Everybody benefits from regular exercise. If you have diabetes, or are at risk of diabetes it plays an important role in keeping you healthy.
For a person with diabetes exercise helps:
- Insulin to work better, which will improve your diabetes management
- Maintain a healthy weight
- Lower your blood pressure
- Reduce your risk of heart disease
- Reduce stress.
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Warning- Don’t take part in strenuous physical activity if you are feeling unwell or have ketones present in your blood or urine.
Exercise has so many benefits, but the biggest one is that it makes it easier to control your blood glucose (blood sugar) level. People with type 2 diabetes have too much glucose in their blood, either because their body doesn’t produce enough insulin to process it, or because their body doesn’t use insulin properly (insulin resistant).
In either case, exercise can reduce the glucose in your blood. Muscles can use glucose without insulin when you’re exercising. In other words, it doesn’t matter if you’re insulin resistant or if you don’t have enough insulin: when you exercise, your muscles get the glucose they need, and in turn, your blood glucose level goes down.
If you’re insulin resistant, exercise actually makes your insulin more effective. That is—your insulin resistance goes down when you exercise, and your cells can use the glucose more effectively.
Exercise can also help people with type 2 diabetes avoid long-term complications, especially heart problems. People with diabetes are susceptible to developing blocked arteries (arteriosclerosis), which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesterol—and that helps you avoid arteriosclerosis.
Additionally, there are all the traditional benefits of exercise:
- Lower blood pressure
- Better control of weight
- Increased level of good cholesterol (HDL)
- Leaner, stronger muscles
- Stronger bones
- More energy
- Improved mood
- Better sleep
- Stress management
When most people are diagnosed with type 2 diabetes, they are overweight, so the idea of exercising is particularly daunting. For your health, you have to get started on a good, reasonable exercise plan, but first, you should talk to your doctor.
Exercise programs. Set realistic goals.
Before commencing a regular exercise program see your doctor for a full medical examination. Initially take it slow - you don’t want to start off too hard, if you are not used to the exercise you will be sore the next day and this will not make exercising a fun experience! Over time, you can slowly increase the intensity of the exercise.
If you have any 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.
What exercise can I do?
Anything that gets you moving. Here are some suggestions for you to discuss with your doctor:
- Cycling/ exercise bike
- Weight training
- Tai Chi
- Water aerobics
Increasing your general physical activity is also helpful, e.g. taking the stairs instead of the lift, getting up to change the TV station instead of using the remote control, housework, and gardening. Avoid watching too much TV or sitting at the computer for a long time.
Use a pedometer to increase the overall physical activity level. Stanford University researchers conducted a review of 26 studies looking at the use of pedometers as motivation for physical activity. Published in 2007, the review found that people who used a pedometer increased their activity by 27%.
Having a goal of 10,000 steps a day (about five miles) was important, even if the goal wasn't reached. Pedometer users lost more weight, had a greater drop in blood pressure, and walked about 2,500 steps more per day than those who didn't use a pedometer.
How much exercise is good?
For good health, you should be doing about 30 minutes of exercise every day. If this is not possible, then this time can be divided in 3 x 10 minutes sessions. You can break up exercise throughout the day.
If you need to lose weight, you need to do 45-60 minutes of exercise every day.
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.
Taking care of your feet
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.
- Always inspect your feet before and after exercise
- 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
- Wear comfortable and well-fitting shoes.
- 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 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 Credentialed 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.
Advice for people with type 1 diabetes
Regular exercise is an important part of your diabetes management. It will help your insulin to work more efficiently and assist with your blood glucose control. However, if you have fluctuating or high blood glucose levels (i.e. fasting blood glucose levels greater than 14 mmol/L and urinary ketones), 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.
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