Getting Started

You’ll need to meet with your healthcare team as one of the first steps. If you haven’t recently, you should have a physical exam and a comprehensive medical history taken. To keep your blood glucose levels within the target range, you’ll want to discuss with your team how to modify your eating strategy and your insulin or oral diabetes medication.

You could also want to talk about the kinds of physical exercise you’re thinking about.

Check to see if you have any health issues that can prevent you from exercising safely. You should get checked for signs of retinopathy, heart disease, and any issues with kidney or nerve function before starting a regular exercise regimen. Although having any of these issues may prevent you from exercising, you may need to address them before beginning a regular exercise routine.

Physical Activity Topics to Discuss with Your Doctor

• How can I get more exercise safely?
• When is the ideal time of day for me? How long should my appointment be?
• At what intensity can I work out safely?
• Should I always follow the same regimen or can I change the length and intensity of my workouts?
• How can I keep track of how hard I work out? Do I need to monitor my heart rate? What heart rate should I aim for? How frequently should I check?
• Are there any sports I should steer clear of?

What signs of hypoglycemia or heart problems should I watch out for?

Any special safety measures I should follow?

• Do I need to modify my injection site or take less insulin or other medicines before working out?
• Should I change my meal plan?
• Will working out change how my diabetic meds or other prescriptions operate on me?

In some instances, your doctor could suggest that you see an exercise physiologist so they can examine your health in further detail. To ascertain your degree of fitness, an exercise physiologist will do a number of tests, including calculating your strength, flexibility, endurance, and body fat. You might also receive a treadmill stress test from the physiologist, in which you walk while having your blood pressure and heart rate monitored. The test measures your blood pressure and heart rate after an exercise.

When a Treadmill Stress Test May Be Required

• If you’re planning to start an exercise program with a moderate or high level of intensity.
• If you are over 35 and suffer from vascular issues, nerve disease, heart disease, or cardiovascular risk factors.

If your doctor chooses not to administer the test, you will require a referral to see an exercise physiologist. There are numerous wellness programs for diabetics and rehabilitation programs for those who have had heart surgery or strokes at hospitals and universities. These programs include a broad range of exercise options to get you started in a medically supervised environment, as well as stress assessments by exercise physiologists.

Listening to your body is the finest guideline for a risk-free workout. There shouldn’t be too much discomfort, exhaustion, or difficulty breathing. Trying to accomplish too much too soon may result in accidents or even dangerous circumstances. Any workout you perform should be warmed up for and cooled down from.

Heat up

Your chance of suffering from torn muscles and other injuries is decreased by warming up before exercising.

• Warm up for five to ten minutes before engaging in any physical activity.
• Start out slowly and warm up your muscles with gentle, low-intensity movements.
• Stretch slowly for 5 to 10 minutes without bouncing. For instance, if you intend to walk for exercise, stroll for 5 to 10 minutes at a slow or comfortable pace before stopping and stretching. Resuming your walk, quicken your stride. Alternatively, if you want to run, you may warm up by walking first. To enter the aerobic phase, attempt a brisk walk or any mild jog.

Exercise Phase

You ratchet up, stay going, and get your heart pumping during the aerobic phase. During this phase, your muscles will require extra oxygen. In order to get more oxygen into your muscles through your small blood vessels, your heart beats quicker and your breathing becomes deeper.

It’s possible that you won’t be able to maintain aerobic activity for very long if you’re just beginning an exercise regimen. That’s alright. Start with 5–10 minutes, then gradually extend the aerobic period. A simple workout is preferable to none at all. Sometimes, once you start moving, you’ll start to feel better and continue the entire distance. You will eventually be able to last the full 20 to 30 minutes. Simply pay attention to your body’s signals and slow down as needed.

Keep Your Pace

Do not forget to take it slow. Pay attention to the signals your body sends. Finding the proper pace for you is essential for a safe and efficient workout.

Exercise Stopping or Slowing Down

• Slow down if you begin an aerobic workout and find that your symptoms get worse.
• Stop and check your blood glucose if you believe you are experiencing a hypoglycemic episode.
• Treat your symptoms and check your blood glucose as soon as you can if it’s not possible to do so.

Your desired heart rate should be reached while engaging in aerobic exercise. You can seek advice on the target zone that is safe for you from your doctor or an exercise physiologist. Your desired heart rate can be determined with the aid of an exercise stress test. The chart below can be used to determine your desired heart rate based on your age.

