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diabetes and exercise

Alternative Names 
exercise for people with diabetes

Diabetes mellitus, or DM, more commonly known as diabetes, is a condition that affects the body's ability to control the level of glucose in the blood. Glucose is the main form of sugar used by the body. When a person has diabetes, his or her body does not make enough insulin to meet its needs. Insulin is a hormone made by the pancreas. One of its primary functions is to help the body control the level of glucose in the blood.

Glucose is an important source of energy for the body's cells. When a person eats, the sugar in food causes the glucose level in the blood to rise. Normally, the pancreas responds by making extra insulin. The insulin causes the glucose in the blood to move inside the body's cells.

In a person with diabetes, the pancreas doesn't make enough insulin for this to happen effectively. As a result, the cells are left without a main source of energy. Glucose also builds up in the blood. The result is a high blood glucose level, called hyperglycaemia. There are a number of ways to lower the blood glucose level. These include an appropriate diet for diabetes, medication, and exercise. Exercise is a natural way a person with diabetes can help control his or her blood sugar levels. Muscles use more glucose during exercise. This helps to lower the blood sugar level.

Two of the more common types of diabetes are called type 1 and type 2 diabetes. People with either of these types of diabetes mellitus benefit from regular exercise.

What is the information for this topic? 
Benefits of exercise

Exercise is an important part of diabetes treatment. Exercise can lower the level of glucose in the blood, but also may:
  • help the body make better use of its food supply
  • allow the body cells to use insulin and glucose more effectively
  • aid a person in losing excess weight if he or she is overweight or obese
  • improve blood circulation throughout the body
  • increase the heart's ability to pump blood
  • lower high blood pressure
  • help a person feel better physically and mentally
Lack of physical activity contributes significantly to the development of type 2 diabetes. A recent study showed that walking briskly for 3 hours a week, or exercising vigorously for an hour and a half each week, reduces a woman's risk of developing type 2 diabetes by 40%.

Evaluation before starting an exercise program

It is important for a person with diabetes to have a detailed medical evaluation before starting an exercise program. The doctor can help design an appropriate exercise program. To do this, the doctor must first take various factors into account, including a person's: A graded exercise test may be helpful if a person is at high risk for heart disease and is planning to start a moderate to high intensity exercise program. Individuals at high risk include those who:
  • are 35 years of age or older
  • have had type 2 diabetes more than 10 years
  • have had type 1 diabetes more than 15 years
  • have additional coronary risk factors, including high blood pressure
  • have significant diabetic nephropathy, or kidney damage from diabetes
  • have significant retinopathy, or retinal damage in the eye
  • have peripheral vascular disease, or impaired circulation in the legs and arms
  • have autonomic neuropathy, or damage to the part of the nervous system that controls blood pressure and other involuntary functions

Guidelines for exercise

It is important to regulate the body's glucose levels in response to exercise. The following are exercise guidelines for people with type 1 diabetes:
  • Monitor blood glucose levels before and after exercise.
  • Do not exercise if fasting glucose levels are greater than 14 mmols/L (millimoles per litre) and ketosis is present (shown by a test for ketones).
  • Use caution if glucose levels are greater than 17 mmols/L and no ketosis is present.
  • Eat or drink added carbohydrates if glucose levels are less than 6 mmols/L before exercise.
  • Eat additional carbohydrates as needed to avoid hypoglycaemia, or low blood sugar. Foods high in carbohydrates should be readily available during and after exercise.
  • Adjust insulin doses and food intake as needed in response to exercise.
  • Learn how the body's blood glucose levels change in response to exercise.
People with diabetes should include warm-up and cool down periods in their exercise program. The warm-up should include 5 to 10 minutes of aerobic activity such as low-intensity walking, followed by 5 to 10 minutes of gentle muscle stretching. The cool down after exercise should last about 5 to 10 minutes and gradually bring the pulse down to the level it was before exercise.

Because people with diabetes often have impaired circulation and sensation in their feet, good exercise footwear is important. The use of silica gel or air midsoles in athletic shoes, along with polyester or polyester-cotton-blend socks, to prevent blisters and keep the feet dry are some recommendations.

Individuals with diabetes should let those exercising with them know they have diabetes. They should also tell them what to do if they become weak. An identification bracelet or shoe tag indicating the person's diabetes should be clearly visible. People who exercise by themselves should tell others where they are going and when they will be back.

Exercising regularly, eating a healthy diet, and following the treatment plan set up with a doctor can improve control of diabetes and help people feel healthier and happier.

Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 28/02/2005
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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