Physical activity and diabetes
Safety first
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If you have been inactive for some time, talk to your doctor before starting any exercise program that
is more strenuous than brisk walking.
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Make sure you wear comfortable, proper-fitting shoes.
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Wear your MedicAlert® bracelet or necklace.
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Listen to your body. Speak to your doctor if you are very short of breath or have chest pain.
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Monitor your blood glucose before, during and many hours after your activity to see how it affects
your blood glucose levels.
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Carry some form of fast-acting carbohydrate with you in case you need to treat low blood glucose
(hypoglycemia), for example, glucose tablets (preferred) or Life Savers®.
What kind of activity is best?
Both aerobic and resistance exercise are important for people living with diabetes.
Aerobic exercises such as brisk, walking, running, swimming, dancing, hockey and skiing, work the heart
and lungs and carry oxygen to the muscles.
Resistance exercises such as weight training, increases muscle strength and complements the benefits of
aerobic exercise. Before beginning resistance exercise, first get some instruction from a qualified exercise
specialist and start slowly.
How much is enough?
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Complete at least 150 minutes of moderate- to vigorous intensity aerobic exercise each week, (e.g.
30 minutes, 5 days a week).
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Start slowly, with as little as 5 to 10 minutes of exercise per day, gradually building up to your goal.
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The good news, though, is that multiple, shorter exercise sessions of at least 10 minutes each is
probably as useful as a single longer session of the same intensity.
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When you are ready, try adding resistance exercises like lifting weights 3 times a week
How hard should I be working?
A common way of measuring how hard you are working is to use your heart rate as an indicator. Everyone
has a different maximum heart rate but a good overall average has been calculated at 220 beats per
minute. There is a range where we do the most amount of good with the least amount of stress called the
target heart range or (THR). This range changes as you get older. The desirable range has been estimated
to be between 65 per cent and 85 per cent of the maximum heart rate. The following chart shows the
approximate target heart rate (THR) for various age groups.
Physical activity and diabetes
To keep within your (THR), just before your cool down walk, take your pulse for a 10 second period and
multiply by 6 to find your beats per minute. For example, if you count 20 beats in 10 seconds your heart
rate is 120 beats per minute. It’s important to keep moving while you are counting. If you are plus or
minus two beats in a 10 second count don’t worry because there is always some inaccuracy built into
taking your pulse, especially while still moving. Your pulse can be found on the inside of the wrist on the
same side as the thumb.
Target Heart Rate
Age
65%
85%
20
130
30
40
45
50
55
60
65
70
124
117
114
111
107
104
101
98
170
162
153
149
145
140
136
132
128
Regular exercise also has special advantages if you have Type 2 diabetes. Regular physical activity
improves your body’s sensitivity to insulin and helps manage your blood glucose levels.
Time out
Occasionally there are times when you should not continue your physical activity.
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On your doctor ’s advice,
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If you are nauseated or have abdominal pain,
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If your blood glucose is less than 4 mmol/L, until you have a snack,
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If your morning or pre-meal blood glucose is above 14 mmol/L and there are ketones in your
urine, or
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If there are climate extremes and your activity is out of doors - too cold or too hot, excessive
humidity or pollution alerts.
Physical activity and diabetes
Sample walking program
Week 1
This program is based on walking 4 times per week. All sessions include a 5 minute warm-up period of
stretching/flexibility exercises and walking slowly to start. Then pick up the pace so that for the next 5
minutes you are walking briskly. Cool down by walking slowly for the next 5 minutes. The total exercise
time is 15 minutes.
Week 2
Continue walking 4 times per week. All sessions include a 5 minute warm-up period of stretching/flexibility
and walking slowly to start. Then pick up the pace so that for the next 7 minutes you are walking briskly.
Cool down by walking slowly for the next 5 minutes. The total exercise time is 17 minutes.
Weeks 3 to 12
Continue the program as indicated in week 2 but now increase to 9 minutes of brisk walking. Continue
this basic pattern for 12 weeks, increasing the brisk walking by 2 minutes each week up to a maximum of
30 minutes of brisk walking by the twelfth week. By this time you might well be looking for a further
challenge and in that case you may add some other forms of exercise that you can comfortably enjoy. It’s
a good idea to check your pulse periodically to make sure that you are within your (THR) range.
The power of a pedometer
A pedometer is a great way to track how active you really are. The average person takes anywhere from
2,000 to 5,000 steps in a day with a normal routine. Some researchers have suggested that taking
10,000 steps a day leads to a healthier you. 10,000 steps are roughly equal to 8 kilometers (5 miles).
To use a pedometer, wear it for a few days to see what your usual daily step total is. When you have this
number set a goal to increase it by 500 steps. When you achieve the new goal for several days in a row,
set a new one… and you are on your way.
When each step is tracked, you will soon be looking for ways to collect more. Park a little farther away
from an entrance, take an extra loop around the mall…or just walk with a friend. The added steps
contribute to improving your health.
When choosing a pedometer, there are several points to consider. Check to see if the brand is accurate. A
strap to secure the pedometer to your belt is helpful if your pedometer slips off your waistband. A cover
will protect the button from accidentally being reset. A one button model is the easiest to use. Happy
stepping!
Things to remember
Physical activity can have an effect on your blood glucose for up to 12 hours. When getting started, check
your blood glucose just before and right after your activity, as well as in several hours after your activity
stops. It is a great way to see the benefit of physical activity. It also helps you watch for any potential low
blood glucose levels if you are at risk.
Physical activity and diabetes
If you take medication that increases insulin release, or you take insulin injections, take a snack along in
case your blood glucose runs low. Discuss some healthy snack ideas with your diabetes educator. Review
low blood glucose levels with your educator, and find out if you are at risk. If you are, always carry
glucose tablets with you in case your blood glucose drops too low.
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Begin gradually and work at your preplanned pace.
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Try to be physically active on a regular basis to establish a comfortable routine.
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Carry glucose tablets if they are required.
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Drink plenty of water.
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Your feet are important. Make sure your shoes fit well and that you replace them on a regular basis.
Your athletic shoes wear out on the inside far sooner than the outside, so pay attention. Check your
shoes on the inside for any rough areas or small objects.
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Wear medical identification—it can speak for you if you are unable.
Make physical activity a regular part of your day—you are worth it!
Keep going!
Habits can be hard to change, so be prepared with a plan in case your motivation starts to fade:
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Do something you like. It is hard to stick to an activity that is not fun.
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It may take you a few tries before you find the activity that is right for you.
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Have a support network. Ask your family, friends and co-workers to help you stay motivated by
joining you for a walk or a workout at the gym.
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Set small, attainable goals and celebrate when you reach them.
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Reward yourself in healthy ways.
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Maintain a healthy weight.
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Seek professional help from a personal trainer, or someone knowledgeable who can help you find a
fitness regimen that will work for you.
Sources:
Understanding Nutrition, ninth edition by E. Whitney and R. Rolfes
Canadian Diabetes Association Clinical Practice Guidelines
Harvard University School of Public Health