All About Diabetes > Living With Diabetes > Exercises for diabetics


What are the precautions to be observed before starting exercise?

When a diabetic decides to begin an exercise regime, he/she must ensure that they choose one that copes with their type of diabetes. An inappropriate exercise regime can prove hazardous to a diabetic. He/she must keep many factors in mind (i.e. blood sugar level, types of exercises, the hours of exercise, how much exercise etc.) while choosing a type of regime. Hence, before starting an exercise programme, a detailed physical examination and laboratory investigations including electro-cardiogram should be carried out to ensure:

  • The blood glucose level should be reasonably controlled. If a diabetic controls his/ her diabetes poorly and exercises vigorously, particularly in Type 1 diabetics, could worsen his/her blood glucose control. This will precipitate an emergency, as insulin is required to facilitate entry of glucose into the cells where it is burned down as fuel. In cases of severe insulin deficiency, glucose is unable to enter the cells and can accumulate in the blood at dangerous levels.
  • The condition of cardio-vascular system is stable. Ischaemic heart disease is more common in diabetes and may remain silent or have atypical symptoms, thus remaining undetected. Sudden vigorous exercise in such patients could precipitate serious problems such as acute myocardial infarction or left ventricular failure.
  • Absence of advanced proliferative retinopathy. This complication is present in some long-standing diabetics, particularly those who are poorly controlled. If sudden vigorous exercise is performed by diabetics having proliferative retinopathy, vitreous haemorrhage and retinal detachment can occur. Hence, long-standing diabetics having diminished vision should consult ophthalmologists before they embark on an exercise programme.
  • Prevention of Hypoglycaemia
    i.   Do not exercise around three hours after plain insulin and seven hours after intermediate acting insulin.
    ii.  Do not inject insulin in exercising arms as exercise hastens the absorption of insulin and may precipitate hypoglycaemia.
    iii. The ideal time to perform exercise is in the morning after a light snack.
  • Always ensure that your feet are well maintained and healthy. There should not be any sores or open wounds, in order to avoid infection.
  • Invest in a good pair of shoes for your workout regime.

Which types of exercise regimes can diabetics take on to control their diabetes?

The exercise regimes are broadly divided into two categories:

  • Dynamic or aerobic:

In these exercises, the major muscle groups are stretched in a rhythmic pattern and the entire body is in motion.
Examples: Walking, jogging, cycling and swimming.

  • Static or anaerobic:

In these exercises, muscles contract against some fixed objects and the body is static.
Examples: Weight-lifting, Pressing palms against the walls.

Dynamic exercises are ideal for diabetics, as it involves a large amount of energy to be used.
Approximate calories spent per minute while doing dynamic exercises have been tabulated below:

Type

Calories spent per minute

Brisk walking

 3.6

Cycling

 4.5

Jogging

 4.5

Running

 5.0

Swimming

 6.0

Tennis (Singles)

 7.0

For older diabetics, brisk walking is safe, easy to perform and an inexpensive exercise. All they have to do is invest in time and a pair of properly fitting and comfortable footwear. Younger and fitter diabetics can choose from swimming, running, cycling or tennis.

For how long should a diabetic exercise?

Ideally, a diabetic should carry out a dynamic exercise for about 30-45 minutes, without any breaks. A diabetic's exercise regime should last for about 10 minutes in the initial week and then gradually move up to 30-45 minutes in the next 3-4 weeks.
Sustained exercise is essential and it should be strenuous enough to raise heart beats to 75% of Maximal Heart Rate (MHR) for 10-15 minutes. The steps for calculating MHR are given below:

a. Subtract age from 220, suppose your age is 45, then 220-45 = 175

b. Calculate 75% of result of Step 'a' - 75% of 175 = 131.25~ 131

c. MHR is approximately 130 beats per minute

Some tips:

  • Exercise at least five times a week.
  • Avoid using lifts. Climbing stairs are a better way of performing cardio exercises.
  • If you drive to work, then park your car a few 100 metres away from your office and walk the rest of the way.
  • If you commute by public transport to work, then alight at a bus/rail stop earlier from the one nearest to your office/home and walk to your destination.

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