Exercising With Diabetes

For type 2, the benefits are great...but be aware of the risks.

By Stephen Hanks

July/August 2006

The notion that regular exercise might help prevent type 2 diabetes or diminish its complications seems like a top-of-the-chart no-brainer. Health experts agree that a moderate exercise program (30 to 45 minutes, five to six times a week) can reduce glucose (blood sugar) and blood pressure, lower the bad cholesterol and raise the good stuff, improve the body’s ability to use insulin and lower the risk of heart disease and stroke. In fact, a recent Diabetes Prevention Program study showed that if people with pre-diabetes got 150 minutes of physical activity a week and lost 10 to 20 pounds, they could prevent or delay type 2 diabetes. Sounds like a good deal, no?

But before you go rushing off to the gym, you need to be aware of the risks. First talk to your doctor or healthcare practitioner to determine what kind of fitness program is right for you. While most health experts recommend that people with type 2 diabetes do a combination of aerobic exercise and strength training, the workout regimen must be dictated by your specific diabetes-related health issues. For example, if you have problems with nerves in your feet or legs (more on that later) you don’t want to be pounding a treadmill three or four times a week.

Exercise Awareness

If you have type 2 diabetes, the first thing on your exercise checklist should be to monitor your glucose level before and after exercising. If your blood sugar is either too low or too high right before you begin to exercise, wait until your numbers improve. If you start pumping when your glucose is above 300 mg/dl, your level can shoot up so you should test your blood sugar every 15 minutes during a workout. And exercise is not recommended if your fasting glucose is above 250 and you have ketones in your urine. According to the website www.familydoctor.org, regular physical activity makes the body more sensitive to insulin and blood-sugar levels may fall too low (a condition called hypoglycemia) after exercising.

Hypoglycemia is a major risk if you have type 2 diabetes because of the insulin-like effect of exercise. The increased glucose taken in by the muscles produces low glucose levels, which can last for 12 to 24 hours. Hypoglycemic reactions can range from trembling and sweating to excessive hunger, headaches, rapid heart rate and abrupt mood changes. Talk to your healthcare practitioner about what to do if you have a hypoglycemic episode during exercise.

For anyone with diabetes, the tootsies can be a trouble spot. Even a simple blister can become infected so you must check your feet daily—especially if you exercise—for sores or cuts. Wear smooth, thick cotton-blend socks to prevent blisters and keep your feet dry to stave off athlete’s foot.

And make sure you wear running shoes that fit comfortably.

Some resistance exercises can be harmful for people with retinopathy, or diabetic eye disease. Using weight machines, free weights or exercise bands can raise blood pressure and cause bleeding in the eyes. A qualified professional can help you design a safety-first fitness plan.

Exercising with diabetes may be tricky and take a lot of work, but the benefits far outweigh the risks. Can you really afford not to hit the gym?

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