Diabetes and Exercise

Exercise is very important in managing diabetes. Combining diet, exercise and medicine (when prescribed) will help control your weight and blood glucose level.

Exercise helps control diabetes by:

Improving your body’s use of insulin.

Burning excess body fat, helping to decrease and control weight decre4ased body fat results in improved insulin sensitivity).

Improving muscle strength.

Increasing bone density and strength.

Lowering blood pressure.

Helping to protect against heart and blood vessel disease by lowering ‘bad’ LDL cholesterol and increasing ‘good’ HDL cholesterol.

Improving blood circulation and reducing your risk of heart disease.

Increasing energy level and enhancing work capacity.

Reducing stress, promoting relaxation, and releasing tension and anxiety.

How Does Exercise Affect Blood Glucose Levels?

Normally, insulin is released from the pancreas when the amount of glucose (sugar) in the blood increases, such as after eating. Insulin stimulates the liver and muscles to take in excess glucose. This results in a lowering of the blood glucose level.

When exercising, the body needs extra energy or fuel (in the form of glucose) for the exercising muscles. For short bursts of exercise, such as a quick sprint to catch the bus, the muscles and the liver can release stores of glucose for fuel. With continued moderate exercising, however, your muscles take up glucose at almost 20 times the normal rate. This lowers blood glucose levels.

But intense exercise can have the opposite effect and actually increase your blood glucose levels. This is especially true for many people with diabetes. The body recognizes intense exercise as a stress and releases stress hormones that tell your body to increase available blood glucose to fuel your muscles. If this happens to you, you may need a little bit of insulin after intense workouts.

For a variety of reasons, after exercise, people with diabetes may have an increase or a decrease in their blood 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.

 What Types of Exercise Are Best for Blood Glucose Control?

While most any exercise is healthy for people with diabetes, let’s look at some specific types of exercise and their benefits:

What is Exercise?

Exercise is  physical activity and includes anything that gets you moving. Learn more about how exercise can make you feel better physically and mentally.

The National Diabetes Education Program has designed a national awareness campaign to target people at risk for type 2 diabetes. The campaign will create awareness that type 2 diabetes can be prevented through modest lifestyle changes and losing about 5 to 7 percent of body weight.

What is Diabetes?

Type 1 diabetes is caused by an autoimmune disorder-a problem with the body’s immune system. In a healthy body, specialized cells (called beta cells) in the pancreas make insulin. Insulin is a hormone that allows the body to use energy from food. In type 1 diabetes, the immune system mistakes beta cells for invaders and attacks them. When enough beta cells are destroyed, symptoms of diabetes appear.

Type 2 diabetes, the beta cells still produce insulin. However, either the cells do not respond properly to the insulin or the insulin produced naturally is not enough to meet the needs of the body. So insulin is usually still present in a person with type 2 diabetes, but it does not work as well as it should. Some people with type 2 can keep it under control by losing weight, changing their diet, and increasing their exercise. Others take one or more medications, including insulin.

A diabetes myth – diabetes is not caused by eating too much sugar. This myth probably began when people with diabetes were absolutely forbidden from consuming sugar.  Researchers no longer believe this.  Your child can still have all of her favorite sweets as long as they are scheduled in her eating plan.

Types of Exercise

A comprehensive physical activity routine includes three kinds of activities:

• Aerobic Exercise
• Strength Training
• Flexibility Exercises

Aerobic Exercise

Aerobic exercise increases your heart rate, works your muscles, and raises your breathing rate. For most people, it’s best to aim for a total of about 30 minutes a day, at least 5 days a week. If you haven’t been very active recently, you can start out with 5 or 10 minutes a day and work up to more time each week. Or split up your activity for the day — try a brisk 10-minute walk after each meal. If you’re trying to lose weight, you may want to exercise more than 30 minutes a day. Here are some examples of aerobic exercise:

• Take a brisk walk (outside or inside on a treadmill)
• Go dancing
• Take a low-impact aerobics class
• Swim or do water aerobic exercises
• Try ice-skating or roller-skating
• Play tennis
• Stationary bicycle indoors

Strength Training

Strength training, done several times a week, helps build strong bones and muscles and makes everyday chores like carrying groceries easier for you. With more muscle, you burn more calories, even at rest. Here are some ways to do it:

• Join a class to do strength training with weights, elastic bands, or plastic tubes
• Lift light weights at home

Flexibility Exercises

Flexibility exercises, also called stretching, help keep your joints flexible and reduce your chances of injury during other activities. Gentle stretching for 5 to 10 minutes helps your body warm up and get ready for aerobic activities such as walking or swimming. Your health care team can provide information on how to stretch. Even if you are laying in bed or on the couch, you can give yourself a total body stretch. Do each of these little stretches six to eight times. Start with your fingers and toes and gently stretch and contract them, progress to your wrists and ankles, making circles with the joints. Bend your elbows, bringing your hands in to your shoulders, bend your knees, one at a time, up toward your chest. Bring your arms up to your ears and down, gently stretching your shoulder muscles. Raise each leg, straightened, as far as you can. Even this little range of motion exercise will increase the circulation in your extremities and work your joints.

The American Diabetes Association offers these basic guidelines:

Discuss with your doctor what types of exercise might be appropriate for you. Complications of diabetes such as  severe eye disease and nerve damage may make some forms of exercise dangerous for you. Your doctor may also schedule a test to see how your heart responds to exercise.

Do not exercise if your blood sugar is greater than 250 mg/dL (milligrams per deciliter) and your ketones  positive. This is an indication that you already may have a lack of insulin and exercise will only cause a greater rise in your glucose levels. Hydrate yourself and adjust your insulin as necessary, contact your health care provider.

Use caution when exercising if your sugars are greater than 300 mg/dL without evidence of ketones, exercise may help decrease your sugars, but it’s possible they will increase instead. Hydrate well prior to and after exercise and keep track of your sugars and ketones.

Learn the effects of various types of exercise on your blood sugars.

Have carbohydrate-based foods available for exercise and for the period following exercise. Add carbohydrates to your meals if you plan on doing exercise, adjust you insulin dose appropriately in anticipation of exercise

Should I Stop Exercising When I Reach My Ideal Weight?

Exercise is a lifetime commitment. Regardless of your weight, you should exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day.

Dealing With Neuropathy Pain

When a person is suffering from neuropathy, the ability to exercise is often curtailed by burning, numb and tingling feet and lower legs. It’s a vicious circle. Exercise can help improve neuropathic pain and increase circulation, but it hurts too much to do it. In this case, slow and gentle wins the race.

Swimming

If walking for exercise is painful, perhaps swimming might be a better alternative, because movement is easier in water, and there’s little weight on the person’s feet. It’s a good idea, however, to find a pool that’s on the warmer side, because too much exposure to cold water can reduce circulation even more.