Exercise and Diabetes

EXERCISE AND DIABETES

** This information is not intended as a substitute for medical treatment. Before starting any exercise program, consult a physician.

by Charlene Marange, PT

If you have diabetes the best thing for you to do is to have an active lifestyle and to either continue to exercise or begin a program. A regular exercise program can help to stabilize your blood sugar, reduce your need for insulin and medication and keep your weight under control. Diabetes increases your risk for heart disease, but exercise can help to lower your risk. With this increased risk in mind, consulting with a doctor before beginning any exercise program is imperative.

What Activities can I do?

Activities that most likely will help to keep your diabetes under control and decrease your risk for heart disease are aerobic exercises. These exercises include, but are not limited to, walking, jogging, swimming or biking. These exercises are most beneficial when performed for 30 minutes or more three times per week. In addition, weight training and strengthening also help to improve fitness and heart health.

Any exercise is better than none. You should try to include physical activity into your daily routine. This can be accomplished by taking the stairs instead of the elevator or parking further away from the entrance to the store, if possible.

When you know an activity is not suitable

If you become dizzy or lightheaded when exercising in an upright position, swimming or biking may be better than hiking or jogging. People who have retinopathy should avoid activities that sharply raise blood pressure, such as weight lifting. If you have poor sensation in your feet be sure to take special care of your feet by choosing proper footwear, and consider low-impact exercise such as swimming, biking or rowing rather than walking or jogging. Activities such as scuba diving and rock climbing can be dangerous if you have hypoglycemia (low blood sugar). In addition, lifting weights can complement an exercise program. However, most people who have diabetes and use lightweights should lift them 12 to 15 reps rather than lifting heavy weights a few times.

Staying Safe

Warming up before you exercise can prevent injuries. You should start with 5 to 10 minutes of moderate activity and then stretching. Every exercise session should also end with a 5 to 10 minute cool-down. An example of a good warm-up or cool down is walking at medium pace. Also, be sure to check your blood sugar levels before and after workouts and every 20 to 30 minutes during prolonged exercise. Many activities can burn up to 500 to 600 calories per hour. If your blood sugar is under 100mg/dl, eat a snack that contains 15 to 30 grams of carbohydrates before you exercise. If your blood sugar is excessive (over 250 mg/dl for people with type 2 diabetes, or over 200mg/dl for those with type 1) postpone exercise until it comes down. For people who become hypoglycemic (dizzy, sweating, trembling, double vision) be sure to have a snack ready if this occurs.

Other safety precautions:

Exercise 1 to 2 hours after a meal
Avoid exercise at times of peak insulin activity. Morning exercise is ideal. People with type 1 avoid evening exercise.
Adjust insulin or anti-diabetic dosage, if necessary. (Be sure to follow your doctor’s advice.)
After prolonged or intense exercise, you may need extra carbohydrate foods for up to 24 hours to refill muscle starch reserves. Be aware of delayed hypoglycemia.
Be sure to drink lots of fluids. Approximately a pint two hours before exercising this will replace what you sweat away during exercise.
Be sure to wear shoes that fit well and have cushioned midsoles. Be sure they also have a toe box that fits your longest toe. Your socks should fit well and absorb or wick moisture to avoid sores and blisters.
Avoid alcohol around the time of exercise ( even the night before a workout)
Wear a Med-Alert or similar identification bracelet or tag where it can be seen easily
Know yourself and be aware of your own pattern of blood-glucose repose to exercise

If you have any questions please feel free to contact one of our physical therapists or athletic trainers.

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