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Exercise and Diabetes

Source:  The Cleveland Clinic

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

Following are the ways exercise helps control diabetes:
· Improves your body’s use of insulin
· Helps burn excess body fat, helping to decrease and control weight
· Improves muscle strength
· Increases bone density and strength
· Lowers blood pressure
· Helps protect against heart and blood vessel disease by lowering cholesterol
· Improves circulation and reduces your risk of a heart attack
· Increases energy level and enhances work capacity
· Reduces stress, promotes relaxation, and releases tension and anxiety
· Improves physical appearance
· May raise HDL, or “good” cholesterol

How Does Exercise Affect Blood Glucose Levels?

Insulin is released when the concentration of glucose (glucose) in the blood increases, such as after eating. Insulin stimulates muscle and fat cells to absorb the glucose they need to fuel the body.

Muscles store some glucose in the form of glycogen for use during short bursts of exercise, such as a quick sprint to catch the bus. As you continue exercising, your muscles take up glucose at almost 20 times the normal rate. Thus, moderate exercise usually helps lower 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.

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. The American Diabetes Association offers this basic guideline:  If you find that your blood glucose level is high just before exercise– 300 mg/dL (milligrams of glucose per deciliter of blood) or higher– you should wait until your blood glucose is under control before exercising.

Should I Stop Exercising When f 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. Changes in your metabolism that help reduce your blood glucose go back to their original levels within 72 hours after exercise has stopped.

General Exercise Guidelines and Precautions

Check with your healthcare provider before you begin an exercise program. Tell your doctor what kind of exercise you want to do so adjustments can be made to your medicine schedule or meal plan, if necessary.

· Start slowly and gradually increase your endurance.
· Choose an activity that you enjoy. You’ll be more likely to stick with a program if you enjoy the activity. Make exercise a lifetime commitment.
· Exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day.
· Wear good shoes and practice proper foot care.
· Consider a water exercise program. Some other exercise options include walking, riding a stationary bicycle, swimming, or muscle stretching.

· A good exercise program should include a 5- to 10-minute warm-up and 15 to 30 minutes of continuous aerobic exercise (such as walking or biking) or muscle stretching exercises, followed by a 5-minute cool down.

· To reduce the risk of hypoglycemia, the best time to exercise is 30 to 60 minutes after eating. Follow a regular routine of exercising, eating your meals and taking your medicines at the same time each day.

· Prolonged or strenuous exercise can cause your body to produce adrenaline and other hormones that can counteract the effects of insulin and cause your blood glucose to rise. If you are participating in strenuous exercise (exercising at your maximum capacity) or prolonged exercise (lasting for several hours or more), your insulin and/or oral diabetic medicine may need to be changed. Talk to your healthcare provider about how to adjust your medicine.

· Be careful exercising when your medicine is reaching its peak effect.

· Do not ignore pain –discontinue any exercise that causes unexpected pain. If you continue to perform the activity while you are in pain, you may cause unnecessary stress or damage to your joints.

· Drink water before, during and after exercise to prevent dehydration.

· Test your blood glucose before and after you exercise. If your blood glucose is less than 100 mg/dL or lower before you start exercising, eat a snack. If your blood glucose is 300 mg/dL or higher before exercising, do not exercise.

· If you are taking insulin or an oral glucose-lowering medication, always carry a glucose source with you while exercising.

· Exercise with someone who knows you have diabetes and knows what to do it you have a low blood-glucose reaction.

· Wear a medical identification tag (for example, MedicAlert) or carry an identification card that states you have diabetes. (To obtain a MedicAlert identification tag, please call 1-800-432-5378.)