Sure, it’s no secret – exercise is good for your health. But, did you know that exercise can be a great partner in managing your diabetes? Simply getting up and getting moving can get you on your way to a happier, healthier you.

Benefits of Exercise

Exercising can make you look and feel better, have more stamina and deal better with stress. Some people eat when they are stressed. Exercise helps you feel more relaxed, and perhaps you will find you are less likely to eat excessively.

Exercise improves overall cardiovascular health. It lowers blood pressure and cholesterol levels. It also strengthens your heart and circulation. It decreases body fat and increases muscle tone. Exercise also increases metabolism, so you burn more calories, even when you are resting.

Before You Start

Before beginning any exercise program, check with your health care team. You may need to have some tests done prior to starting. If you are taking insulin, you will also need to discuss necessary dosage changes.

Depending on your medical condition, some types of exercise may worsen diabetes complications. For example, if you have eye complications, weight lifting, jogging and other activities of high impact may not be an option for you. These high-impact activities may cause weak blood vessels in your eyes to break. Low impact activities, such as walking or swimming, may be a better choice.

Depending on your level of activity, you may need different meal plans for different days, i.e. one for exercise days and one for rest days or one for weekends and one for work days. This is especially important when you use insulin for your diabetes.

Types of Exercise

There are two types of exercise. Aerobic exercise uses oxygen to release energy from cells. Anaerobic exercise does not use oxygen.

Aerobic exercise includes activities like walking, bicycling, cross-country skiing and swimming. Anaerobic exercise includes bowling, golfing with a cart and weight lifting. Aerobic exercise burns glucose and fat and provides the greatest benefit for blood glucose and weight management. It also helps with stress and decreases hunger.

Anaerobic exercise builds muscle tissue, which can increase metabolism. Some anaerobic exercises, such as strenuous lifting, can worsen diabetes complications by putting stress on an area of the body. Check with your health care team before doing this type of exercise.

Intensity of Exercise

Levels of exercise can be described as light, moderate or strenuous. Depending on your fitness level, light exercise for you could be strenuous exercise for another person.

• Light exercise does not make you breathe heavily, but your pulse does increase slightly. Light exercise will not affect blood glucose if done less than 10 minutes. If light exercise is done more than 10 minutes, blood glucose may be lowered.
• Moderate exercise results in heavier breathing that you will notice and a pulse rate increase to more than 100 beats per minute.
• Strenuous exercise involves rapid breathing with a pulse rate between 125 to 160 beats per minute.

Moderate and strenuous exercise will increase your blood glucose if done for less than 10 minutes. This is your body’s way of supplying energy for the exercise. When done for longer than 10 minutes, moderate and strenuous exercise lowers blood glucose.

It is generally recommended that you increase your time spent exercising and the frequency of exercise before you increase your intensity. This approach is generally safer.

Before, During and After Exercise

If you take insulin within 30 minutes of exercise, remember that insulin is absorbed faster if injected into a working muscle. To help prevent hypoglycemia, do not inject a working muscle.

For example, if you will be running, do not inject in the thigh. Remember this for daily activities too. If you are going to be scrubbing while cleaning, do not use an arm site.

Before you exercise, check your blood glucose.

• If your blood glucose is under 70mg/dL, treat yourself for hypoglycemia. Do not exercise. Wait until your blood glucose is at least 100mg/dL to exercise.
• If your blood glucose is over 240mg/dL, test your urine for ketones. If you have ketones in your urine, do not exercise.
• If your blood glucose is over 300mg/dL, do not exercise, regardless of whether you have ketones in your urine or not.

Don’t forget to warm up your muscles. Do some low intensity exercise like walking for 5 to 10 minutes, and then stretch for 5 to 10 minutes. This will prevent muscle cramps and injuries and will help prevent hunger after you exercise.

Wear your diabetes identification jewelry and have personal identification with you. Bring your carbohydrate source in case of hypoglycemia, particularly if you use insulin or if you take sulfonylurea medications.

Wear comfortable shoes and socks. Cotton socks without seams are a good option. Shoes and socks should not rub or cause calluses.

It’s also a good idea to bring a portable phone with you or know how to access a phone in case of an emergency.

While exercising, take your pulse every 10 to 15 minutes to determine if you are exercising at your target heart rate. However, do not over do it. You should still be able to talk while you are exercising.

If you have any of these signs of overexertion, stop exercising and let your health care team know about them.

• Increased shortness of breath
• Nausea or vomiting
• Irregular heartbeat
• Excessive fatigue
• Feeling faint or lightheaded
• Pain or pressure in the chest or arm

Finish your exercise by gradually decreasing your intensity for 5 to 10 minutes. Then stretch for 5 minutes. By cooling down after you exercise, you will prevent aches and muscle cramping.

Test your blood glucose after exercising to see how the exercise affected your blood glucose. This will help you when planning for future exercise. If you exercise for prolonged periods of time, you may need to test your blood glucose during exercise. Do not use alternate site testing during this time.

Remember to drink plenty of water before, during and after exercise, especially if you sweat a lot.

Creating an Exercise Plan

To be successful, you must enjoy the activities you participate in. It’s also important to set realistic goals. Start slowly and work your way to a more intense activity.

Motivation is essential to succeeding with any exercise plan. Ideas that may help include:

• Having an exercise buddy
• Scheduling your exercise
• Taking a class
• Choosing activities that don’t depend on the weather
• Rewarding yourself when you reach short-term and long-term goals

Copyright 2006 Medicine Shoppe International, a Cardinal Health company. All rights reserved.

These materials were adapted from Life with Diabetes: A Series of Teaching Outlines, American Diabetes Association, 2000, Diabetes Care, Volume 27, Supplement 1, January 2004 and Diabetes Forecast, January 2006. Byetta package label., and Symlin package label.