Training With Diabetes

Diabetes, particularly type 2, is reaching epidemic proportions throughout the world as more and more cultures adopt Western dietary habits.

Aerobic exercise is proving to have significant and particular benefits for people with both type 1 and type 2 diabetes.

Benefits of Exercise for People with Diabetes:

People with diabetes are at particular risk for heart disease, so the heart protective effects of exercise are very important for this patient population.

Moderate exercise, in fact, protects the heart in people with type 2 diabetes, even if they have no risk factors for heart disease other than diabetes itself.

Regular exercise, even of moderate intensity, improves insulin sensitivity, one study reported that yoga helped patients with type 2 diabetes reduce their need for oral medications.

Studies suggest that regular or moderate aerobic exercise lowers the risk for developing diabetes in the first place in overweight people, even if they don't lose weight.

There is some indication that aerobic exercise before and during pregnancy can lower glucose levels and may be protective for women at risk for or who have gestational diabetes. (Any pregnant woman should check with her physician before embarking on any exercise regimen.)

Some Precautions for People with Diabetes Who Exercise:

The following are precautions for all people with diabetes:

• Because people with diabetes are at higher than average risk for heart disease, they should always check with their physicians before undertaking vigorous exercise.
  
• For best and fastest results, frequent high-intensity (not high-impact) exercises are best for people who are cleared by their physicians.
  
• For people who have been sedentary or have other medical problems, lower-intensity exercises are recommended using regimens designed with physicians.
  
• Strenuous strength training or high-impact exercise is not recommended for uncontrolled diabetes.
  
• Resistance or high impact exercises can strain weakened blood vessels in the eyes of patients with retinopathy.
  
• High-impact exercise may also injure blood vessels in the feet, patients who are taking medications that lower blood glucose, particularly insulin, should take special precautions before embarking on a workout program.
  
• Glucose levels swing dramatically during exercise, people with diabetes should monitor their levels carefully before, during, and after workouts.
  
• Patients should probably avoid exercise if glucose levels are above 300 mg/dl or under 100 mg/dl.
  
• To avoid hypoglycemia, diabetics should inject insulin in sites away from the muscles they use the most during exercise.
  
• Before exercising, they should also avoid alcohol and, if possible, certain drugs.
  
• Insulin-dependent athletes may need to decrease insulin doses or take in more carbohydrates prior to exercise but may need to take an extra dose of insulin after exercise.
  
• Stress hormones released during exercise may increase blood glucose levels; in non-diabetics insulin is released to control this.
  
• Diabetics therefore need to test their blood sugar and take an extra dose as instructed by their diabetes healthcare provider.
  
• Diabetics also need to drink plenty of fluids prior, during and after training.