Get Moving: Diabetes and Exercise

Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for immediate energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin which helps the sugar in our blood streams get into the cells of our bodies. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugar to build up in your blood. The excess sugar levels that result can, over years, cause damage to your cell walls, blood vessels, heart, kidneys and eyes.

Diabetes, and its related complications, is the seventh-leading cause of death in the United States. People with blood glucose levels that are higher than normal but not yet in the diabetic range have “prediabetes.” Doctors sometimes call this condition impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Insulin resistance and prediabetes usually have no symptoms. You may have one or both conditions for several years without noticing anything. If you have prediabetes, you have a higher risk of developing type 2 diabetes. People with prediabetes also have a higher risk of heart disease.

Progression to diabetes among those with prediabetes is not inevitable. Studies suggest that weight loss and increased physical activity among people with prediabetes prevent or delay diabetes, and may return blood glucose levels to normal.

Risk Factors for Developing Diabetes Include:

• Being overweight or obese.
• Having a parent or sibling with diabetes.
• Having African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino heritage.
• Having a prior history of gestational diabetes or giving birth to at least one baby weighing more than nine pounds.
• Having high blood pressure measuring 140/90 or higher.
• Having abnormal cholesterol with an HDL (“good”) cholesterol of 35 or lower, or a triglyceride level of 250 or higher.
• Being physically inactive – exercising fewer than three times a week.

The Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a large, federally funded study of 3,234 people at high risk for diabetes. The study showed that people can delay and possibly prevent the disease by losing a small amount of weight (five to seven percent of total body weight) through 30 minutes of physical activity five days a week. Research studies have found that moderate weight loss and exercise can prevent or delay type 2 diabetes in high-risk adults. Physical activity can help you control your blood glucose, weight and blood pressure, as well as raise your “good” cholesterol and lower your “bad” cholesterol. It can also help prevent heart and blood-flow problems, reducing your risk of heart disease and nerve damage, which are often problems for people with diabetes.

Experts recommend moderate-intensity physical activity for at least 30 minutes five or more days a week. Some examples of moderate-intensity physical activity are walking briskly, mowing the lawn, dancing, swimming, or bicycling. If you are not accustomed to physical activity, start with a little exercise, and work your way up. As you become stronger, add a few extra minutes to your physical activity.

Do some physical activity every day. It’s better to walk 10 or 20 minutes a day than one hour once a week. Even wearing a pedometer can help by giving you a clear idea of just how much you move your body in a day. Parking farther away when you shop or run errands, taking the stairs more often at work, or taking a walk around your building at lunch help to quickly burn up extra sugar.

Walking vigorously, hiking, climbing stairs, swimming, aerobics, dancing, bicycling, skating, skiing, tennis, basketball, volleyball, or other sports are just some examples of physical activity that will work your large muscles, increase your heart rate, and make you breathe harder – important goals for fitness. In addition, strength training exercises with hand weights, elastic bands or weight machines can help you build muscle. Stretching helps to make you flexible and prevent soreness after other types of exercise. The bottom line is to do physical activities you really like. The more fun you have, the more likely you will do it each day.

Before You Get Moving

Exercise is very important way for people with diabetes to stay healthy, but there are a few things to watch out for. Talk to your health care provider about a safe exercise plan that’s right for you. He or she may check your heart and your feet to be sure you have no special problems. If you have high blood pressure, eye or foot problems, you may need to avoid some types of exercise. For example, exercise involving heavy weights may be bad for people with blood pressure, blood-vessel, or eye problems.

Diabetes-related nerve damage can make it hard to tell if you’ve injured your feet during exercise, which can lead to more serious problems. If you do have diabetes complications, your health care provider can tell you which types of physical activity would be best for you.

Physical activity can lower your blood glucose too much, causing hypoglycemia, especially in people who take insulin or certain oral medications. Hypoglycemia can happen at the time you’re exercising, just afterward, or even up to a day later. You can get shaky, weak, confused, irritable, anxious, hungry, tired or sweaty. You can get a headache, or even lose consciousness. To prevent hypoglycemia during physical activity, check your blood glucose before you exercise. If it’s below 100, have a small snack – and bring food or glucose tablets with you when you exercise just in case. It is not good for people with diabetes to skip meals at all, but especially not prior to exercise. After you exercise, check to see how it has affected your blood glucose level. If you take insulin, ask your health care provider if there is a preferable time of day for you to exercise, or whether you should change your dosage before physical activity, before beginning an exercise regimen.

On the other hand, you should not exercise when your blood glucose is very high because your level could go even higher. Do not exercise if your blood glucose is above 300, or your fasting blood glucose is above 250 and you have ketones in your urine.

When you exercise, wear cotton socks and athletic shoes that fit well and are comfortable. After you exercise, check your feet for sores, blisters, irritation, cuts, or other injuries. As always, drink plenty of sugar-free fluids during physical activity, since your blood glucose can be affected by dehydration. So, keep on moving to keep burning up the sugar!

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