Diabetes: Guidelines for Exercise
Regular physical activity and exercise are part of a healthful lifestyle and benefit people with type 1 and type 2 diabetes. Exercise can improve the health of people with diabetes by:
• Decreasing the risk of heart disease by improving heart health through aerobic activities (walking, jogging, swimming, dancing, etc.)
• Improving cholesterol levels by decreasing the LDL (“bad”) cholesterol and increasing the HDL (“good”) cholesterol.
• Reducing blood pressure.
• Improving blood sugar control and may decrease the amount of medications a person needs by:
- Increasing lean body mass, or the amount of muscle a person has,
o Improving insulin resistance and helping muscles to use blood sugar better, and - Achieving and maintaining a healthy weight.
• Reducing the risk of diabetic complications, such as neuropathy (nerve damage), retinopathy (eye damage), and nephropathy (kidney damage).
• Improving strength, self-image, feeling of well-being and overall quality of life.
Starting an exercise program
• Check with your doctor before starting an exercise program.
• Choose aerobic activities that you enjoy and fit into your lifestyle, such as:
- fast walking
- jogging
- swimming
- skiing
- cycling
- jumping rope
- aerobic dance
- water-aerobics
Slowly increase the frequency (how often), intensity (how hard) and duration (how long) you exercise to a goal of at least 150 minutes (2 ½ hours) per week.
Before Exercise
It is best if blood sugar is in good control before exercise. If a person exercises when their blood sugar is high:
• Blood sugar and ketones will continue to rise,
• Muscles will not be able to use the blood sugar for energy,
• The liver will create more sugar to meet the needs of the muscles, and
• The increased sugar from the liver will increase the blood sugar even more.
Exercise Plan
An exercise plan includes how long, often, and how much a person would like to exercise in order to meet their goals. Each of these areas is based on a person’s current activity level, age and goals. The American College of Sports Medicine (ACSM) recommends:
• Duration: At least 150 minutes per week. This may be 30 minutes per day and can be divided into 10-minute intervals. Persons interested in weight loss may need to exercise for 60-90 minutes, in order to achieve their goals.
• Frequency: At least 5 days per week, however for good blood sugar control daily is best.
• Intensity – Using the individualized heart rate goals and perceived effort to gauge intensity. It is best to gradually increase and decrease the heart rate. Use the following equation to identify your target heart rate for 60-80% intensity:
Target Heart Rate at 60% intensity = (220 – Age) x 0.6
Target Heart Rate at 80% intensity = (220 – Age) x 0.8
Use the table below to measure your perceived effort, or exertion. It is best to exercise near an 11-13 rating on the perceived exertion scale (PES).
| Perceived Exertion Scale 6 7 Very, Very Light 8 9 Very Light 10 11 Fairly Light 12 13 Somewhat Hard 14 15 Hard 16 17 Very Hard 18 19 Very, Very Hard 20 |
Guidelines for Persons with Type 1 Diabetes
The risk of high blood glucose (hyperglycemia) and low blood glucose (hypoglycemia) episodes is a concern for persons with type 1 diabetes. Hyperglycemia can occur if the blood sugar is high before exercise. Hypoglycemia can be caused by:
• Too little food before exercise or
• Exercise when insulin is peaking.
It is best for persons with type 1 diabetes to consider the following guidelines prior to exercise:
• Monitor blood glucose levels before and after exercise.
• Make sure blood glucose is in good control; do not exercise if blood glucose is greater than 250 mg/dl.
• Exercise after meals, not before and consider increasing food intake before exercise
• Inject insulin into non-active muscle group and ask physician if you need to adjust insulin to support regular exercise.
• Always carry identification that shows you have diabetes and a sugar source during exercise, such as glucose tablets or hard candy.
Guidelines for Persons with Type 2 Diabetes
It is best for persons with type 2 diabetes to consider the following guidelines prior to exercise:
• Monitor blood glucose levels before and after exercise.
• If your blood glucose is greater than 250 mg/dl, do not exercise until it is under control.
• If you use insulin or take pills, always carry a sugar source with you such as glucose tablets or hard candy.
• When just starting out, avoid strenuous exercise and intense weight-lifting.
• Strive for regular exercise at least 3 times per week.
Guidelines for Nutrition during Exercise
Type of exercise |
If blood glucose is: |
Increase food intake by: |
| Short duration 30-45 minutes, IE: walking, an easy bike ride |
Less than 100 mg |
10-15g carbohyrdrate(carb) per hour 1 fruit or 1 starch serving |
100mg/dl or above |
Not necessary to eat more |
|
Moderate intensity 30-60 minutes IE: tennis, swimming, jogging, cycling, golfing, etc. |
Less than 100 mg |
20-50g carbs per hour (2 fruit or 2 starch with 1 meat and 1 milk serving) |
100-180 mg/dl |
15g carbs per hour (1 fruit or 1 starch serving) |
|
180-250mg/dl |
Not necessary to eat more |
|
| Strenuous intensity 60 + minutes IE: football, hockey, soccer, swimming, snow shoveling, etc. |
Less than 100 mg/dl |
50g carbs per hour (2 starch, 1 fruit, 1 milk and 1-2 meat servings) |
100-180mg/dl |
25-50g carbs per hour (2 starch or 2 starch, 1 fruit and 1 milk serving) |
|
180-250mg/dl |
10-15g carbs per hour (1 fruit or 1 starch serving) |
If you are a UW patient and have more questions please contact UW Health at one of the phone numbers listed below.
| Nutrition Clinic University Station 2880 University Avenue Madison, WI 53705 Office 608-263-5012 Appt scheduling 608 263-4360 |
Nutrition Clinic UW Health West Clinic 451 Junction Road Madison, WI 53717 Office 608-265-7526 Appt scheduling 608 262-9181 |
Nutrition Clinic UW Health East Clinic 5249 East Terrace Drive Madison, WI 53718 Office 608-265-0963 Appt scheduling 608-265-7405 |
American Family Children’s Hospital,
|
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 11/09/2012
Copyright © 11/09/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#260
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