Healthy Exercise

from the Canadian Diabetes Association

Almost everyone, whether or not they have diabetes, benefits from regular 
exercise. Well-known health benefits include weight loss, stronger bones, 
improved blood pressure control, lower rates of heart disease and cancer 
as well as increased energy levels.

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.

Safety first

• If you have been inactive for some time, talk to your doctor before starting any exercise program that is more strenuous than brisk walking.
• Make sure you wear comfortable, proper-fitting shoes.
• Wear your MedicAlert® bracelet or necklace.
• Listen to your body. Speak to your doctor if you are very short of breath or have chest pain.
• Monitor your blood glucose before, during and many hours after your activity to see how it affects your blood glucose levels.
• 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 your heart and lungs and carry oxygen to your 
muscles.

Resistance exercises (such as weight training) increase muscle strength and 
complement the benefits of aerobic exercise. If you decide to begin resistance exercise, you should first get some instruction from a qualified exercise specialist and start slowly.

How much is enough?

Your goal should be to complete at least 150 minutes of moderate- to vigorous-intensity aerobic exercise each week (e.g. 30 minutes, 5 days a week).

You may have to start slowly, with as little as 5 to 10 minutes of exercise per day, gradually building up to your goal. The good news, though, is that multiple, shorter exercise sessions of at least 10 minutes each are probably as useful as a single longer session of the same intensity.

If you are able and when you are ready, try adding resistance exercises like lifting weights 3 times a week.

Keep going!

Habits can be hard to change, so be prepared with a plan in case your 
motivation starts to fade: 

• Do something you like! It is hard to stick to an activity that is not fun. It may take you a few tries before you find the activity that is right for you.
• 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.
• Set small, attainable goals and celebrate when you reach them. Reward yourself in healthy ways.
• Maintain a healthy weight.
• Seek professional help from a personal trainer, or someone knowledgeable who can help you find a fitness regimen that will work for you.

Physical activity and diabetes can be a complex issue. For more information, talk to your healthcare team or visit diabetes.ca.

Regardless of your age, making the decision to become more physically active is one of the greatest gifts you can give yourself and the people who love you

Take that first step today!

Some advice before taking that first step.

If you’d like more information on the many benefits of exercise and tips on how to get started, please read: 

Canada’s Physical Activity Guide to Healthy Active Living for Older Adults 
Canada’s Physical Activity Guides for Children and Youth

Physical Activity and Type 1 Diabetes

Important note: 
The information in this section pertains specifically to people with type 1 diabetes.

Physical Activity and type 1 diabetes

As people with type 1 diabetes know, many factors influence blood glucose levels. While exercise has been shown to improve blood glucose management in people with type 2 diabetes, the story is more complicated with type 1 diabetes.

In people with type 1 diabetes, blood glucose levels vary considerably depending on the type of activity, duration, intensity of activity, as well as the amount and timing of insulin administration and carbohydrate intake. Low- to moderate-intensity exercise lowers blood glucose levels both during and after the activity, increasing the risk of hypoglycemia. In contrast, high-intensity exercise raises blood glucose levels during and immediately after the activity. The stress of competition and even heat can also affect the delicate balance between glucose and insulin. These effects on blood glucose levels can be addressed by carefully matching carbohydrate intake to insulin and planning the type and timing of exercise.

Self-monitoring of blood glucose before, during and, especially, for many hours after exercise is critical for establishing how your body responds to exercise. This information will help you make the right adjustments to exercise, medication or carbohydrate intake to avoid high or low blood glucose.

Some advice before getting started

With careful planning and common sense, the benefits of exercise almost always outweigh the risks. However, if you have been inactive for some time and want to start an exercise program that is more strenuous than brisk walking, you should first see your doctor. He or she will want to ensure that you don’t have any conditions or complications that might be aggravated by exercise. It you are at high risk of heart disease, you may undergo an exercise stress test. This test monitors your heart rate while you walk on a treadmill. If you have neuropathy (nerve damage), retinopathy, very high blood pressure, or very high blood glucose your doctor may want you to avoid some kinds of exercise or take special precautions.

Tips for safe exercising

1. Plan your exercise sessions so you can take the appropriate measures to exercise safely. Decide on the timing, type, duration and intensity of exercise.
2. Every person with type 1 diabetes will have a different response to exercise. The only accurate way to determine your response is frequent self-monitoring of blood glucose. Monitor your blood glucose before, during, and many hours (including overnight if necessary) after exercising to see how the activity has affected your blood glucose.  Record your results.
3. If your pre-meal blood glucose level is >14.0 mmol/L and urine ketone level is >8.0 mmol/L or blood ketone level is >3.0 mmol/L, exercise should not be performed as it could cause high blood glucose and more ketone production. Wait until your blood glucose is back in the normal range before exercising.
4. Estimate how much carbohydrate and insulin you need to keep your blood glucose levels stable. You may need to work with your healthcare team to learn how to do this. A general rule of thumb for most moderate-intensity exercise is 15 to 30 g of carbohydrate every 30 to 60 minutes of exercise.
5. Avoid injecting insulin into the body part that will be exercising.
6. If you use an insulin pump, see your healthcare team for more information on how to calculate carbohydrate intake and to adjust the basal and bolus components of your insulin dosage.
7. Keep some form of fast-acting carbohydrate with you at all times in case you need to treat a low blood glucose.
8. Drink enough water to stay well hydrated while exercising.
9. People who exercise vigorously or who train for competition should work closely with their healthcare team.
10. Make sure you have the right shoes — this is so important for people with diabetes. Buy your shoes from a reputable store with knowledgeable staff who can ensure a proper fit. Buy the right shoes for your activity (e.g. tennis shoes for tennis, walking shoes for walking, pool shoes for swimming).
11. Wear your MedicAlert® bracelet or necklace.
12. Listen to your body. While exercising will probably cause some muscle fatigue or even slight discomfort, it should not cause pain before or after.
13. Speak to your doctor if you are very short of breath or have chest pain.