How to Determine Your Goal Heart Rate

• Heart Rate at Rest. The first thing in the morning before you get out of bed, count the number of beats your heart makes in a full minute to determine your heart rate when at rest. Start counting from zero on the first beat.
• Peak Heart Rate. Subtract your age from 220 to get your maximal heart rate.
• Reserve Heart Rate at Maximum. Calculate your maximum heart rate by deducting your resting heart rate.
• Lower Heart Rate Limit. To find 50% of your heart rate reserve, multiply your highest heart rate reserve by 0.5. Include it in your resting heart rate.
• The maximum heart rate. Calculate 70% of your heart rate reserve by multiplying your maximum heart rate reserve by 0.7. Include it in your resting heart rate.
• Voilà. The range between your lower and upper heart rate limits is your goal heart rate. Remember that none of your individual medical problems or prescription drugs are included in this computation. Verify that your goal heart rate calculation is accepted by your healthcare practitioner.

Here’s an illustration of how it operates. Your maximum heart rate is 180 if you are 40 (220 – 40 = 180). If your resting heart rate is 75, your heart rate goal range (see below) would be 128–149 in order to perform at 50–70% of your aerobic capacity.

Be cautious! Any specific medical problems or prescription drugs you may be taking are not considered in this computation. Verify with your provider that the computed target heart rate is secure for you.

Become calm

Your breathing and pulse rate might progressively slow during a cool down as your movement slows. Never stop working out abruptly, regardless of how exhausted you are. This may lessen the likelihood of pain and cramping.

• Continue to move your arms and legs at a slow rate.
• Spend 5–10 minutes moving about, stepping from side to side, walking still, or attempting some simple kicks.
• Try to avoid stooping to the point when your head is below your heart.
• After that, stretch your muscles one more while they are still warm. Stretching should be considerably easier than it was during the warm-up.

No pain, no gain is a common phrase associated with exercising. But unless you’re Rocky Balboa, you can definitely find some kind of enjoyable and helpful activity. The secret is to choose a task you enjoy and complete it at a pace that seems natural to you. If you adopt this strategy, you’ll be more likely to persist with your fitness program.

There isn’t a single activity that is ideal. There are different kinds that increase calorie burn, certain kinds that are very good for building strength and flexibility, and different kinds that are especially good for your heart.

Walking

The safest and most affordable method of exercise is definitely walking. Because it can be incorporated into other activities, it can fit into practically anyone’s schedule. You could walk to the post office instead of driving a half-mile, for instance.

The only thing you need to spend money on is a good pair of walking shoes. You receive an exercise that strengthens your cardiovascular system, lungs, arms, legs, abdomen, lower back, and buttocks in exchange for this—and additional care with your feet.

Pedometer

A pedometer is a cheap device that counts your steps and can estimate the length and speed of your walks. As a fun and inspiring approach to move more, you might wish to buy one.

A mile is roughly equal to 2,000 steps. To begin, put your pedometer on for two or three days to determine how many steps you currently take while being active. After that, try to progressively boost your daily step count to 10,000.

Begin moving

Walking for 30 minutes a day, five days a week, is good for your heart and lungs.

• You don’t need to walk for 30 minutes straight. Walking for 10 minutes three times every day will provide you with the same benefit. For instance, you could wish to park further away from your workplace so that your morning and afternoon commutes will each take 10 minutes. After that, you can add a 10-minute walk during lunch to finish your 30 minutes of exercise.
• You should progressively increase the amount of time you walk each day to 60 minutes if you’re aiming to reduce weight.

If you walk quickly and over hilly terrain, it can be particularly energizing. It is possible to live an active lifestyle by walking, which is a lifelong hobby. If you have recently been diagnosed with diabetes or are not accustomed to exercising, it can also help you ease into more strenuous activity.

For instance, you might be a little concerned that over-vigorous exercise will unbalance your blood glucose levels. After a while of walking, you’ll get the self-assurance, endurance, and fitness needed to try new activities.

You should stroll at a rate that is enjoyable and energizing for you. Some people feel that exercising while walking with hand weights makes the activity more difficult, but before you try it, see your doctor or an exercise physiologist.

Stepping Speed

A mile can be covered by a seasoned walker in 10–12 minutes. A good target to aim for is a pace of 4 miles per hour, or 15 minutes each mile. A mile may, however, take you 30 minutes to walk in the beginning.

Running and Jogging

Walking will take longer than jogging or running, which will give you a more intense workout. Jogging, however, puts more stress on your joints and feet since each stride you take weighs three to five times as much as you do. Before you begin, make sure to talk to your physician about your running or jogging program. Purchase a quality pair of running shoes as well.

