Exercising Safely With Diabetes

Having diabetes doesn’t mean you have to avoid physical activity. It just means that you need to take more precautions than others do when you work out. Here’s how to get on the road to regular physical activity and stay the healthy course.

Exercising Safely With Diabetes

1. Talk to Your Doctor

Tell your doctor if you’re planning to change your activity level. If you’re starting an exercise program, the American Diabetes Association recommends a physical exam (and usually a graded exercise test) if you have had type 1 diabetes for more than 15 years, if you have had type 2 diabetes for more than 10 years, if you’re sedentary, or if you’re over age 35. Your doctor also will want to consider your physical condition-including such issues as heart disease, kidney disease, nerve damage, and eye damage-in helping you decide what kinds of exercise are good fits for you.

Discuss medication changes. Regular physical activity can lessen the amount of insulin or other diabetes medication that you require.

2. Learn When to Test and When to Rest

If you’re on insulin, check your blood sugar before, during, and after exercise. This is the best way to tell how your workout has affected your glucose levels.

Check your blood sugar before exercising if you have type 2 diabetes and you’re taking insulin or drugs that prompt the pancreas to produce more insulin. If your glucose is below 100, have a snack that contains carbohydrate before exercising. During a prolonged activity check every 30 minutes to make sure your glucose stays in your target range.

If you’re prone to hypoglycemia, check your glucose over the course of several hours after exercise. This applies particularly to people who have type 1 diabetes. Your muscles will continue to pull glucose out of your bloodstream, so taking a reading right after a workout won’t give you the full picture of your activity’s effect on your glucose levels. You might think your blood sugar is normal while it’s actually plummeting. Also, physical activity can speed up how fast insulin goes to work.

Schedule workouts so they follow meals. If you find that you often have to compensate for hypoglycemia by eating a snack during physical activity, see if you do better exercising an hour or two after a meal.

As sport seasons change, adjust food and medications accordingly. For instance, when your recreational tennis league starts up its season, you might be surprised to find your blood sugar running low if you don’t account for the twice-a-week tennis practices.

3. Be Prepared

Keep essentials with you. If you’re working up a sweat away from home, carry a high-carbohydrate snack, diabetes ID (bracelet, necklace, or sneaker tag), and a cell phone for emergencies.

Brief a buddy on emergency procedures. Make sure someone in the vicinity knows that you have diabetes and knows what to do in an emergency. If you’re working out at home, make sure a family member is nearby; if you’re at the gym, alert a staff member.

Don shoes designed specifically for your sport. That means running shoes for running, soccer shoes for soccer, tennis shoes for tennis, and so on. Sneakers with air or gel cushioning are a good bet because they will absorb shocks to your feet and knees.

Drink plenty of water before exercising. In the two hours before you start working out, drink at least two cups of water.

4. Learn How to Warm Up and Cool Down

Start moving around and stretching 5 or 10 minutes before real physical activity. A warm-up can entail a light-and-easy version of the primary exercise. For instance, if you plan to go running, warm up with a 5- or 10-minute walk and then some gentle stretches to get your muscles ready for more intense activity. Weightlifting while your muscles are cold can injure you, too; before you lift anything heavy, raise your body temperature by jogging, riding a stationary bike, or walking on a treadmill.

Cool down gradually. As with the warm-up, do a brief, light version of your workout, keeping your arms and legs moving while your heart rate and breathing slow down.

5. Exercise Care While Exerting Yourself

Exhale during every lift. When you are lifting weights, exhale during exertion and inhale while you are returning the weight to its starting position. Holding your breath while lifting weights can be dangerous. Not only does it raise your blood pressure, but it also raises the pressure within your eyes and can worsen eye diseases to which people with diabetes are vulnerable, such as glaucoma and diabetic retinopathy.

Watch for symptoms of hypoglycemia. It’s easy to mistake symptoms of hypoglycemia for the effects of exercise. Among the signs of low blood sugar are profuse sweating, rapid heartbeat, trembling, extreme hunger, difficulty thinking, blurred vision, loss of coordination, and “just not feeling right.” If you suspect you have hypoglycemia, stop exercising immediately and consume a source of glucose, such as raisins, hard candy, water with fruit juice added to it, or glucose tablets.

If you feel pain, stop exercising. We’ve said it before, but it is worth repeating: If you start to feel uncomfortable or short of breath when you are exercising, immediately reduce your degree of exertion or stop exercising altogether.

Drink water while you’re working out. Experts recommend at least one-half to 1 cup of water every 15 minutes.

Avoid exercising in extreme temperatures. If it’s particularly hot or cold outside, find an indoor venue for your workout. In particular, be wary of hot, humid weather because it will be difficult for your body to cool down.

Calories Burned Per 30 Minutes*
Bicycling: 272
Cross-country skiing: 255
Gardening: 170
Golfing (walking with clubs): 187
Hiking: 204
Ice skating/roller skating: 204
Kayaking/canoeing: 170
Racquetball: 238
Snowshoeing: 272
Swimming: 272
Tennis: 238
Volleyball (casual): 102

*Burn rates are for a person who weighs 150 pounds. Lighter people will burn fewer calories; heavier people will burn more.

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