Exercise Safely with Diabetes Exercise can improve your health and your outlook on life. A blend of aerobic exercise (e.g. walking), strength training (e.g. weight lifting), and stretching (e.g. yoga) has tremendous benefits for your health. Exercise also helps you maintain a healthy weight, lifts your mood and promotes mental wellbeing. And if you have , regular physical activity can actually lower your blood sugar, improve insulin sensitivity, strengthen your heart and raise your life expectancy. The evidence is that exercise reduces mortality and morbidity for just about all populations with diabetes, both type 1 and type 2. Because you have diabetes, however, it pays to be doubly careful not to injure yourself or upset your diabetes control. Follow the safe exercise basic guidelines that everyone who exercises needs to know. And you’ll want to add some extra safety steps that take your diabetes into account. Here are some helpful tips to keep in mind when exercising with diabetes:Before Starting an Exercise Program Talk to your doctor about any individual guidelines. Schedule an appointment with your doctor and ask about precautions and any tests you may need. For example, your doctor may order a cardiac workup to be sure you’re healthy enough to exercise. Also, some types of exercise can be harmful if you have complications from diabetes. Your doctor can tell you whether you need to avoid certain kinds of exercise. Choose an exercise you enjoy. This is important because an exercise routine can be tough to stick with. Your chances of success will improve when you choose an exercise or activity that you like and that fits easily into your daily schedule. If you choose something you enjoy, you will be more willing to continue the program. Try to include exercises that will work your heart and lungs and give you healthy muscles. Consider a variety of activities, taking walks, riding a stationary bike, or taking a group dance class, to keep things fun. Find someworkout friends. Have someone with you when you exercise, if possible. You may need help if your blood sugar level drops below a target range. And having a workout buddy (or several) can help you stay committed and motivated to exercising regularly. If you know someone is relying on you or expecting you, you may be more likely to stick to your exercise plan, even on a day you might not want to. Watch your feet. Protect your feet from damage by taking a few sensible precautions. Wear cotton or cotton-polyester socks, and choose shoes that feel good and fit well. Keep your feet dry, and check them regularly for blisters. Wear the right clothes. In the summer, wear lightweight, light-colored clothes. Be sure to use sunscreen and wear a hat. In winter, dress in layers. Polypropylene, silk, or thin, fine wool make a good first layer. These materials help lift sweat from your body and prevent chafing. Your outer layer should be made of material that can “breathe” and let sweat escape. Besure to protect your feet, hands, and head from the cold. Wear a medical ID bracelet. It’s also a very good idea to wear your medical alert bracelet or some other visible tag that identifies your diabetes. If you become injured or develop low blood sugar, this will tell emergency personnel that you have diabetes and ensure that you receive the right treatment. Take a snack with you. When you exercise, make sure you always carry an emergency snack or drink that will raise your blood sugar quickly, like glucose tablets, hard candy or fruit juice. You may have symptoms of low blood sugar while you exercise or up to 24 hours after you stop. Starting an Exercise Program Warm up and stretch when you start exercising. Warm up with a low-impact exercise like walking. This gets your heart and muscles prepared to work. After you are warmed up, you may want to stretch gently. Stretching helps keep muscles and joints flexible. Tight muscles and joints are more prone to injury. End your workoutwith a cool-down. Slow down gradually, until your breathing becomes more normal. For example, if you’ve been jogging, walk for 5 minutes to cool down. Some people prefer to stretch at the end of their workout, when muscles are warm and can stretch more easily. When your breathing is back to normal, start your stretching routine. Drink plenty of water. Sweating means you’re losing fluid. It’s important to drink to replace fluids lost in sweat. Water is usually the best choice. Everyone should make an effort to stay hydrated when they exercise. But if you have diabetes, it’s even more critical. Dehydration can cause blood sugar problems as well as stress your heart. Drink plenty of water before, during, and after your workout. If it’s hot out, be sure to load up on extra fluid. If you are exercising for a long time, you may want the extra fuel from a drink that contains carbohydrate. Check your blood sugar before exercising. If your blood sugar is less than 100 before you start toexercise, eat a carbohydrate snack. If your blood sugar is 250 or higher, don’t start exercising until your blood sugar level is under 250. Be consistent. Plan to exercise at about the same time and for the same length of time each day to help keep your blood sugar levels in the same range. If you want to increase your exercise, increase the intensity or the duration in small amounts. It is very important to be consistent with exercise. Try to do similar activities almost every day because exercise lowers your blood sugar, and consistency can help regulate your blood sugar levels. During exercise Don’t overdo it. Slow and steady wins the race. Trying to do too much too soon can leave you discouraged or even injured. One way to pace yourself is to count your heart rate and make sure it stays below a certain level. Another is to rate how difficult exercise feels and avoid too much huffing and puffing. Step up your workout as you become more fit. Gradually increase how long and how hardyou exercise. For instance, you may start out walking for just 5 or 10 minutes. Over many weeks, you may build up to 25 or 30 minutes. Work with your health-care team to adjust your exercise, meals, and medicines as you get in shape. Watch for Low Blood Glucose. If you take insulin or oral diabetes medicine, you may have low blood glucose levels during and after exercise. In fact, you may get low blood glucose 12 or more hours after a workout. People who have type 2 diabetes that is controlled by meal planning and exercise usually don’t have problems with low blood glucose. Glucose fuels your muscles during exercise. At the same time, exercise helps pep up insulin’s action. Both things lower your blood glucose level. Through careful planning, you and your health care team will learn to adjust your insulin treatment to avoid low blood glucose levels caused by exercise. Stop exercising. Stop exercising if you: have pain or trouble breathing feel dizzy or faint have nausea or vomitinghave low blood glucose have high blood pressure feel really tired feel your heart beating too fast or skipping beats After exercise Check your blood sugar again after exercise. Exercise can lower your blood sugar hours later. Test your blood sugar and have a plan for treating low blood sugar. If delayed hypoglycemia (lower blood sugar) occurs frequently, extra carbohydrates should be taken with the next meal or snack and insulin dose decreased. Adrenaline released with short bouts of vigorous exercise can cause high blood sugar. Combining short bursts of vigorous activity with longer moderate-intensive exercises can help prevent this problem. Learn how exercise affects your body. Keep records to learn how your body reacts to exercise. This way you’ll be able to plan the timing and amount of your meals, medicine, and exercise to keep blood sugar levels stable. Exercise with diabetes does demand a few extra safety steps. You’ll find that, once you’re into regular exercise, these willbecome a part of your routine. And the rewards of exercise are well worth a little extra effort.
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