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Diabetes and Exercise
What to Watch For and What to Avoid

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Diabetics who exercise can see significant health benefits, but you must choose your workout programs carefully. Some fitness routines can cause potentially serious problems. To understand what works best, you first have to know a little about the different types of diabetes and how they affect the body.

Type 1 Diabetics are people who have a lack of insulin. (It's also called juvenile diabetes or insulin-dependent diabetes). About 5 to 10 percent of the people who have diabetes have this type. When tested, a Type 1 diabetic has an abnormal glucose-tolerance test and there is little or no insulin in their blood.

Type 2 Diabetics are people whose bodies don't respond to or can't use their own insulin, and that insulin resistance is linked to obesity. (This type is also called adult-onset diabetes or non-insulin-dependent diabetes.) 90 to 95 percent of the diabetics fall into this category and it's more typical in adults over the age of 40.

There is a third type called Gestational Diabetes. It's similar to Type 2 diabetes and occurs in some pregnant women. This can often be treated with a modified diet or insulin injections. Because this type of diabetes typically goes away once the baby is delivered, we won't be addressing it here.

When you exert yourself exercising, your body uses blood glucose (also called blood sugar) for energy. Problems start to occur when your blood glucose drops too low. It's a condition known as hypoglycemia and it leaves you anxious, confused, hungry, irritable, shaky, sweaty, tired or weak. In severe cases, you can get a headache or even lose consciousness.

If you aren't a diabetic, when your blood glucose drops your body produces insulin to boost it back up again. Type 1 diabetics can't do that and that's why they're susceptible to hypoglycemia.

To help avoid hypoglycemia, you should check your blood glucose before you exercise. If it's below 100, have a small snack to give your blood sugar a boost. You should also carry a little food or some glucose tablets with you as a backup. Then measure your blood glucose again after exercise to see where your numbers are.

Another step you can take if you have problems with hypoglycemia is to change the intensity of your workout. In several recent studies, researchers have found that people who engage in a moderately intense workout can see their blood sugar drop significantly, up to 24 hours after the exercise. By changing that to an intermittent high-intensity workout, it's possible to slow or even stop the blood sugar drop.

TECHNICAL STUFF: (A moderately intense workout is defined as 30 minutes of continuous exercise at 40% of your VO2 Max. An intermittent high-intensity workout is the same workout, punctuated with 10 seconds of sprints approximately every 10 minutes during the workout. VO2 Max is defined as: "The maximum capacity of an individual's body to transport and utilize oxygen during incremental exercise.")

Exercising with low blood sugar is bad, but so is exercising when it's too high. If you test yourself and your number is over 300, or if your fasting blood glucose is over 250 and you have ketones in your urine, you might want to avoid strenuous exercise because it could push your levels even higher. Talk to your doctor about modifying your diet or insulin and put together a plan to get back in the gym.

Also, consider this. If you have serious diabetic complications like high blood pressure, blood vessel or eye problems, you might avoid heavy lifting. Concentrate on lighter weights and more reps. You should also wear white socks to monitor your feet. Diabetes-related nerve damage can make it difficult to tell if you injure your feet. With white socks, you can quickly see if there's any damage.

Remember that exercising is a vital and important tool that can help you lose fat, build muscle and better manage diabetes. You just have to approach it carefully and monitor your results.

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