Exercise

Benefits of exercises include:

• Decreased insulin resistance or increased effectiveness of insulin, thus improving blood sugar control
• Weight loss or maintenance of body weight
• Aerobic exercise lowers LDL (bad) cholesterol and triglycerides and increases HDL (good) cholesterol.
• Lowers blood pressure
• Increases energy levels, muscle strength, flexibility
• improves endurance
• Reduces stress
• Improves sleep
• Keeps the heart, lungs, and muscles in good shape
• Improves sense of well being by increasing endorphins

It is always a good idea to be evaluated by your doctor before starting any serious exercise program. Discuss with your doctor whether the exercise you plan to do is appropriate for you. Depending on diabetic complications that you may have, certain exercises could be inappropriate. Very strenuous exercise is not generally recommended if you have severe retinopathy or heart disease. A stress test may be indicated before starting a strenuous exercise program. Strenuous exercise is not recommended till blood sugars improve.

Gently build the exercise intensity, starting with 5 to 10 minutes and gradually increasing it by 5 minutes every week. An exercise program should not cause severe aches and pains. If you are having difficulty talking during exercise, this may signify that the exercise is too strenuous. Try to keep your heart rate just below the maximum target heart rate. The target rate can be calculated by subtracting your age from 220 and multiplying by 0.8.

Frequent blood sugar monitoring should be done before, during, and after exercise. It is always a good idea to wear a bracelet mentioning that you have diabetes. In the event of low blood sugar, this would certainly help anyone assisting you. Considering the risk of low blood sugars and variability in blood sugars with exercise, it is generally advised to keep exercise very consistent, preferably daily and at a particular time. If the exercise is sporadic and variable, you will need to discuss this with your Personal Care Physician to help make adjustments to insulin or diabetic pills since exercise can increase the risk of low blood sugar. Short-acting insulin taken for a meal just before the exercise time may need to be reduced depending on the exercise type. You may need to eat a snack before prolonged exercise. Strenuous exercise can cause low blood sugars for as long as 24-hours after the exercise, so it is recommended that you monitor blood sugars.

Check blood sugars before and after exercise to see what the exercise does to your blood sugars. Generally, blood glucose tends to go down with exercise, but if your blood sugars were high before starting the exercise, it could occasionally worsen it. When doing prolonged exercise, it is good to check blood glucose every 30-minutes to see how the blood glucose is trending to make suitable adjustments such as taking an extra snack. If you are on an insulin pump, you may need to use a lower temporary basal rate with exercise. Drinking plenty of fluids before, during, and after exercise is recommended.

Aerobic exercise such as brisk walking, bicycling, swimming, jogging, dancing is good for your heart, lungs, and muscles. Stretching is important to maintain good flexibility of joints and muscles. Some weight-bearing exercise should be part of your exercise regimen. Weight-bearing exercise increases muscle strength as well as bone strength. It is a good idea to do both weight-bearing and aerobic exercise. Most gyms have exercise trainers who can advise you on a good exercise program and show how the various exercises should be done. Use correct exercise techniques to prevent exercise-induced injury. Always start with small resistance and gradually increase the resistance over time. Remember to breathe in as you lower the resistance and breathe out as you work against resistance.

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