Diabetes and Exercise

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By Adriel Yapana, CPT

There are two main types of diabetes, type I and type II. Type I
diabetes is characterized by the pancreas making too little or no
insulin. An individual with diabetes type I will have to inject
insulin throughout the day in order to control glucose levels. Type II
diabetes, also known as adult onset diabetes, is characterized by the
pancreas not producing enough insulin to control glucose levels or the
cells not responding to insulin. When a cell does not respond to
insulin, it is known as insulin resistance. When a subject is
diagnosed with type II diabetes, exercise and weight control are
prescribed as measures to help with insulin resistance. If this does
not control glucose levels, then medication is prescribed. The risk
factors for type II diabetes include: inactivity, high cholesterol,
obesity, and hypertension. Inactivity alone is a very strong risk
factor that has been proven to lead to diabetes type II. Exercise will
have a positive effect on diabetes type II while improving insulin
sensitivity while type I cannot be controlled be an exercise program.
Over 90% of individuals with diabetes have type II.

Exercise causes the body to process glucose faster, which lowers blood
sugar. The more intense the exercise, the faster the body will utilize
glucose. Therefore it is important to understand the differences in
training with type I and type II diabetes. It is important for an
individual who has diabetes to check with a physician before beginning
an exercise program. When training with a diabetic, it is important to
understand the dangers of injecting insulin immediately prior to
exercise. An individual with type I diabetes injecting their normal
amount of insulin for a sedentary situation can pose the risk of
hypoglycemia or insulin shock during exercise. General exercise
guidelines for type I are as follows: allow adequate rest during
exercise sessions to prevent high blood pressure, use low impact
exercises and avoid heavy weight lifting, and always have a supply of
carbohydrates nearby. If blood sugar levels get too low, the
individual may feel shaky, disoriented, hungry, anxious, become
irritable or experience trembling. Consuming a carbohydrate snack or
beverage will alleviate these symptoms in a matter of minutes.

Before engaging in exercise, it is important for blood sugar levels to
be tested to make sure that they are not below 80 to 100 mg/dl range
and not above 250 mg/dl. Glucose levels should also be tested before,
during, after and three to five hours after exercise. During this
recovery period (3-5 hours after exercise), it is important for
diabetics to consume ample carbohydrates in order to prevent
hypoglycemia.

Exercise will greatly benefit an individual with type II diabetes
because of its positive effects on insulin sensitivity. Proper
exercise and nutrition are the best forms of prevention for type II
diabetics. It is important for training protocols to be repeated
almost daily to help with sustaining insulin sensitivity. To prevent
hypoglycemia, progressively work up to strenuous activity.

As with individuals with type I diabetes, carbohydrates should also be
present during training to assist in raising blood sugar levels if the
individual becomes low.