Experts are forever expounding on the benefits of exercise for people with diabetes—and with good reason. A regular workout regimen can help a diabetic lose weight, and also plays an important role in helping the body better manage blood sugar levels.
According to Lori McCourt-Stull, an occupational therapist for Fox Rehabilitation, losing just five pounds can dramatically improve a diabetic's glucose management capabilities.
However, the American Council on Exercise says that those who suffer from the metabolic disorder need to take steps to prevent the advantages of physical activity from being nullified by issues of unsafe sugar levels and injury.
The primary problem facing diabetics during exercise is blood sugar that drops too low—a condition known as hypoglycemia.
Hypoglycemia can come on quickly and, according to the National Institutes of Health, may include symptoms such as: confusion, dizziness and weakness. If a person becomes severely hypoglycemic, they can fall into a coma, have a seizure, and may even die.
The one thing every diabetic should do
The best way for someone with diabetes to stay safe while working out is to make sure they check their blood sugar levels before, during and after exercise, according to McCourt-Stull.
"While low blood sugar is more often the impact of exercise, some people do experience a rise in glucose levels," she says.
Typically, increases are only seen when a person engages in activities that produce an adrenaline surge—such as a competitive sporting event, or weightlifting—but it's good to be aware that blood sugar can fluctuate in both directions during exercise.
McCourt-Stull, herself a diabetic, also points out that testing blood glucose (sugar) levels is critical because the exertion of exercise may mask signs of low blood sugar, including rapid heart rate, sweating and muscle weakness. A diabetic may not be able to determine whether these feelings are a normal by-product of their physical efforts, or an indication of dangerously dipping glucose levels.
Managing sugar's highs and lows
Each individual will have a different response to physical activity, but Kristina Volkmer, an exercise physiologist at the Nebraska Medical Center in Omaha, says that 30 minutes of moderately intense exercise can cause as much as a 50 point reduction in blood sugar.
To manage ever-changing glucose concentrations, diabetics should try to keep sources of fast-acting carbohydrates handy.
McCourt-Stull says she needs about 50 grams of carbohydrates per hour of exercise, and generally uses a combination of sports drinks (Gatorade, Powerade, Cytomax), glucose tabs and specially-made exercise gels for diabetics to control her sugar levels while she sweats.
She also discusses the importance of staying hydrated during a workout, emphasizing that the body cannot properly absorb insulin unless it has enough water.
Exercise tips for diabetics
McCourt-Stull and Volkmer mention a few additional steps diabetics can take to keep their workouts safe and productive:
- Carefully carbo-load: Properly fueling your body is a pre-workout must. McCourt Stull says eating a snack that has fat and protein, as well as carbohydrates (i.e. crackers and peanut butter), can help keep your sugar levels more balanced. If weight loss is your goal, Volkmer suggests scheduling a sweat session after a meal—when your blood sugar is already elevated—so you won't have to eat anything extra.
- Dress the part: Elevated levels of blood glucose can make a diabetic more susceptible to skin infections, says McCourt-Stull. Be sure to wear shoes that fit properly, and protect your entire foot. Stick to temperature-appropriate clothing that's breathable and don't forget to check yourself for blisters and cuts post-workout. The nerve damage that often accompanies diabetes can make it difficult to feel when you get a skin tear.
- Stretch it out: Stretching pre and post-workout to prevent injury is valuable for everyone—from inconsistent elliptical-ers to Olympic athletes. According to McCourt-Stull, a regular stretching regime is a must for diabetics because high blood sugar levels (as well as increasing age) can make your muscles more prone to stiffness.
- Mix it up: A good exercise program contains a combination of cardio, strength and flexibility training. Cardiovascular work (jogging, swimming, cycling, etc.) can help you lose weight, increase your glucose absorption capabilities and improve nerve regeneration. The muscle-building benefits of strength training also aid in weight loss, and can help strengthen your bones and improve your balance.
- Don't go it alone: Having an exercise partner serves the dual purpose of making a workout safer and more enjoyable. Especially if you're a diabetic who is just starting a new exercise regimen, it's a good idea to have someone around who can help in case you have a problem. If you can't find a buddy to break a sweat with, make sure you exercise in a public place. If you're a gym-rat, notify the instructor or an available trainer, of your condition.
- Beware post-workout binge: Exercise depletes muscle glycogen, so your muscles may continue to draw on available blood sugar even after you've stopped exercising. Because of this, McCourt-Stull says it's not uncommon for a diabetic to have to eat more or decrease their insulin doses for several hours after you're done sweating. This is when consistent blood sugar testing comes in handy to keep your levels in check and help you avoid canceling the benefits of a workout by over-eating.
- Be patient: "Start slow," says Volkmer. When starting a new workout plan, she suggests consulting with a diabetes educator or another health care professional, who can help come up with an exercise regimen that fits your specific needs and health considerations (i.e. foot sores, dietary restrictions).