Good footwear

• Try on shoes in the afternoon when the average foot size is a bit larger.
• Put on the socks you’ll be using for exercise. You might want to give some special, extra-cushioned socks made for exercising a try. In actuality, any excellent athletic sock composed of a cotton and synthetic material mix will offer warmth, cushioning, and the ability to wick away moisture.
• Opt for footwear that fits properly and feels comfy the moment you put them on. You might not be able to trust how a shoe feels when you try it on if you suffer from nerve disease or diminished feeling in your feet. To ensure a proper fit, consult a podiatrist or a professional shoe fitter (pedorthist).
• Start out by wearing new shoes just seldom.
• Look for red, irritated patches on your feet. To avoid friction, you might require more cushioning in some regions of the shoe.

On concrete, do not jog since it is very hard. Instead, try the track at a nearby park or school. Spend some time building up the muscles in your feet and legs to lower the risk of injury. Avoid risking additional harm if you begin to experience any persistent pain, especially in your joints. Rest, take a few days off, or consider going for a stroll.

Walking to Running Transition

• Begin your usual route or distance of walking.
• Start out by walking for a while, then try jogging.
• Jog as long as it feels comfortable to you. Change to a brisk walk if you begin to feel winded or uncomfortable out of breath. Continue walking without stopping.
• Jog for a short while after catching your breath. You might discover that soon you can jog the entire distance.
• Of course, you might want to keep to a running and walking regimen or switch between the two activities sometimes. Do what makes you feel wonderful.

Training in Strength

Strength training is beneficial for almost everyone. Whether you’re carrying groceries, using stairs, or doing laundry, having muscles that are in good shape will help you with all of your daily tasks. Strength training can also be used to increase muscle and prevent osteoporosis, especially in elderly individuals. People typically lose muscle mass and tone as they age. Even in your 80s and 90s, lifting weights can increase your strength.

The fact that larger, more toned muscles burn more calories even when you’re not moving is another advantage of weight training. Therefore, a consistent weightlifting program can aid in long-term fat loss and blood glucose control both during and in between exercises.

Strength training safely

• Consult with your doctor before beginning any weightlifting regimen. Inquire about possible effects on your blood pressure or other diabetes issues.
• Perform an aerobic exercise, such as walking, jogging, or jumping rope, for 5 to 10 minutes before lifting weights.
• Breathe normally when lifting. Instead, take deep breaths while lifting and exhaling when lowering weights.
• Exercise beside a friend or trainer who can assist you if something goes wrong.

After lifting weights, cool down.

• Always give yourself at least one day of rest in between workouts, or alternate days of upper- and lower-body exercise.

There are various methods for lifting weights. For a full workout, the majority of people mix weight training with aerobic activities. Lifting a tiny set of hand weights in your living room can suffice. Or you could wish to join a health club or gym where you can use a variety of weight machines and exercise equipment.

Sets of weightlifting exercises are a staple of most weight-training regimens. A sequence of repeats makes up each set. Perform one set every session when you first begin. Work your way up to three to six sets per session eventually. You’ll discover that you can lift greater weight as your strength increases. As your muscles gain strength, gradually add additional weight.

Goals for Strength Training

• If all you want to do is build endurance, pick a weight that you can only lift 15 to 20 times. Between each set of repetitions, commonly known as reps, take a short break.
• Pick a weight that you can only lift 8–12 times if you want to increase both your strength and endurance. Between sets of exercises, take a little break.
• If you plan to compete in weightlifting, you might want to choose a weight that you can only lift two to six times to enhance your strength. Between sets of exercises, take a little break.

Various Other Physical Activities

If you want to become more flexible, consider yoga or aerobics lessons if you enjoy dancing. Senior and community centers may have equipment available or provide lessons that are inexpensive or free. You may test out machines to see if there are any you would use at home by signing up for a free trial membership at a health club.

You might rediscover your passion for volleyball, squash, or tennis. Make sweeping the deck or cleaning the windows an aerobic workout.

Other elements, including the weather, might also have a role in your activity selection. Consider walking indoors at a nearby mall or around your home, for instance, if the weather is too hot or cold to go outside.

Special Precautions for Exercise and Physical Activity

When exercising, you should pay particular attention to your feet, especially if you’ve had diabetes for a time. Most diabetic kids and teenagers don’t have to worry too much about foot issues. Ingrown toenails, blisters, corns, calluses, and red, irritated regions should all be looked for on a daily basis. If an issue is present, don’t anticipate it to disappear on its own. Dial your podiatrist or diabetes specialist right away.

Your choice of activities may be impacted by specific diabetes issues, so always talk to your doctor about safe alternatives.

