Exercise for Diabetics

People with diabetes are encouraged to exercise regularly for better blood sugar control and to reduce the risk of cardiovascular diseases. The reason for this is that muscles which are working use more glucose than those that are resting.

Muscle movement leads to greater sugar uptake by muscle cells and lower blood sugar levels. Additional benefits of exercise include a healthier heart, better weight control and stress management. There are some exercise precautions which people with diabetes must take, however, when done safely, exercise is a valuable aid to optimal health.

Safety in general, there are 4 areas of safety to consider with exercise. Exercise precautions are designed to help people with diabetes avoid problems which can result from unwise exercise choicesHypoglycemia can occur if a person who is taking blood sugar lowering medication has:

Eaten too little carbohydrate (fruit, milk, starch) relative to the exercise.
Taken too much medication relative to the exercise
Combined effect of food + medication imbalances relative to the exercise

Those who do not take diabetes medication do not need to take these precautions.

Precautions

Precautions to take if you take insulin or oral diabetes medication:

If your blood sugar level is less than 100 mg/dl prior to exercise, take a carbohydrate snack prior to beginning the exercise. A good rule of thumb is to add 15 grams of carbohydrates (1 Carbohydrate Exchange) to your usual diet for each 30 minutes of moderate exercise, or for each 15 minutes of intense exercise.
If your blood sugar level is higher than 100 mg/dl before exercise, it is probably not necessary to take the carbohydrate snack before a light exercise session, but you may need extra carbohydrates 1/2 hour to 2 hours following the exercise. Add 1530 grams of carbohydrate (12 Carbohydrate Exchanges) to the next meal or snack if your blood sugar dips below 70 mg/dl within an hour or more following exercise.
If you experience hypoglycemia, follow the Carbohydrate Treatment guidelines. Follow up with your doctor. You may be advised to lower your medication on days you exercise if your blood sugar levels are well-controlled and usually within target range.
For long duration and/or high intensity exercise sessions, plan extra carbohydrate snacks during the activity. An additional 15 to 30 grams of carbohydrates is suggested each 3060 minutes of exercise (e.g., soccer game, hiking, biking, skating, etc.)
Always carry a fast-acting carbohydrate food (juice, hard candy, raisins) or glucose tablets when exercising in the event blood sugar drops too low and hypoglycemia symptoms develop during exercise.
Wear an ID which identifies you as having diabetes whenever you are exercising alone (or anytime) so that others may help you appropriately in the event something unexpected happens. (Timi Links above go to: Carbohydrate Exchanges...the 1 page summary Carbohydrate Treatment section for hypoglycemia Hypoglycemia section of acute complications)

Severe Hyperglycemia (with or without Ketoacidosis)

This can occur when:

Too little insulin is available to counteract the liver's production of sugar which is stimulated by exercise hormones.
Too little insulin is available to assist glucose enter muscle cells quickly during exercise.
Too much fat is utilized for exercise because sugar is unable. Ketones levels rise in the blood.

Precautions to take

Do not exercise if:

Your blood sugar is above 300 mg/dl, especially with positive urine test for ketonuria.
Follow your doctor's advice to lower blood sugar before recommencing exercise.
You are sick with flu, infection or another illness that is worsening blood sugar control.
If your blood sugar level is above 250 mg/dl but less than 300 mg/dl prior to exercise, your insulin activity is low.
If you exercise, choose one of light to moderate intensity (walking, light biking), rather than a high intensity exercise (running, weight lifting, tennis).

Drink plenty of water before, during and after exercise to stay well-hydrated.

Worsening complications

Foot Problems can occur when:

Shoes fit poorly
Socks are not worn or are not absorbent
Friction or pressure points develop on feet

Precautions to take

Inspect feet daily for signs of friction or pressure sores.
Speak with your physician, podiatrist or diabetes educator about proper foot care procedures.
Buy shoes which are well-made for the type of exercise you do and which fit you.
Consult a shoe retailer who specializes in exercise foot wear.
Buy cotton, absorbent socks.