Nutrition for endurance sport with type-1 diabetes

If you’re an active person with type-1 diabetes, how do you feel about your sport nutrition strategies?

In today’s post, we’re going to break down the nutrition recommendations for endurance sport with type-1 diabetes, and I’m going to provide some recommendations of my own.

T1D in sport

Mandy Marquardt. Kate Hall. Kris Freeman. Evita Leter. Barbara Jardin.

Do you know what all these people have in common?

They all have type-1 diabetes and they are all elite endurance athletes!

Long gone are the days where people with type-1 were advised not to engage in fast-paced, high intensity sports. Nearly every sport has type-1 representation. And the above are just a small handful of that incredible representation.

The times have changed.

When I was diagnosed with type-1 diabetes in 1987, my parents were told absolutely no endurance sports for me.

The fear was that my blood sugars would go severely low.

They did not want my blood sugars to go severely low.

Still, they knew that physical activity was a benefit to T1D outcomes. And that is why I was relegated to a stationary bike – slow pedalling only – and picking clovers in the outfield of a softball pitch.

Needless to say, my early ventures into sport were short lived, because I was BORED. AS. HELL.

Thank goodness the times have changed.

Katie Bartel RD completes the Toronto half marathon with type-1 diabetes

Nutrition for endurance sport

I have spent the last several years extensively researching the literature on nutrition for type-1 diabetes in endurance sport.

This is an area of passion – both professionally and personally.

The image below is a brief summary of the during-sport, fuelling-specific recommendations.

Nutrition for sport with type-1 diabetes recommendations

If you were to compare these recommendations to those of the non-diabetes population, you would see great similarities, especially in the blue column where there’s very little active insulin circulating.

That’s because these recommendations were developed predominantly from a non-diabetes population.


The orange column is where the tweaks occur. These tweaks are focused solely on reducing the risk of hypoglycemia when there’s peak, active insulin circulating.

For some, they are not realistic.

Consuming up to 75 grams of carbohydrates per hour can can sometimes cause stomach cramping and severe urges of having to poop. It can also create feelings of food anxiety, especially given that carbohydrates are the main foods that increase our blood sugars. And quite frankly, it can be just plain onerous having to constantly stuff your face full of food while you’re running, cycling, swimming to the podium.

So, what do we do?

Trial and Error

These recommendations are a starting point, but they are just another page in a textbook.

They are general guidelines.

They are not specific to the individual.

But, Type-1 diabetes is not a textbook disease.

I cannot say that enough.

We need recommendations that are specific to us and our individual disease.

And until we get that, we need to work on our own recommendations using the above general guidelines as a starting foundation.

It’s all about trial and error, my friends.

Documenting your efforts is key to finding success.

Documenting blood sugars, food consumption, insulin dosing, any kind of adjustments, stresses, emotions, hormones – anything that can affect your blood sugars before, during, or after should be recorded.

That way if you find a strategy that works, you’ve got it. And if you don’t, you have documentation of things to work on for the next time.

Because there will always be a next time!

Mastering sport nutrition with type-1 diabetes is all about trial and error

If you’d like to learn more, book a session with me and we can work towards creating specific sport nutrition recommendations for you and your diabetes.

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