By Brandon Pollock, PhD. ACSM-EP-C
There are well known health benefits associated with performing regular physical activity, such as weight loss, increased energy, lower blood pressure, and reduced risk of heart disease. According to the American College of Sports Medicine (ACSM), regular physical activity also improves your body’s sensitivity to insulin and promotes blood glucose uptake. These benefits are particularly useful for patients with diabetes as they experience a heightened level of insulin resistance (body does not use insulin properly) which frequently results in hyperglycemia (high blood sugar). Unfortunately, the complications and symptoms of diabetes make performing physical activity challenging, therefore special exercise recommendations have been developed for this population.
Safe participation in exercise and sports is largely dependent upon self-monitoring techniques and planning; as lifestyle, diet, and symptom severity can vary between individuals. Due to increased risk of hypoglycemia (low blood glucose), diabetics should get in a good habit of checking their blood glucose level prior to, every 30 minutes during, and following exercise activity. In addition to being a safety precaution, regular monitoring of blood glucose helps with understanding the impact different forms of exercise and conditions have on blood glucose levels.
Diabetics should be aware and understand any medications that they are currently taking as they may influence blood glucose. Recognizing personal tolerance and limits are critical for any diabetic wishing to safely perform exercise activity. Prior to beginning exercise, general considerations for diabetics include staying adequately hydrated, wearing appropriate foot wear (midsoles and socks to avoid blisters), keeping feet dry and protected, wearing a diabetes identification bracelet (if available), and not exercising alone. It is also a good idea to carry a small bag containing a blood testing kit, contact information, and carbohydrate-based foods at all times, in case of an emergency.
Exercise Regimen with Diabetes
An effective exercise regimen for diabetics should consist of a proper warm up,cool down, as well as aerobic, strength,and flexibility components:
Exercise activity should always begin and end with a period (5 – 10 minutes) of low intensity warm up and cool down. Both the warm up and cool down should consist of low intensity whole body aerobic activity or static stretching. The warm up is designed to prepare your body for exercise, and the cool down is designed to return your body from an exercise to resting state.
Aerobic exerciseshould involve large muscle groups and effectively increase both breathing rate and heart rate. The duration of aerobic activity should begin short and increase gradually at a rate based upon individual discretion. A projected long term goal should be 30 minutes of aerobic activity per day, for five days of the week. It is important to note that this activity can be broken up into several different sessions, and not all 30 minutes needs to be performed consecutively (you can perform 10 minutes in the morning, 10 minutes at lunch, and 10 minutes at dinner).
Strength trainingshould be designed as low intensity and high repetitions. Hand weights, elastic bands, and weight machines are acceptable modes of strength training. Strength training is recommended three times per week in order to build muscle, which is important because muscle burns more calories than fat. To have more muscle and less fat means burning more total calories at rest and during exercise.
Flexibilityexercises such as stretching or modified yoga (chair yoga) should be incorporated into the program as well to help prevent muscle soreness and reduce stress.
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National Institute of Diabetes and Digestive and Kidney Diseases- www.niddk.nih.gov/