By Pamela Long, Fitness programmer, FMWRMay 30, 2013
FORT JACKSON, S.C. -- Sometimes we decide to get our health under control when we are faced with a health scare. One of those scares is Type 2 diabetes. Once diagnosed, we want to dive into better eating and exercising. However, the seriousness of this disease requires us to take the proper steps to make sure that our willingness to change our lifestyle is in tune with our doctor and diabetic coach. Having a consistent relationship with both is necessary to create the safe and long lasting management of Type 2 diabetes.
What role does exercise play in managing Type 2 diabetes? What precautions must you take before exercising? Which exercises should you avoid? Learn the steps you should take before beginning or continuing an exercise program. Awareness, exposure and accessibility to services are some of the keys to not just managing Type 2 diabetes, but thriving in spite of it.
Exercise can help you manage your blood sugar control, as well as boost your overall fitness and reduce your risk of heart disease and nerve damage. But, before you begin exercising with Type 2 diabetes, you should speak with your doctor about which exercises are safe for you. Discuss with your doctor which activities you are thinking about doing and the best time of day to exercise, as well as the potential impact of current medications on your blood sugar as you become more active.
According to the American Diabetic Association, when exercising, you should track your blood sugar before, during and after exercise. Your records will show how your body responds to exercise and potentially help you prevent dangerous blood sugar fluctuations. The ADA recommends working closely with your health team -- your doctor, diabetic nutritionist and your family -- to ensure they are aware of your exercise activities as a Type 2 diabetes patient.
For improving blood sugar control (stabilizing blood sugar is one key to management) , the ADA recommends at least two and a half hours of moderate-intensity physical activity per week through exercising at least three days a week, and no more than two consecutive days without physical activity. The ADA recommends exercise such as brisk walking, swimming laps in a pool or bike riding.
People with Type 2 diabetes must check with their doctor before starting a strength training regimen to be sure they are able to do this type of exercise. The ADA recommends performing resistance exercise three times a week. Again, make sure you are cleared by your doctor to exercise.
According to the ADA, if you are taking insulin, you should check your blood sugar level about 30 minutes before your exercise and then check it again right before you exercise. This will help you determine if your blood sugar level is stable and if it is safe to exercise that day. From working with a doctor and diabetic nutritionist, patients learn their healthy blood sugar range.
Please note, if you are exercising and you feel your blood sugar is too low; stop exercising and check your blood sugar before continuing; then follow the steps provided by your doctor to bring sugar levels back to a healthier range.
Recheck your readings in about 15 minutes. If the numbers are still low, you do not want to exercise. If the numbers are normal, you should exercise with caution.
Check your blood sugar right after exercise and again several times during the next few hours. Exercise draws on reserve sugar stored in your muscles and liver. As your body rebuilds these stores, it takes sugar from your blood. The more strenuous your workout, the longer your blood sugar will be affected. Low blood sugar is possible even hours after exercise. Exercise can be good, but type and intensity play a major role in keeping blood sugar leveled. You do not want to overdo it.
If you do have low blood sugar after exercise, it is recommended that you eat a small carbohydrate snack, such as fruit or crackers, or drink a small glass of fruit juice. A small snack which can boost blood sugar significantly. Too large of a snack could boost your blood sugar too much.
Other suggested tips to make exercise a healthy part of your Type 2 diabetes control:
- Always check your feet for any problems before and after exercise.
- Wear socks that keep moisture away from your feet.
- Wear comfortable, well-fitting shoes.
- Wear a bracelet or necklace that says you have diabetes.
- Always have fast-acting carbs with you.
- Carry emergency phone numbers with you.
- Drink plenty of water. Do this before, during and after exercising.
- Try to exercise at the same time of day, for the same amount of time, and at the same level. This will make your blood sugars easier to control.
A look at Hypoglycemia
For people with diabetes who take medication or insulin, hypoglycemia is a concern. Whenever you are physically active, your muscles burn glucose. First, they gobble up the glucose they have stored as glycogen. As the activity continues, glucose from the blood pours into the muscles to supply their energy needs, lowering blood glucose levels. However, this march of glucose from the blood into the muscles doesn't end when the activity stops.
The body needs to refill the muscles' glucose storage tanks in preparation for future movement. As a result, a hypoglycemic reaction can occur not only during periods of activity, but up to 24 hours later. Some people with diabetes who have frequently experienced hypoglycemia begin to associate any form of activity with a loss of glucose control. These fluctuations create great confusion and frustration, leaving many people upset and scared.
They may decide that activity is not worth the unpredictable swings in glucose. That is why you must continuously check your blood sugar to help better understand your body's response to exercise and prepare for it by adjusting medication or food intake. Exercise can be beneficial to your health in many ways, but if you have diabetes, testing your blood sugar before, during and after exercise may be just as important as the exercise itself. The ADA offers a free living with Type 2 diabetes program. It is a 12- month program for people who are newly diagnosed. For more information, call 799-4246 or visit www.diabetes.org.
Editor's note: Information from the American Diabetic Association was used in this article. Do not attempt any exercise program before getting clearance from your doctor.