If you suffer from diabetes, you well know that exercise can and should be a part of the comprehensive treatment of both type I and type II diabetes. However, the potential for complications associated with diabetes often means that exercise is neglected, leading to inactivity. Inactivity, in turn, can further affect the complications of diabetes.

According to the American College of Sports Medicine, relatively healthy persons with diabetes can engage in walking, jogging, cycling, cross-country skiing, and similar forms of aerobic activity for 20-60 minutes on 3-5 days per week, with exercise intensity ranging between 60-90% of max heart rate.  Recent research also indicates that regular resistance training may be beneficial for patients with diabetes. Therefore, including both cardiovascular and strength training exercise into a weekly fitness regimen may be beneficial for diabetes sufferers.

It is important to note that the possible glucose-altering effects of exercise make close monitoring of blood sugar before, during, and after exercise very important.  Because exercise makes the body more sensitive to the way the body responds to insulin, use of an insulin pump for individuals with type I diabetes is recommended in order to closely monitor blood sugar levels.

Before you begin an exercise program, it is important to get the okay from your physician and/or diabetes specialist.  Then, follow these tips to ensure that your exercise sessions are safe and effective.

1. Immediately  before exercising, test your glucose levels, then again during exercise (especially if you are just beginning a new program). You should re-check immediately after your session as well.
2. If your blood glucose level drops to less than 70 mg/dl or is higher than 250 mg/dl, and you know you have ketones in your urine, do not exercise. If blood glucose is 300 mg/dl or higher (regardless of the presence of ketones),  you should not exercise.
3. If you suffer from diabetes-related foot problems, make sure you were well-cushioned shoes and dry-wicking socks that keep moisture away from your feet.
4. Be aware that certain conditions associated with diabetes, such as autonomic neuropathy, neuropathy, or retinopathy, it is a good idea to seek your physician’s approval before beginning an exercise program. If you have one of these conditions and your physician gives you the go ahead to exercise, it is important that your trainer or exercise physiologist works closely with your physician, as there will likely me restrictions as to what activities you may participate in.
5. Know the warning signs of hypoglycemia: trembling or shaking, rapid heart rate, increased sweating, excessive hunger, headache, irritability and mood changes, impaired concentration, mental confusion, and drowsiness. Stop exercising if you experience any symptoms of low blood sugar and test blood glucose to confirm hypoglycemia.
6. If you are suffering from low blood glucose, eat or drink 10-15 g of simple sugar immediately to restore glucose levels. It is a good idea to keep foods such as raisins, hard candy, crackers, or boxed juice in your gym bag where it can be accessed easily, just in case you need it.
7. After replenishing your glucose, rest for 10-15 minutes before resuming any activity. This will allow the intestines time to absorb the glucose.
8. Continue to monitor blood glucose, preferably within 30-40 minutes of resuming exercise, if possible.
9. After exercise, replenish glucose immediately with complex carbohydrates.

[Sources: ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription, 4^th ed, Lippincott Williams & Wilkins, 2001.

Exercise Physiology, 5^th ed, McArdle, Katch, and Katch, Lippincott Williams & Wilkins, 2001

IDEA Fitness Journal, Peggy Kraus, MA,  “Working with Diabetic Clients,” Nov-Dec 2007]

This piece of equipment might well be one of the coolest things I’ve seen (and after more than a decade in the fitness business, I’ve seen a lot of cool things)…Skywall! A motorized climbing wall that enables you to hone your climbing skills, without the height (or necessary belts and harnesses). The wall is about 11 ft tall, has 10 different climbing speeds, and the rocks can be moved around, so each climb is completely unique.

Some benefits to climbing, in case you’re new to this sport (as am I):

Climbing…

• strengthens and tones nearly every muscle in the body
• strengthens joints
• strengthens the core
• burns an incredible number of calories: 150-250 per 15 minutes on the motorized wall!!

You can find out more about the Skywall at Motion Fitness.

P.S – There is a kid-sized version of this wall that is 9ft high and recommended for kids up to age 9. Another, slightly larger model is designed for kids up to age 12. My two cents: this seems like a fun way to introduce kids to climbing in a safe environment. If I can find out what gyms/where have these, I’ll pass the info along.

So how do you get your iPod-loving, DS-playing, YouTube-watching kids off their duffs and onto their feet? By encouraging movement, rather than exercise.

A whopping 40% of children already have at least one risk factor for heart disease and reduced fitness due to inactive lifestyles, yet there are opportunities everywhere you look that have the potential to turn mundane activities into heart-pumping, muscle-strengthening movements. The trick is to make the activity fun, and not seem like exercise at all.

Try this fun game…
Carpet Coaster Frenzy

Ages: 6-8

Instructions: Pair up players in groups of two and give each group two plates.  Using only the feet, players pass the plates back and forth to one another from a variety of directions for 30 seconds. Clever twist: have them stand on one leg, then bend down and push the plates with hands only and without letting the other leg touch the floor.  All of the reaching and lunging activity strengthens  leg muscles and gets hearts pumping too.