Incorporating exercise into one’s lifestyle is among the first steps people newly diagnosed with diabetes should consider to help control their condition. Therefore, those who previously led sedentary lives, the prospects of initiating an exercise program can often be intimidating, filled with uncertainties and unfounded fears.

In order to help people with diabetes work through issues associated with starting an exercise regimen, Genesis Sports Medicine and Rehabilitation introduces a new Diabetes Fitness Program that makes exercise safe and fun.

How exercise can help?
Aerobic exercise increases insulin sensitivity and, along with proper nutrition, helps restore normal glucose metabolism by decreasing body fat. Strength training (aka resistance or weight training) also decreases body fat by raising the metabolism. Its main benefit, however, is increasing glucose uptake by the muscles and enhancing the ability to store glucose. Exercise can mean the difference between medical management and lifestyle management of type 2 diabetes.

Who can exercise?
The American Diabetes Association recommends that anyone with diabetes have a thorough medical exam to see if there are risks for coronary artery disease and that blood glucose control is adequate before starting an exercise program. The doctor will usually advise exercise if the patient has:
1. Blood glucose less than 250 mg/dl
2. No symptoms of retinopathy, (damage to the blood vessels of the eye), neuropathy (damage to the nerves and circulation to extremities), or nephropathy (kidney damage).
3. No cardiovascular problems such as angina, embolism, or aneurysm
4. No other condition that makes exercise inadvisable

Why should my exercises be monitored?
1. Blood glucose will be monitored by your physical therapist to prevent hypoglycemia.
2. Blood pressure and pulse rate will be monitored to ensure safe exercise zones.
3. Feet will be monitored for blisters or sores before and after exercises.
4. Proper warm up before and after exercises with stretches to prevent muscle soreness.
5. Design proper exercises to prevent unnecessary stress on your feet.
6. Establish proper sets and reps for strength training as well as duration for aerobic exercises.

Guidelines for Diabetes Exercises Program

Foot care guidelines
A person with diabetes, there is no such thing as a “just a little blister”. An open sore can turn into a serious infection proper footwear is a must. Shoes should be comfortable, well-fitting and appropriate for the chosen exercise. Socks should be worn properly (fabric should be smooth and wrinkle free) during exercise and changed after each workout. Sweaty socks increase blisters, ingrown toenails, corns, and calluses. Immediately contact a doctor for ingrown toenails, athlete’s foot, and cuts or sores that are not healing.

Hypoglycemia prevention
Hypoglycemia is a major risk among Type 2 diabetics on oral medication because of insulin-like effect of exercise. The warning signs for mild and moderate hypoglycemic reactions are: trembling or shakiness, rapid heart rate, palpitations, increased and excessive sweating, excessive hunger, headache, drowsiness, mental confusion, and abrupt mood changes.

In the event of a hypoglycemic attack:
1. Take action even if you are not sure you have hypoglycemia - waiting can make it worse
2. Take a blood glucose test to confirm the problem
3. Eat or drink foods high in sugar such as: ½ cup of fruit juice, six lifesavers or 1 small box of raisins
4. Take at least a 10-15 minute rest and retest blood-glucose level before resuming exercise
Don’t exercise if it’s below 100 mg/dl or if you still don’t feel right
5. Take your blood glucose level every 20-30 minutes during your workout
You should monitor blood glucose for 12 hours after long workouts (longer than 45 minutes) or when changing the intensity or duration of your exercise even if your workout is less than 45 minutes.

Exercise guidelines for the type 2 diabetic
Let your body get used to exercising. Warm up and cool down for 5-10 minutes each by exercising at a low intensity before and after your moderate intensity workout.

Aerobic exercises are very imperative for Type 2 diabetics. A large majority of diabetics are sedentary and overweight, low-impact exercises such as walking or stationary cycling is recommended, along with enough exercise to promote weight management. The ultimate goal should be to exercise five times per week, up to 40-60 minutes per session at a moderate intensity.

Strength training is safe and can provide many benefits. It can increase lean mass which will help in weight management, as well as increase glucose uptake by the muscles and help the body to store glucose.

Medications are not enough to make a diabetic feel good and live a full life. Exercise and good nutrition provide real physical payoffs they are essential to controlling diabetes. Exercise can help prolong lives and improve the quality of your life for months and years to come.