Exercise is an important part of staying and keeping healthy. Many health benefits come from an exercise program:

1. Exercise lowers blood glucose
2. Exercise improves your fitness level
3. Exercise helps you lose weight, or avoid weight gain
4. Exercise improves blood cholesterol levels
5. Exercise helps control blood pressure
6. Exercise relieves fatigue and depression
7. Exercise makes you feel good physically and mentally

• The more often you move your body, the more benefit you will get from it.
• How long you exercise is more important then how hard you "work out".
• Wear medical identification bracelet or necklace at all times.
• If you take insulin or are on certain diabetes pills:
  • Be alert for hypoglycemia during and several hours after exercise.
  • Carry fast-acting carbohydrate during exercise and use to prevent or treat hypoglycemia. Stop the exercise at the first sign of a reaction and treat it. Do not keep exercising.
• Wear supportive shoes and comfortable clothes.
  • Shoes & socks: Be sure you exercise with new socks (to prevent blisters) and appropriate shoes that are properly fitted to provide good support to your feet.
  • Clothing: Clothes should allow freedom of movement. Wear layers if it's cold outside and don't forget hats and gloves. In hot weather, light-colored, loose-fitting clothes are best. The fabric closest to your skin should be chaff-resistant.
• Avoid the risk of dehydration (which may be a problem when blood glucose control is less than desired) by taking extra fluids or by skipping exercise on particularly hot days.
• Choose activities you enjoy and can perform safely.
• Let your exercise partner, or if you play a team sport, another team-mate know of your diabetes. Educate them about any help you may need. If you exercise alone, let someone know where you went, and when you expect to be back.

Type:  The kind of activity you choose to do. Your routine may include activities for flexibility, aerobic conditioning, or muscle strengthening.

Frequency:  How often you do the activity. Daily exercise is best for diabetes, especially those on medication because of the balancing of food and medication. Exercise three to five times a week will give cardiovascular benefit from aerobic activity.

Intensity:  How hard you do the activity. The correct intensity of exercise depends on your fitness level. Start at the level you feel comfortable with.

Duration:  How long an exercise session lasts.

An exercise plan includes three important parts:  
The warm up, the work out, and the cool down.

1. The warm-up: This is extremely important in preventing injury to your muscles. The best warm-up is to actually do the exercise you will be doing at a slow pace for ten minutes.

2. The work-out: The portion of the exercise when the muscles are working and sugar is being used for fuel. Choose an activity the you enjoy (walking, swimming, tennis, biking, hiking, etc).

   The appropriate intensity of exercise for the "work-out" portion of your exercise is in the "fairly light" to "somewhat hard" area (see the scale below).

Perceived Exertion Scale very, very light very light fairly light somewhat hard hard very hard very, very hard

Another general guide for the right level of intensity is the "talk test". You should still be able to carry on a conversation while you are "working out".

3. The cool-down: Take ten minutes from the time you finish your work-out to let your body return to normal. Continue to do the same activity at a slower pace so your body recovers from the exercise. This will prevent sore muscles and dizziness.

Avoiding Low Blood Sugar When Exercising  
Since less insulin is needed during exercise, if you take a sulfonylurea drug, Prandin, Starlix, or insulin injections, your BG may drop too low with exercise.

1. Carry fast-acting carbohydrate with you at all times. Be alert for signs and symptoms of hypoglycemia (low blood glucose). If it occurs, treat it and stop exercising.
2. The best time to exercise is 30 - 60 minutes after a meal, depending on the intensity of the exercise.
3. If you are exercising more than an hour after eating, eat some carbohydrate before you start. Usually 15-30 grams is enough for a half hour of moderate or an hour of light activity.
4. Extended strenuous exercise (cross-country skiing, hiking) can deplete your liver stores of sugar. In this case, you should double your bedtime snack that night. Often this will prevent hypoglycemia during the night or the following morning.

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