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Fitness Safety Tips for Type 2 Diabetes


If you have diabetes, your blood sugar can fluctuate when you exercise. Get tips on fitness safety to keep glucose levels in range and prevent injury.

Exercise is so beneficial for people with type 2 diabetes that many experts believe doctors should prescribe it like medication. Exercise can help you manage your blood sugar levels and reduce or eliminate your need for insulin. It can also strengthen your heart and lower your risk for heart attack and stroke, both potential diabetes complications.

Even if you’ve been sedentary until now, you can start to exercise with diabetes as long you’re mindful and take some precautions, says Jacqueline Shahar, MEd, RCEP, a certified diabetes educator and manager of exercise physiology at the Joslin Diabetes Center in Boston, Mass.

Exercise and Your Blood Sugar

Checking your blood sugar before and after exercising is your most important fitness safety step. Blood sugar levels can fluctuate depending on how vigorously and how long you exercise or what you ate before you went to the gym or out for a walk. You need to check your blood sugar periodically because you won’t always know when it might be too high or low, says Erica Christ, RD, a certified diabetes educator at the Greenwich Hospital Weight Loss & Diabetes Center in Greenwich, Conn.

If your blood sugar is already high before you exercise, it may go even higher when you exercise. When you work out, your muscles demand more glucose. and your liver responds by releasing it into your bloodstream. If you don’t produce enough insulin, the glucose can back into your bloodstream. That means you should wait for your blood sugar to come back down to a healthy level before exercising.

Exercise can also sometimes cause low blood sugar (hypoglycemia), especially if you exercise for a long time. Never start to exercise if your blood sugar is low. If it goes too low, you could pass out, resulting in a dangerous situation.

If your muscles have used all your blood sugar and you continue to exercise, you will start to burn fat for fuel. Burning fat for fuel can cause substances called ketones to build up in your urine. Signs of ketone buildup include dry mouth, the need to urinate frequently, tiredness, a fruity smell to your breath, flushed skin, stomach pains, difficulty breathing, and trouble concentrating. Testing your urine with special test strips can show when ketones have built up in your body. Don’t exercise if you have any of these symptoms or if you have ketones in your urine. You could develop a serious condition known as ketoacidosis. Instead, you may need more insulin or something to eat before you’re ready to exercise safely.

Talk to your doctor before starting a new exercise routine. Discuss which activities are safe for you given the condition of your blood vessels, joints, feet, eyes, and nervous system — all of which can be affected by diabetes. Your doctor may suggest changes in your medication or the timing of your insulin pills to match your increased activity. If you use an insulin pump, you may need to adjust it for your exercise routine.

Keep water and snacks handy. You need to stay hydrated when you have diabetes. Becoming dehydrated can affect the concentration of glucose in your blood. Be sure to drink plenty of water before your exercise, while you’re exercising, and after your activity. Because exercise can make blood sugar drop as working muscles demand more blood sugar, have a source of carbohydrate (raisins, hard candy, or glucose tablets) in your pocket or gym bag in case you need it to treat low blood sugar.

Wear a medical ID. Choose a bracelet, necklace, or medical ID tag that identifies you as a person who has diabetes. “If your blood sugar gets too low and you pass out, if you’re wearing an ID bracelet, the people around you will be able to determine that you have diabetes and get you the appropriate help,” Christ says.

Protect your feet. Diabetes can damage your blood vessels and lead to poor circulation. Poor circulation can cause your hands and feet to feel numb or tingly. Protect your feet when you exercise by wearing sneakers that fit well. Treat any blisters, cuts, or calluses immediately. “Be sure to be properly fitted for sneakers before starting an exercise program,” Christ says. And wear good, breathable cotton socks.

Stretch first. To prevent injury, warm up and stretch before you begin your exercise routine. Then take a few minutes to cool down properly afterwards.

Go indoors in the heat. Take extra care in extreme temperatures to avoid dehydration and heat exhaustion. If it’s really hot outside, move your workout indoors. Instead of a mid-day walk or run, head out in the early morning or later in the day when it’s cooler.

Listen to Your Body

If you’re too tired to exercise, then don’t push yourself. No matter how important exercise is to your health, if you’re exhausted, you can be less attentive to safety details and injure yourself. If you’re experiencing pain or discomfort, stop exercising. Work with your doctor to determine what’s causing your discomfort and how to fix it. Following basic fitness safety tips can help keep you healthy and on track with your exercise goals.

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