If you have been recently diagnosed with diabetes (Type 1 or 2) or would like to start exercising, you have come to the right place!
The 14th of November marks World Diabetes day. Diabetes affects approximately 1.7 million Australians.
Type 1 is an auto-immune condition where the body’s own immune system attacks insulin-producing cells located in the pancreas. This means that the pancreas has little or no ability to produce insulin.
Type 2 diabetes occurs when the body is unable to effectively use insulin making it difficult to properly regulate blood sugar levels. A study from the American Diabetes Association found that exercise improves blood glucose control and can assist in reducing the risk of other diseases including high blood pressure and heart disease.
If you are looking to start exercising or learning how to manage your current exercises with diabetes, read the tips below to help get started. Please note that the following tips should be used as a general guide only, and may not be applicable.
Talk to your doctor
It is important to talk to your doctor before starting any new program or exercising for the first time with diabetes. This is especially important if you are suffering from any complications or additional conditions that may affect your participation in exercise. Your doctor will ensure that you are medically able to begin a new program and help provide appropriate exercise options. If you would like an individualised exercise program or have additional health conditions or complications it is best to seek a physiotherapist or exercise physiologist to determine a plan tailored to your needs. Your GP can refer you to a physiotherapist or exercise physiologist.
Know your blood glucose (and your body!)
Your muscles require glucose to convert into energy for exercising. This means that exercising will lower your blood glucose level. Different types of exercises, the intensity and duration can have different effects on your blood glucose so it is important to monitor these changes. Aim to check your blood glucose before and after you exercise.
The Cleveland clinic's article provides general guidelines for pre-exercise blood sugar to ensure that you exercise safely. The measurements are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).
Ensure that your blood glucose is within 100-250mg/dL (5.6-13.9 mmol/L) before exercising. Keep a small, sugary snack of approximately 15-30 grams in your bag, for example fruit juice, jelly beans or fruit to consume if your blood glucose is under 100mg/dL. If your blood glucose is 250mg/dL(13.9mmol/L) or higher your blood sugar may be too high to exercise. Before exercising, test your urine for ketones — substances made when your body breaks down fat for energy.
Know the signs of a hypo- or hyper-
If your blood glucose drops below 100mg you may be at risk of developing hypoglycaemia. Early warning signs of a hypoglaecemic episode are:
Early signs and symptoms of diabetic hypoglycemia include:
Shakiness
Dizziness
Sweating
Hunger
Irritability or moodiness
Anxiety or nervousness
Headache
A hyperglaecemic episode is when your blood sugar is too high. Watch for signs such as thirst or needing to urinate frequently. If the body does not have enough insulin the body uses fats for energy instead resulting in a potentially dangerous build up of ketones (a side product of breaking down fats). Signs of ketoacidosis include:
breathlessness
Fruity-smelling breath
Vomiting and feeling sick
Parched mouth.
If you are experiencing signs of ketoacidosis, seek emergency assistance as soon as possible.
Start small!
The current exercise recommendations for physical activity are 30 minutes or more of moderate physical activity on most days (at least 3-4 times a week) for adults over the age of 65. The RACP encourages patients to undertake aerobic training which brings your heart rate between 60-70% of your maximum. Resistance training e.g. free weights, machine or body weights is recommended at least twice a week.
Your maximum is calculated by 220 – age [years] = maximum beats per minute).
The most important thing for beginners to remember is that there is no specific type of exercise that is best over the other. As long as you keep moving while at a level that “makes you puff”, any exercise that you enjoy will be beneficial to your physical wellbeing. For beginners, low-impact exercises such as swimming, walking and cycling may be good to start. If you would like an exercise program or guidance in starting exercises, consult a physiotherapist or exercise physiologist for input.
For people new to exercise, it may be a good option to start by building up your incidental exercise before commencing an organised program. Incidental exercise is physical activity accumulated over the day including walking up stairs, cleaning etc. Small changes, such as walking more throughout the day can make a big difference.