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Sharp Health News

Diabetes and exercise

May 19, 2017

Diabetes and exercise

Everyone can benefit from exercise. Even those with medical conditions such as diabetes can take an active role in their overall physical health - with their doctor's approval and guidance.

Here are a few tips from Dr. Neelima Chu, an endocrinologist with Sharp Rees-Stealy Medical Group, on how people with diabetes can get started with an exercise plan.

Are there certain medications that would affect exercise tolerance?
Regular exercise is very important to improve glucose control and helps insulin work better than without exercise. Diabetes medications may need to be adjusted when starting an exercise regimen. Other medicines such as beta blockers are used to lower blood pressure and heart rate, so no matter how hard you exercise when taking a beta blocker, you may never reach your target heart rate. I would recommend patients aim for moderate physical activity. If a person can't talk while exercising, then they are probably overdoing it.

What should people with diabetes do if they have pain in their fingers or feet?
It is still important to continue a modified exercise regimen because exercise may reduce pain and improve quality of life. Start with low-impact or non-weight-bearing exercises such as chair aerobics classes, stationary bicycling, using an exercise ball, swimming or yoga. Strength training using weights or resistance bands and working on improving flexibility are also very helpful.

Use pain as your guide and do not overdo it. Rest in between sets or different activities. With time and continued efforts, the pain will lessen and your endurance will improve. If you are having more or increased intensity of pain the next day, you probably exercised too hard and should consider decreasing the time or intensity of your activity.

Peripheral neuropathy or foot pain can be a complication of poorly controlled diabetes. It does not occur in every person with diabetes. It results from damaged nerves from chronically elevated glucose levels. When exercising, it is important to wear comfortable shoes that are wide and do not compress the feet. A podiatrist can make recommendations regarding the need for special shoes or inserts.

What should a person with Type 2 diabetes know about exercise-induced hypoglycemia?
Exercise can cause glucose levels to decrease (hypoglycemia). It is important to check glucose levels before, during and after exercise to ensure that glucose levels are within normal range. The range for where the glucose levels should be can be determined on an individual basis, in coordination with your doctor.

What are the symptoms of exercise-induced hypoglycemia?
The symptoms of low blood sugar can differ individually and can change over time. During the early stages of low blood sugar, you may experience sweating or trembling, and feel hungry and shaky. If you have these early symptoms, you should check your blood sugar level to see if it is low and if so, treat it immediately. If low blood sugar levels are not treated, more severe symptoms can occur. Severe symptoms can include feeling weak, trouble with walking and blurry vision, as well as feeling confused, having a seizure or losing consciousness.

What should people do if symptoms arise?
Low blood glucose can be treated by eating or drinking quick sources of sugar such as:

  • Four glucose tablets
  • One-half cup of juice or regular soda
  • Six to eight regular candies
  • One tablespoon of honey

If none of these are readily available, you can also use one tablespoon of sugar. Usually 15 to 20 grams of glucose is adequate to normalize glucose levels. Check with your doctor to see which one he or she recommends for your specific care.

How can exercise-induced hypoglycemia be avoided?
You can avoid hypoglycemia by checking glucose levels often and eating more high-carbohydrate snacks prior to exercise. Your doctor may suggest adjusting your amount of insulin or oral medicines before exercise.

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