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LIVING WITH DIABETES - DIABETES & EXERCISE
This article is an
excerpt from the book Living Well with
Diabetes from the Cleveland Clinic
Foundation.
Exercise is
very important in managing diabetes. Combining
diet, exercise and medication (when prescribed)
will help control your weight and blood glucose
levels.
Benefits of exercise
-
Improves your body's use of
insulin
-
Helps burn excess body fat,
helping to decrease and control weight
-
Improves muscle strength
-
Increases bone density and
strength
-
Decreases blood pressure
-
Helps protect against heart
and blood vessel disease (by lowering
cholesterol)
-
Improves circulation and
reduces your risk of a heart attack
-
Increases energy level and
enhances work capacity
-
Reduces stress, promotes
relaxation, and releases tension and anxiety
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Improves physical appearance
-
May raise HDL or 'good'
cholesterol
How
exercise Affects Blood Glucose Levels
Insulin is
released when the concentration of glucose in
the body increases, such as after eating.
Insulin stimulates muscle and fat cells to
absorb the glucose they use as fuel for their
activities.
Muscles store excess glucose in the form of a
starch called glycogen. During exercise, muscles
use stored glycogen as the first source of
energy. Your body burns glycogen for energy
during short bursts of exercise, such as a quick
sprint to catch the bus. As the exercise
continues, your muscles take up glucose at
almost 20 times the normal rate.
In a person whose blood glucose is controlled,
exercise may lower blood glucose levels. In the
person whose blood glucose is poorly controlled
(particularity for people with type 1 diabetes)
exercise may increase glucose levels.
Is Blood Glucose Ever Too
High to Exercise?
Yes. In some
cases, you should hold off on exercising if your
blood glucose is very high. The American
Diabetes Association offers this basic
guideline: if you find that your blood glucose
level is high8 just before exercise [300 mg/dl
(milligrams of glucose per deciliter of blood)
or higher], you should consult with your health
care team and wait until your blood glucose is
under control before exercising.
General Exercise Guidelines
and Precautions
-
Check with
your doctor before you begin an exercise
program. Tell your doctor what kind of
exercise you want to do so adjustments can
be made to your medication schedule or meal
plan, if necessary.
-
Start slowly and gradually
increase your endurance.
-
Choose an activity that you
enjoy-you'll be more likely to stick with a
program if you enjoy the activity. Make
exercise a lifetime commitment.
-
Exercise at least three to
four times per week for 20-40 minutes each
session. Ideally, you should exercise every
day.
-
Wear good shoes and practice
good foot care.
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Consider a water exercise
program. Some other exercise options include
walking, riding a stationary bicycle,
swimming or muscle stretching.
-
A good exercise program
should include a 5-10 minute warmup and 15
to 30 minutes of continuous aerobic exercise
(walking, biking) or muscle stretching
exercises, followed by a 5-minute cool down.
-
To reduce the risk for
hypoglycemia, the best time to exercise is
½ to 1 hour after eating. Follow a regular
routine of exercising, eating your meals and
taking your medications at the same time
each day.
-
Prolonged or strenuous
exercise can stimulate the production of
adrenaline and other hormones that ca
counteract the effects of insulin and cause
blood glucose to rise. If you are
participation in strenuous exercise
(exercising at your maximum capacity) or
prolonged exercise (lasting for several
hours or more), your insulin and/or oral
diabetic medication may need to be changed.
Talk to your health care provider about how
to adjust your medication.
-
Be careful exercising when
your medication is reaching its peak effect.
-
Do not ignore
pain-discontinue any exercise that causes
unexpected pain. If you continue to perform
the activity while you are in pain, you mayu
cause unnecessary stress or damage to your
joints.
-
Drink water before, during,
and after exercise to prevent dehydration.
-
Test your blood glucose
before and after you exercise. If your blood
glucose is 120 mg/dl or higher before
exercising, do not exercise.
-
If you are taking insulin or
an oral diabetes medication, always carry a
sugar source with you while exercising.
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Exercise with someone who
knows what to do if you have a low blood
glucose reaction.
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Wear a medical identification
tag or carry an identification card that
states you have diabetes.
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