Tips for Exercising with Diabetes

Physical Fitness – How does this help manage sugar level and other diabetic complications?

There are many ways exercise is beneficial to a person with diabetes. But first and foremost, being physically active plays a large role in prevention. 30 minutes of exercise, 5 days a week can reduce your risk of diabetes by 40%!  However if you’re already diabetic, there are many ways exercise can help:

1. Improves blood pressure and reduces overall cardiovascular risk and mortality (diabetes increases risk, exercise lowers it). People with diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counter- parts.  3-4 hours aa week cut the risk even more.
2. Assists with weight management – fat can build up around your organs, like your liver and pancreas. This can cause something called insulin resistance.
3. Improves glycemic control and cholesterol levels – The increased tissue sensitivity to insulin produces a beneficial effect on glycemic control. It increases uptake of glucose by muscles and improves utilization.  This also alters lipid levels, increases high density lipoprotein (good cholesterol) and decreases triglyceride and total cholesterol.
4. Manages pain and other symptoms of neuropathy and improves strength and balance (decreasing risk of falls and injuries).
5. Helps regain lost function – for example if your fingers have become weak and lost coordination to perform tasks like buttoning a shirt, Exercises can help regain those skills.

Tips for Starting a Program

The recommended amount of exercise to achieve health benefits is150 minutes a week of moderate exercise and/or 75 minutes of vigorous exercise.  Moderate aerobic exercise will increase your heart rate and make you breathe heavier, this includes activities such as brisk walking, biking, or swimming. Vigorous aerobic exercise will challenge you further and that includes activities such as running, swimming laps, heavy yard work or aerobics/dancing.  It’s also important to include different modes of exercises in patients with type 2 diabetes, So strength training should also be included at least 2 days a week. 

How do you ensure success in sticking to a new program?

1. Find something you like – if it’s enjoyable you’ll be more likely to continue.
2. Start small – don’t try to push yourself too hard in the beginning.
3. Set goals – make your goals meaningful to you, and make sure they’re reasonable/achievable.
4. Set a schedule – Try to make it a regular part of your routine.
5. Find a partner – This will help encourage you and keep you accountable.

Exercise Rules and Regulations

• Always carry your own portable blood glucose monitor.  Check their glucose levels before and after exercise. Do not exercise if the blood glucose level is less than 100 mg/dl or greater than 250 mg/dl. If blood glucose is less than 100 mg/dl but not less than 70mg/dl, have a carbohydrate snack and then recheck the glucose level after 15 minutes.

• Preferably, exercise indoors instead of outdoors to minimize the risk of integumentary and musculoskeletal trauma, it’s also good to have immediate access to necessary things to address hypoglycemia, hyperglycemia or diabetic ketoacidosis.

• Always have a carbohydrate snack at hand every exercise session. 10-15 grams of carbohydrates is a half a cup of fruit juice or soda, 8 oz. of milk, 2 packets of sugar or a 2 oz. tube of honey.  During prolonged exercise duration, 10-15 grams of carbohydrate snack is recommended for every 30 minutes.

• Exercise in a comfortable temperature. Never exercise in extreme temperatures.

• For Type 1 (Insulin Dependent) patients, never exercise during the peak times of insulin. Collaborate with your med team regarding the type of insulin administered. Type 1 diabetics may need to reduce insulin or increase food intake prior to the start of an exercise program.

• When you’re physically active, wear cotton socks and athletic shoes that fit well and are comfortable.

• After being physically active, check your feet for sores, blisters, irritation, cuts, or other injuries. Call your health care provider if an injury doesn’t begin to heal after 2 days.

• Type 2 diabetics are advised to have an average of 30 minutes of exercise duration per session.

• Always wear proper footwear and exercise in a safe environment.

• Diabetics who are on Sulfonylureas are red flags because it can cause exercise-induced hypoglycemia. Closely coordinate with the referring physician if this was missed prior to referral.

• There should be no short-acting insulin injections close to the muscles to be exercised within one hour of exercise.

• Eat 2 hours before exercising. If planning to exercise after meal, wait 1 hour prior to start.

• Exercise in the afternoons and evenings has been shown to reduce liver fat content and insulin resistance. Previously morning exercise was advised, but recent studies have shown a possibility that afternoon and evening exercise improves insulin uptake and helps to better to better manage sugar level. However, it’s important to just do the exercise, its better to exercise at any time of the day that works for you than not to exercise at all.

• It’s advisable to drink 17 oz./50cl (about 1 standard water bottle) of fluid before exercise.

• Make sure exercise doesn’t contribute unnecessary stress. Stress increases insulin requirements. A gradual progression of aerobic and resistance exercises is the key.

• If unsure whether hyperglycemia or hypoglycemia is the problem, always give a glass of orange juice or milk, or a carbohydrate snack. This is the safest action because this can relieve hypoglycemia (if it is indeed) and will not cause harm if it is hyperglycemia.

• As much as possible, patient must not exercise alone, so that there will always be someone to help in unexpected situations.

If you’re looking for help in creating a safe and effective exercise program, call us at 08130280496 to schedule an assessment with our physiotherapy team and get started towards your healthier lifestyle!