Regular exercise can be beneficial for patients with Type I (insulin-dependent) and II (non-insulin-dependent) diabetes. Specific advantages for people with diabetes may include reductions in weight, increased insulin sensitivity, although blood sugar control does not always improve and may actually increase risks of hypoglycemia (low blood sugar), especially among Type I diabetics. All patients on an exercise regimen for the management of diabetes should be monitored. To prevent hypoglycemia or hyperglycemia (high blood sugar), some steps may be taken. Eating a meal 1-3 hours before exercise is recommended. If blood sugar is less than 100 mg/dL, a pre-exercise snack is needed. If blood sugar is greater than 250 mg/dL or serum ketones are positive, postpone exercise. If currently taking subcutaneous insulin, it should be given 1 hour prior to exercise in the abdomen. Injections in the fingers, and other extremities, should be avoided. If insulin peaks or hypoglycemia develops while exercising, decrease insulin prior to next workout. Additionally, before exercising, the intensity, duration and energy needed to complete the workout should be known. During long vigorous exercise, carbohydrate feedings (30-40 grams for adults, 15-25 grams for children) are recommended every 30 minutes. Plenty of water or other fluids should be taken while exercising. Blood sugar levels should be monitored during and after a long exercise session. For 12-24 hours after exercising, calorie intake should be increased based on how hard and long the exercise period was. (14)
