The past few times we have discussed the benefits of physical activity and finding time to fit it into our busy lifestyles.  I bet you want the good stuff now, right?  Like, what do I need to do that is different from someone without diabetes?  Yes, you are correct.  There are certain precautions that you want to take if you have diabetes (Type 1 and Type 2) and plan to start a physical activity program.  Here are 7 tips to get you started.  Each tip will be expanded upon in future blogs so keep coming back for more information and remember…Keep Moving!

7 Exercise Tips For People With Diabetes:

1. See Your Doctor First

Did you know that people with diabetes have a higher risk of having a heart attack?  Even if you never had a heart attack in the past, your risk is higher than someone without diabetes.  Make sure you see your doctor before starting a physical activity program.  Your doctor may want to run some extra tests, like an Exercise Tolerance Test, also called a Stress Test, prior to beginning your program.

2. Be Safe

Many people neglect a few simple precautions that are helpful not only for you, the exerciser, but also for others.  For example, always wear a medical identification bracelet which indicates you have diabetes. We will talk more about this later. Be sure to carry some snacks in case you have a low blood glucose and don’t forget your meter and strips!  Make sure you have proper footwear. Sandals and dress shoes do not have the arch support needed for physical activity. Those are just a few things to get you on your way!

3. Be Consistent

Half the battle of getting more regular blood glucose readings is being consistent with your meal planning and also exercise schedule.  In fact, half the battle of achieving physical fitness goals is just “showing up” at the gym.  So, pick a time that you like to exercise and aim to do this 4-6 times a week.  If you want to reduce the amount of medication and/or insulin that you take you need to exercise, at minimum, every other day.  You will start to see the “cumulative” response of activity over the week and might even get to reduce your dose of insulin or medications as the weeks and months progress.  So, be consistent and reap the rewards!

4. Know Your Blood Glucose Goals

It is understandable that people with diabetes dislike having to check their blood glucose. It can be annoying and even slightly painful.  But to prevent a low blood glucose, people should check their blood glucose BEFORE and immediately AFTER exercise.  This does not mean checking 30 minutes before or 30 minutes after.  It means checking within 1-5 minutes before starting your physical activity.  Blood glucose goals are very individual and can party be determined by your physician and certified diabetes educator. However, we do have some general recommendations for people AFTER exercise.  If you take pills or oral agents you want to ensure your blood glucose is 90mg/dl or higher.  If you inject insulin, you want your blood glucose 110mg/dl or higher.  For those that take both insulin and oral agents, always use the insulin guidelines of 110mg/dl.  And of course, speak to your doctor for your specific guidelines.

5. Know How to Treat A Low Blood Glucose Reaction

The wonderful thing about exercise is that it lowers blood glucose.  The bad thing is that it can lower blood glucose too much!  Ugh.  How do we balance this?  More on that later.  First, it is important to know how to treat a low blood glucose.  Follow the 15 rule.  See my blog tomorrow on the 15 rule!  And we need to know the definition of a low blood glucose.  When NOT exercising, a low blood glucose is:  Any Blood glucose 90mg/dl or less WITH symptoms.  OR  Any blood glucose less than 80mg/dl with or WITHOUT symptoms.  This means, if my blood sugar is 75 but I feel AOK, it is still considered a low blood sugar and I should follow the 15 rule.  During physical activity, we use the blood glucose guidelines mentioned in number 4.

6. Adjust Your Insulin (If Applicable)

I already spoke about how being consistent can really pay off to lower dosages of your medications, but the big question is how much do I lower my dose of insulin prior to doing my exercise?  Did you even know that to prevent a low blood glucose you may want to lower the insulin dose?  Yup.  It’s true.  Why?  More on this later but just to get you started, you might try decreasing your FAST acting insulin (like humalog, novolog, or apidra) by one to two units.  How do you know which dose you should decrease?  Here is the general rule: if you are exercising 2 hours before a meal OR 2 hours after a meal injection, you adjust that injection dose.  For example:  I plan to exercise at 10am this morning and have lunch at 12pm.  At Noon, I will take 2 units off of my lunch dose.  Or. I am having dinner at 6pm and will exercise at 8pm.  I will reduce my dinner dose by 1-2 units.  Make sense?  More on this later and how to adjust long acting insulin!  And don’t forget…always speak with your doctor about how to adjust you insulin around activity!
7. Know when NOT to exercise

Once you get into the rhythm of an exercise routine it can actually get addicting!  Yes, you might even like it because you will see such wonderful benefits.  But, there are times when it might not be safe to exercise.  Just like anyone else who does not have diabetes, don’t exercise when you are sick, have the flu, have a respiratory infection, etc.  I like to use the “neck” rule.  If I have a head cold I will exercise, but at a slower pace.  Anything below my neck (stomach, lungs, aches)  I don’t exercise.  And you don’t want to exercise if your blood glucose is too low or too high.  More on this in future blogs!

I hope these 7 tips were helpful.  Please come back for more and feel free to write in your questions.

Keep Moving!