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Physical activity has many benefits for everyone, but it is especially important for people with diabetes. In type-2 diabetes, exercise improves sugar control because as your muscles contract and relax during exercise, they use sugar for energy. To meet this energy need, your body taps into sugar supplies in your blood during and for a period after exercise, reducing your blood sugars. How hard and how long you exercise determines how much your blood glucose is reduced. Exercise also increases your body's ability to use insulin, which means your body needs less insulin to take sugar into your cells, which also reduces your blood sugar levels.

Before You Start

If you are inactive and plan to start an exercise program to help manage your diabetes, be sure to talk to your doctor first. Your doctor can tell you about any precautions you need to take and will likely conduct a pre-exercise physical.

Ready to Start

Follow these general physical activity and exercise recommendations:

• How Long:  A minimum of 30 minutes is needed to improve your fitness level. If you can't start at 30 minutes, begin with 10 or 15 minutes and slowly work up to it in a few weeks time. Thirty to 40 minutes, five days a week, is a good fitness goal. If weight loss or weight management is a concern, aim to get 60 or more minutes of exercise.
• How Often:  Three times a week is the recommended minimum number of exercise sessions, but for good blood sugar control, daily exercise is best.
• How Hard: You need to move enough to increase your heart rate and breathing to sufficient levels, but not so hard as to cause exhaustion. The intensity of an activity can be judged by using the talk/sing method. If you can sing while exercising you are not exercising hard enough; if you can talk, but you're a little out of breath, you are at appropriate level; and if you can't talk at all, you are exercising too hard. 

Guidelines for Exercise

• Start slowly with mild exercise such as a brisk walk in the park or on a treadmill - gradually increase how hard you push yourself.
• Start to exercise 3 to 4 times a week and work your way up to 5 times a week.
• While exercising, have snacks with you, such as sugar tablets or hard candy, in case your sugar drops too low.
• Be sure to drink enough fluids while you exercise, especially when hot. Dehydration can affect blood sugar levels.
• If you have insulin-dependent diabetes, carry identification with you at all times indicating you are diabetic.
• Low-impact exercise to prevent bone injury is best - that means walk instead of run, swim or do water aerobics.
• Strengthening and flexibility activities such as yoga or pilates are encouraged.
• Avoid strenuous exercise and high-intensity weight lifting.

Appropriate Sugar Levels for Exercise

• If your sugar level is below 100 before you exercise, eat a snack based on how long you will exercise:  
  • 30-45 minutes: 10-15g carbohydrate per hour or 1 small apple
  • 30-60 minutes: 20-50g carbohydrate per hour or 1 large apple and 1 cup of milk
  • 60+ minutes: 50g of carbohydrates per hour or 1 large banana, piece of wheat toast and 1 cup of milk
• If your sugar level is greater than 250mg/dl, DO NOT EXERCISE until it is under control.
• Check your sugar levels after exercise and eat appropriately if they are too low.

Hypoglycemia

Hypoglycemia occurs when blood sugars fall too low because of exercise, skipping meals and/or having too much insulin in your system. The following are signs and symptoms of hypoglycemia:

• Cold, clammy or sweaty skin
• Paleness
• Inability to concentrate
• Shakiness, lack of coordination
• Irritability, hostility and poor behavior
• Nervousness
• Fatigue
• Unsteady gait
• Excessive hunger
• Headache
• Blurred vision and dizziness
• Abdominal pain or nausea
• Fainting and unconsciousness

Know your body, recognize the early signs of hypoglycemia and take action immediately.  Be safe - your body will thank you for it!
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