydration pack with me when I ride, and can’t recommend them enough. A hydration pack will allow you to carry up to 100 ounces of water, as opposed to the 20–30 ounces offered by water bottles. Plus, this allows you to fill those bottles with a sugary drink for glucose.

7. Keep it clean

If you’ve never had the pleasure of a saddle sore, count yourself lucky. They are not fun! Saddle sores develop when a (potentially very small) break in the skin becomes infected, leading to a painful sore. The cause of that break in the skin can be the leg rubbing against a poorly fitted saddle, an abrasive seam in your cycling shorts or even an ingrown hair. Whatever the cause of the irritation, the problem starts when it becomes a bacterial infection. And cycling can be a bacterial nightmare if we’re not careful. As we cycle and sweat, we create a warm, moist environment that is simply perfect for bacterial growth.

As with dehydration, those of us with diabetes have more to lose than our fellow riders. An infection means higher blood glucose while our body fights the infection, and with our weaker immune systems, that fight tends to take a bit longer. The best thing you can do to avoid these unwanted guests is to always shower immediately after a ride. Don’t give that bacteria any chance to take hold!

Now get out there and ride

Now that you’re armed with some knowledge, hop on your properly fitted bike and enjoy the open road. Cycling is a glorious adventure, and there’s no reason for those of us with diabetes to sit on the sidelines!

Want to learn more about cycling with diabetes? Read “Biking for Health.”[19]

  1. exercise:
  2. lower A1C:
  3. heart health:
  4. lowers weight:
  5. insulin resistance:
  6. type 1:
  7. type 2:
  9. hypoglycemia:
  10. lead to elevated blood sugars:
  11. glycogen:
  12. a quick Google search:
  13. ample glucose:
  14. bladder function:
  15. sexual health:
  16. ISM:
  17. surge in blood glucose:
  18. Hydrate:
  19. “Biking for Health.”:

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