Exercise and Complications from Diabetes

• Peripheral neuropathy, which causes numb feet. You might need to restrict weight-bearing exercises like jogging. Walking or using a stationary bike may be safe alternatives, but you must take extra precautions to safeguard your feet.
• Nerve illness (autonomic neuropathy). Avoid engaging in some aerobic activities that could impact your ability to control blood pressure and heart rate.
• Eye illness (proliferative retinopathy). Using specific weightlifting motions could endanger your vision. Inquire with your doctor.
• Heart disease or high blood pressure. Avoid pressing against a wall or engaging in isometric exercises, which require you to maintain a contracted state of your muscles. Swimming and walking are frequently secure options.
• Dialysis. A regimen of activities that progresses gradually can be beneficial to you.
• Transplantation of organs. After receiving an organ transplant, people can benefit from physical activity. Anti-rejection medications can result in muscle atrophy and weight gain. Once you’ve been given the all-clear and are prepared, try some aerobic and strength training.

Regular exercise is a fantastic way to lower blood sugar levels. When you begin exercising, your body uses the glucose that is stored in your muscles and liver as fuel. Afterward, as these reserves are depleted, your muscles take up glucose from your blood. Consequently, your blood glucose levels may decrease during activity.

You don’t want your blood glucose to drop too low if you have type 1 diabetes or type 2 diabetes and take insulin with a sulfonylurea.

You are susceptible to hypoglycemia. As your body refills the stores of glucose in your muscles and liver after exercise, your blood glucose levels may also drop. You should watch out for low blood glucose even hours after you’ve finished exercising. People who use insulin or other diabetic treatments are more likely to experience low blood sugar after exercise.

Monitoring Blood Glucose During Exercise and Physical Activity

• Before working out, measure your blood sugar. Have a snack like a piece of fruit or a few crackers if your blood sugar is under 100 mg/dl.
• After 15 to 30 minutes, test again. Start working out just after your blood sugar is greater than 100 mg/dl.

The way that insulin works can also be impacted by physical activity. Insulin is absorbed by the body differently every day. The absorption of insulin can also be influenced by exercise. Through increased blood flow throughout the body, physical activity hastens the rate at which the insulin you inject starts to operate. For instance, injecting into an arm or leg that is being used for exercise can hasten the absorption of insulin. When exercising, always check your blood glucose levels because insulin has a variety of impacts.

Lows at Night after Exercise

If you work out in the evening, you run the risk of developing hypoglycemia while you’re sleeping. Make careful to monitor your blood sugar levels before bed and possibly while you sleep.

Exercise and Type 1 Diabetes

It’s not entirely clear how exercise affects blood glucose levels in patients with type 1 diabetes. Blood glucose levels should not fluctuate too much in people with type 1 diabetes. This involves being aware of how various activities affect your blood sugar levels. Monitoring frequently—before, during, and after working out—will help you learn this.

Lows during exercising

• If you exercise for a long time or on an empty stomach, your blood glucose levels may fluctuate too much.
• You maximize the effects of your workout, be sure to take the appropriate dosage of insulin. Spend some time getting to know how to anticipate your insulin and food demands by monitoring in various circumstances.

Stop exercising right away if you feel a low blood glucose reaction coming on. Consume or consume some kind of carbohydrate. Do not deceive yourself into thinking you can go for another five minutes.

• Always have a source of glucose on hand in case you need it while working out. This can be a fruit juice or soft drink that will deliver sugar in place of the water. Or you may use raisins, glucose pills, or hard candy.
• Because the body uses blood glucose to rebuild muscles after exercise, blood glucose might fall to lower levels up to 16–24 hours later. Therefore, be sure to check your blood sugar levels before, after, and for a long time after exercise.

With high exercise

• Vigorous exercise or a lack of accessible insulin in your body might cause blood glucose levels to spike excessively high.
• The nerves occasionally tell the liver to release glucose from storage during intense exercise, which can result in a sharp increase in blood sugar. If your insulin levels are too low, this surge happens even when you exercise at a moderate intensity.
• Exercising can raise blood glucose levels that are already elevated.
• Your body could create ketones, which could lead to ketoacidosis. To prevent excessive blood sugar, check your blood glucose levels before and after working out.

If you exercise vigorously or for an extended period of time, you might need to eat during or after. Consider having a snack that is low in fat and contains 15 to 30 grams of carbohydrates. Depending on your blood glucose levels, you might need to repeat this snack if you’re really pushing yourself.

You might want to be aware of the direction your blood glucose level is going before you begin exercising. This is particularly true if you are about to begin an activity that you find difficult to stop (such as a long run or windsurfing). During an activity, it might not be practical or possible to check your blood sugar. 90 minutes before you start, consider checking. You might wish to eat a snack to prevent your blood glucose level from falling any lower if monitoring indicates that it is (even if you are still in a safe range).