Exercise Therapy in Diabetes - Part 2 (cont.)

What does this mean for you?

Before starting on any exercise program, a through examination and medical history should be performed by your doctor. Patients who have diabetes should pay particular attention to blood vessel complications. Another important area to discuss is the estimated calorie expenditure and strategies to lessen the risk of hypoglycemia. Food intake both before and after exercise should be reviewed. Because approximately 50% of the calories burned during exercise come from a carbohydrate source (with the remainder coming from fat), you can calculate that in a 30 minute exercise session, wherein an activity like cycling at 8mph burns about 10 cal/min, a person would need to consume about 38g of carbohydrates (50% of 300kcal =150 kcal or 37.5 g of carbohydrate). We know this because each gram of carbohydrate is 4 kcal, and 150 divided by 4 is 37.5). These calculations, while a little confusing at first, can be a really valuable tool with some practice and guidance.

Regarding aerobic activity, training sessions should begin slowly. Allow 8 to 12 weeks to reach a desired training level. At a minimum, three to four 20 to 30 min sessions are needed to see a benefit. To estimate your predicted maximal heart rate: take 220 and subtract your age in years. You should be working at about 60 to 70% of this maximum rate to ensure a safe, effective workout. For example, if you are 40 years old, calculate as follows: 220 - 40 =180 and 70% of 180 = 126. This means your heart rate should be up to 126 beats per minute. It is also important to remember to add a warm up and cool down period to your workout to help prevent injury.

In addition to the above information, the American Diabetes Association has made the following recommendations for exercising:

  • Carry an ID card and wear a bracelet that identifies you as having diabetes.
  • Be alert for signs of hypoglycemia during and after exercise.
  • Drink plenty of fluids before, during, and after exercise.
  • Measure blood sugar levels and act if the reading is less than 80mg/dl or greater than 240mg/dl.

I hope the above information provides you with useful guidelines to exercising and living healthy with diabetes. If you need more specific information, the American Diabetes Association web site is a great resource (http://www.diabetes.org) and the International Diabetic Athletes Association has additional information. These organizations can be reached by calling (602) 433-2113.

Once again, discuss any question or concerns you may have with your physician before starting any activity program. When done safely, there is no doubt that the benefits of exercise in patients with diabetes far outweigh the risks. (Note: Gary Hall, now famous an an Olympic Gold Medalist is swimming, is an insulin-dependent diabetic.)

To read Part One of this series, please see Exercise Therapy in Type 2 Diabetes: Part 1 - The Benefits.

Last Editorial Review: 4/5/2002


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