Discuss your personal glucose target levels with your diabetes care provider before starting an exercise routine. Once you have the “go ahead” there are a few questions to consider before exercising.
Do I know my blood glucose level?
Check your blood glucose levels before, during and after different types exercise to understand the impact it has on your glucose levels. Your target glucose levels may differ depending on the type of medication and the risk it carries for causing hypoglycemia. Target glucose levels may also vary whether your exercise is aerobic, like walking or jogging, or resistance training, like weight lifting or using exercise bands. Exercise should be delayed if blood glucose levels are outside the safe target range recommended by your diabetes health provider.
Do I have access to a carbohydrate snack in case of hypoglycemia?
If you are taking a medication that puts you at risk for hypoglycemia, you shouldn’t be without a fast-acting source of carbohydrate.
Do I have access to my glucometer for glucose checks?
Since exercise can sometimes have unpredictable effects on blood glucose it is wise to have access to fast acting carbohydrates. It is especially important when first starting an exercise program. It may take some trial and error to determine how different types and durations of exercise affect your glucose levels. Snack and insulin adjustments may be necessary for physical activity over an extended time period. Regular blood glucose checks are necessary before, during and after exercise. Avoid exercising during peak insulin times. Your diabetes care provider will use these glucose checks to make recommendations to help keep your blood glucose stable.
In case of emergency can I be identified as a person with diabetes?
A medical alert bracelet, necklace or some way to alert others that you have diabetes can be a lifesaver in case of emergency. Emergency contacts and an indication of whether you take insulin is also helpful.
Other Considerations
With diabetes there are times when exercise may not be recommended or when certain exercises should be avoided.
Presence of Ketones
During exercise your body uses sugar and stored fatty acids for energy. The exercising muscle needs more glucose in the blood stream to use for energy. If there isn’t enough insulin present to allow the glucose to enter the muscles the body looks for other sources of fuel. When your body breaks down fat to use for energy ketones are produced. If ketones are present in someone with type 1 diabetes it is a sign of a serious lack of insulin and can result in ketoacidosis which is a medical emergency. Exercising with the presence of ketones is not safe and will increase the breakdown of fat for fuel and result in more ketone production.
Diabetic Retinopathy
Strenuous weight lifting or high impact activities should be avoided with certain types of retinopathy.
Advanced Kidney Disease
Avoid strenuous activity.
Diabetic Peripheral Neuropathy
Ulcerations and fractures are a risk with neuropathy, so exercise should be limited to non-weight bearing or lower impact activities.
High Glucose Levels
Exercising is generally not recommended in type 1 diabetes when blood glucose is 250 mg/dl or higher with the presence of ketones.
More frequent monitoring and caution are necessary to exercise if glucose levels are 300 mg/dl or higher without the presence of ketones. In type 2 diabetes exercise isn’t recommended when glucose is 400 mg/dl or higher. These are general recommendations and may not be appropriate for you, so always discuss safe exercising blood glucose targets with your health care provider.
Warm Weather
Exercise tolerance may not be the same in hot weather. Drink plenty of water to stay hydrated.
Sometimes symptoms of hypoglycemia are harder to recognize when the weather heats up because the symptoms are similar to the bodies response to over- heating.