Diabetes and Exercise

Why is exercise important in diabetes?

Why is exercise important in diabetes?Exercise is good for everyone and is an important tool in managing your diabetes. It can be just as useful as diabetes medicine or planning your diet. Most people with diabetes who exercise regularly require less medication. Regular exercises:

• Improves blood sugar control and regulation
• May help reduce the amount of oral insulin medication needed
• Improves physical fitness
• Increases your strength and ease of movements
• Improves blood circulation
• Reduces risk of heart disease
• Decreases blood pressure
• Helps you lose and maintain weight
• Gives a feeling of well being
• Relieves stress

Exercise and Type I diabetes (Insulin dependent diabetes mellitus)

Exercise and Type I diabetes (Insulin dependent diabetes mellitus)You need to plan your exercise schedule to balance both the food intake and insulin dose. Before beginning to exercise, test your blood sugar, if possible. The results of the test will tell you if there is a need to adjust your insulin dose or to eat a snack. This will prevent hypoglycaemia (low blood sugar levels).

If your blood sugar levels are very high and at the same time urine test shows the presence of ketone bodies, it may indicate that there is very less amount of insulin available for activity. Exercise at this time may be harmful as it may result in increased levels of both blood sugar and ketone levels.

In case of type I diabetes, there are also higher chances of hypoglycaemia at night. A preventive measure for this is to exercise in the morning after breakfast and not to exercise before bed.

Exercise and Type II diabetes (Non-insulin dependent diabetes mellitus)

Exercise and Type II diabetes (Non-insulin dependent diabetes mellitus)Type II diabetes can be treated with diet and exercise alone, or these with medicines (oral hypoglycaemic agents) and/or insulin. People with type II diabetes may also be overweight. Weight loss and regular exercise may reduce the blood sugar, need for medication and enable your body to use insulin better.

For type II clients with high morning blood sugars, exercising in the evening (after four p.m.) may help; it is thought that the evening activity may stop your liver from producing excess sugar during the night.

Before you begin

• Since any increase in physical activity can lower your blood sugar, you may need to change your meal plan or medication. Talk to your doctor about making these change.
• Consult your doctor and have a medical check up done, especially if you are over 35 years of age.
• Reduce stress, increase your energy level, and just make yourself feel good.

Getting started

• Whatever kind of exercise you choose, start slowly and gradually. Begin by doing only 5 to 10 minutes a day. Increase the duration and intensity of exercise slowly.
• Exercise regularly, if you can.
• Wear cotton socks and proper shoes.
• Check your blood sugar before and after exercise, if you use insulin or diabetes medicines. If your blood sugar is low before or during exercise, have a snack to raise it.

Choosing the right exercise

There are many things you can do to increase your activity level. It is important for you to choose an activity that is right for you and the one you can enjoy.

• You can walk almost anytime. You can make it a part of your exercise routine, along with using stairs rather than elevators.
• Aerobic exercises are the best choice because they make your heart and lungs stronger.
• Other exercises include walking, jogging, aerobic dance or bicycling
• If you have problems with the nerves in your feet or legs, your doctor may want you to do a type of exercise that will not put stress on your feet. These exercises include swimming, bicycling, rowing or chair exercises.
• No matter what kind of exercise you do, you should warm up before you start and cool down when you're done. To warm up, spend 5 to 10 minutes doing a low-intensity exercise such as walking. Then gently stretch for another 5 to 10 minutes. Repeat these steps after exercising.

Exercise intensity, frequency and duration

Intensity: Intensity should be low to moderate

Frequency: For insulin dependent diabetics-five to seven days a week and for non-insulin dependent diabetics-four to five days a week

Duration: For insulin dependent diabetics: 20 to 30 minutes per session and for non-insulin dependent diabetics: 40 to 60 minutes per session

Exercise guidelines

• Do not inject insulin into the muscle groups that will be used during the exercise session because the insulin will be absorbed too quickly, and may result in hypoglycaemia or low blood sugar.
• Check your blood glucose levels frequently.
• Always carry a quick and rapid source of carbohydrate in case you develop hypoglycaemia.
• Exercise one to two hours after a meal.
• Consume a carbohydrate snack before and during prolonged exercise.
• Pay close attention to your feet for signs of blisters and cuts. Wear well-fitting, good quality exercise shoes.
• Take extra care when exercising in extreme weather conditions. Hot weather can speed up insulin absorption, while cold weather can slow down insulin absorption.

Some exercise tips

• Wear correct footwear
• Avoid dehydration - drink water before/during/after exercise
• Test blood glucose before and after exercise, if possible
• Know symptoms of low blood sugar: shaky, clammy, cold, sweat, weak, irritable and other symptoms