Diabetes and exercise
Everybody benefits from regular exercise. If you have diabetes or are at risk of diabetes, it plays an important role in keeping you healthy.
Regular exercise is an important part of your diabetes management. If you are on insulin, it will help your insulin to work more efficiently and assist with your blood glucose control. However, if your diabetes is poorly controlled (ie fasting blood glucose levels greater than 14 mmol/L and urinary ketones) then it is best to avoid exercise until your blood glucose has settled. Exercise in these circumstances can actually elevate blood glucose and increase ketone production.
For a person with diabetes, exercise helps:
- insulin to work better, which will improve your diabetes management
- you control your weight;
- lower your blood pressure;
- reduce your risk of heart disease; and
- reduce stress.
You are discouraged from strenous physical activity if you are feeling unwell or have ketones present in your blood or urine.
Before commencing a regular exercise programme, see your doctor for a full medical examination. There are also 2 things you have to be careful of.
Take it slow. You don't want to start off too hard because if you are not used to the exercise you will be sore the next day and this will not make the exercise an enjoyable one! Always increase the intensity of the exercise very slowly.
Get checked out. If you have any health problems such as diabetes complications like retinopathy, nephropathy, you should talk to your doctor or an accredited exercise physiologist before you start increasing the intensity of your exercise.
Suitable types of exercise
Suitable types of exercise depend on the individual. Here are some suggestions for you to discuss with your doctor:
- water aerobics
- exercise bike
- walking machine.
Increasing your general physical activity is also helpful, for example, taking the stairs instead of the lift, getting up to change the TV station instead of using the remote control, housework and gardening.
Amount of exercise
Ideally, you should be doing about 30 minutes every day. If this is not possible, then this time can be divided into 3 x 10 minute sessions.
Intensity of exercise
You do not need to puff to gain the benefits of exercise. Aim for moderate intensity. This means you should still be able to talk as you exercise without becoming breathless.
- Drink extra fluid before, during (only if prolonged exercise) and after exercise to avoid dehydration. The fluid may be water or a sweetened drink if extra carbohydrate is required. 250 ml every 15 minutes or one litre of fluid per hour is recommended.
- Take care of your feet when exercising
- Wear comfortable and well-fitting shoes
- Always inspect your feet before and after exercise
- Ulcers or other lesions on the feet are a serious danger for people with diabetes. It is important to avoid foot damage especially for middle-aged and elderly people.
- It is wise to avoid exercise that causes stress to the feet (e.g. running). Exercise which poses minimal weight or stress on the feet is ideal such as riding an exercise bike or brisk walking in good footwear.
- Take extra carbohydrate before and during exercise to prevent hypoglycaemia. Extra carbohydrate is often needed after exercise. Discuss adjusting carbohydrate intake with your doctor or dietitian.
- Monitor your blood glucose levels before, if possible during (at least initially) and after exercise to assess your requirements for extra food.
- It may be necessary to reduce your insulin dose prior to exercise. Insulin adjustment varies with each individual. Discuss appropriate adjustments to suit your exercise schedule with your doctor or Credentialled Diabetes Educator.
- Wear sun block when exercising outdoors.
People with diabetes are generally discouraged from strenuous physical activity if they feel unwell or have ketones present in their blood or urine.
Last Reviewed: 06/09/2011
Reproduced with the kind permission of Diabetes Australia.
Diabetes Australia. Diabetes and Exercise - Keeping Active. Last updated 6/9/2011. http://www.diabetesaustralia.com.au/en/Living-with-Diabetes/Keeping-Active/ (accessed Jan 2013).
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