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Exercise and Diabetes

Published:
28-Feb-2005

By H. Peter Chase, MD
Barbara Davis Center for Childhood Diabetes
Department of Pediatrics

Many people with the best-controlled diabetes are those who exercise regularly. Exercise should be a normal part of life for everyone.

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Exercise And Diabetes

The Importance of Exercise

Exercise is important and helps people with diabetes in the following ways.

  • Exercise Helps Burn Excess Sugar - Physical exercise helps the body burn more sugar. Insulin is still needed to allow the sugar to be burned, but insulin is more effective during periods of exercise. The old belief that people should not exercise if they have high blood sugar is wrong. The exercise usually helps to lower the blood sugar. IT IS ONLY WHEN URINE KEYTONES ARE PRESENT THAT PEOPLE SHOULD NOT EXERCISE.
  • Exercise Helps People Feel Better - There is a feeling of well being and pride that come from being in good physical condition. Many people just seem to feel better when they exercise daily. They tend not to tire as easily. Some people even say they are happier. Other people like to watch TV and eat snacks that raise the blood sugar level. Exercise is a good way to improve a bad mood and to change a bad habit.
  • Exercise Helps Keep the Body in Good Shape - Exercise is important, not only for people with diabetes, but for everybody. The only ways to prevent obesity are to exercise and not overeat.
  • Exercise Helps Keep the Heart Rate and Blood Pressure Lower - The heart is helped by exercise for many reasons. The heart of a person who is in good physical shape can do the same work with fewer heartbeats. Exercise tends to build extra blood vessels in the heart. This lets more blood flow to the heart.
  • Exercise Helps Keep Blood Fat Levels Normal - Exercise and good blood sugar control are the best ways to reduce blood triglyceride levels. Lowering blood fat levels improves the health and lessens the risk of heart attacks.
  • Exercise Helps to Make People More Sensitive to Insulin - The only way humans can increase insulin sensitivity is by exercising. The number of insulin receptors, the places where insulin attaches to cell membranes to allow sugar to pass into the cell, actually increases as a result of regular exercise.
  • Exercise May Help Maintain Normal Blood Circulation to the Feet in Later Life - Data from the Pittsburgh Diabetes Registry showed that when children with diabetes played in high school sports, they were more likely to keep normal foot circulation in later years. Most younger children are constantly active so that exercise is not a problem in the younger age group.

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Which Kind of Exercise are Best?

The best exercise is the one you like. Only aerobic exercises help heart fitness. Aerobic exercises include most continuous activities (such as jogging, walking, swimming, or bicycling) that are done for a period of 25 minutes or longer.

When Should I Exercise?

The best time to exercise will vary with your schedule. Think ahead and make changes in insulin doses and snacks to help prevent low blood sugar levels. Children like to play after school, and most organized sports activities take place then. This is the time that most intermediate-acting insulins are having their main effect so that extra care to prevent low blood sugar is important. When possible, pick an exercise time, preferably the same time each day, and adjust the snacks and insulin dose to fit the exercise. YOUR DIABETES MANAGEMENT CAN BE ADJUSTED TO FIT YOUR LIFESTYLE.YOUR LIFESTYLE DOES NOT HAVE TO BE ADJUSTED TO FIT YOUR DIABETES.

When Should I Not Exercise?

If your urine keytone level is large or moderate, exercise can raise the blood sugar or keytone level even higher. Thus, it is not good for you to exercise when you have urine keytones. Remember to check urine keytones before exercising if you are not feeling well.

How Can I Prevent Low Blood Sugar (hypoglycemic) Reactions During Exercise?

It is essential to prevent low blood sugar reactions during exercise. This can be done in several ways.

  • Check Blood Sugars Before, During, and After the Exercise - Sometimes blood sugars go up with exercise. Keeping good records is important.
  • Eat Before Heavy Exercise - If you are going to exercise around mealtime, you should eat the meal first. When possible allow a half-hour for digestion. Liquids are absorbed most rapidly and generally prevent low blood sugar reactions for the next 30-60 minutes. Solid foods are digested more slowly and usually provide protection for at least 2-3 hours.
  • Have Extra Snacks Available During Exercise - The person with diabetes must always have a source of carbohydrates available. A sandwich or similar snack should be available nearby. The snack that keeps the blood sugar up the longest is one that includes protein and fat along with the carbohydrate. Extra foods taken during the exercise period can help keep blood sugars in the normal range. Extra water is also important, particularly during hot weather.
  • Make Sure Others Know - It is important that coaches and teammates are aware of the diabetes. It is helpful if the coach can have at least some awareness of the symptoms and treatment of low blood sugar.
  • Reduce the Insulin Dose - BEFORE TRYING ANY ACTIVITY FOR THE FIRST TIME, DISCUSS ANY CHANGES THAT MIGHT BE NEEDED IN INSULIN DOSAGE WITH YOUR DIABETES CARE PROVIDER!

By H. Peter Chase, MD
Barbara Davis Center for Childhood Diabetes
2002