Your Physical Activity Plan

What you eat and when also depend on how much you exercise. Physical activity is an important part of staying healthy and controlling your blood glucose. Keep these points in mind:

• Talk with your doctor about what types of exercise are safe for you.
• Make sure your shoes fit well and your socks stay clean and dry. Check your feet for redness or sores after exercising. Call your doctor if you have sores that do not heal.
• Warm up and stretch for 5 to 10 minutes before you exercise. Then cool down for several minutes after you exercise. For example, walk slowly at first, stretch, and then walk faster. Finish up by walking slowly again.
• Ask your doctor whether you should exercise if your blood glucose level is high.
• Ask your doctor whether you should have a snack before you exercise.
• Know the signs of low blood glucose, also called hypoglycemia. Always carry food or glucose tablets to treat low blood glucose.
• Always wear your medical identification or other ID.
• Find an exercise buddy. Many people find they are more likely to do something active if a friend joins them.

Low Blood Glucose (Hypoglycemia)

Low blood glucose can make you feel shaky, weak, confused, irritable, hungry, or tired. You may sweat a lot or get a headache. If you have these symptoms, check your blood glucose. If it is below 70, have one of the following right away:

• 3 or 4 glucose tablets
• 1 serving of glucose gel—the amount equal to 15 grams of carbohydrate
• 1/2 cup (4 ounces) of any fruit juice
• 1/2 cup (4 ounces) of a regular (not diet) soft drink
• 1 cup (8 ounces) of milk
• 5 or 6 pieces of hard candy
• 1 tablespoon of sugar or honey

After 15 minutes, check your blood glucose again. If it’s still too low, have another serving. Repeat these steps until your blood glucose level is 70 or higher. If it will be an hour or more before your next meal, have a snack as well.

When You’re Sick

Take care of yourself when you’re sick. Being sick can make your blood glucose go too high. Tips on what to do include the following:

• Check your blood glucose level every 4 hours. Write down the results.

• Keep taking your diabetes medicines. You need them even if you can’t keep food down.

• Drink at least one cup (8 ounces) of water or other calorie-free, caffeine-free liquid every hour while you’re awake.

• If you can’t eat your usual food, try drinking juice or eating crackers, popsicles, or soup.

• If you can’t eat at all, drink clear liquids such as ginger ale. Eat or drink something with sugar in it if you have trouble keeping food down, because you still need calories. If you can’t eat enough, you increase your risk of low blood glucose, also called hypoglycemia.

• In people with type 1 diabetes, when blood glucose is high, the body produces ketones. Ketones can make you sick. Test your urine or blood for ketones if

  • your blood glucose is above 240
  • you can’t keep food or liquids down
  
  

• Call your health care provider right away if

  • your blood glucose has been above 240 for longer than a day
  • you have ketones
  • you feel sleepier than usual
  • you have trouble breathing
  • you can’t think clearly
  • you throw up more than once
  • you’ve had diarrhea for more than 6 hours

Your Physical Activity Plan

What you eat and when also depend on how much you exercise. Physical activity is an important part of staying healthy and controlling your blood glucose. Keep these points in mind:

• Talk with your doctor about what types of exercise are safe for you.
• Make sure your shoes fit well and your socks stay clean and dry. Check your feet for redness or sores after exercising. Call your doctor if you have sores that do not heal.
• Warm up and stretch for 5 to 10 minutes before you exercise. Then cool down for several minutes after you exercise. For example, walk slowly at first, stretch, and then walk faster. Finish up by walking slowly again.
• Ask your doctor whether you should exercise if your blood glucose level is high.
• Ask your doctor whether you should have a snack before you exercise.
• Know the signs of low blood glucose, also called hypoglycemia. Always carry food or glucose tablets to treat low blood glucose.
• Always wear your medical identification or other ID.
• Find an exercise buddy. Many people find they are more likely to do something active if a friend joins them.
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What can a physically active lifestyle do for me?

Research has shown that physical activity can

• lower your blood glucose and your blood pressure
• lower your bad cholesterol and raise your good cholesterol
• improve your body’s ability to use insulin
• lower your risk for heart disease and stroke
• keep your heart and bones strong
• keep your joints flexible
• lower your risk of falling
• help you lose weight
• reduce your body fat
• give you more energy
• reduce your stress levels

Physical activity also plays an important part in preventing type 2 diabetes. A major Government study, the Diabetes Prevention Program (DPP), showed that modest weight loss of 5 to 7 percent—for example, 10 to 15 pounds for a 200-pound person—can delay and possibly prevent type 2 diabetes. People in the study used diet and exercise to lose weight.

What kinds of physical activity can help me?

Four kinds of activity can help. You can

• be extra active every day
• do aerobic exercise
• do strength training
• stretch
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Be Extra Active Every Day

Being extra active can increase the number of calories you burn. Try these ways to be extra active, or think of other things you can do.

• Walk around while you talk on the phone.
• Play with the kids.
• Take the dog for a walk.
• Get up to change the TV channel instead of using the remote control.
• Work in the garden or rake leaves.
• Clean the house.
• Wash the car.
• Stretch out your chores. For example, make two trips to take the laundry downstairs instead of one.
• Park at the far end of the shopping center parking lot and walk to the store.
• At the grocery store, walk down every aisle.
• At work, walk over to see a co-worker instead of calling or emailing.
• Take the stairs instead of the elevator.

• Stretch or walk around instead of taking a coffee break and eating.
• During your lunch break, walk to the post office or do other errands.
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Do Aerobic Exercise

Aerobic exercise is activity that requires the use of large muscles and makes your heart beat faster. You will also breathe harder during aerobic exercise. Doing aerobic exercise for 30 minutes a day at least 5 days a week provides many benefits. You can even split up those 30 minutes into several parts. For example, you can take three brisk 10-minute walks, one after each meal.

If you haven’t exercised lately, see your doctor first to make sure it’s OK for you to increase your level of physical activity. Talk with your doctor about how to warm up and stretch before you exercise and how to cool down after you exercise. Then start slowly with 5 to 10 minutes a day. Add a little more time each week, aiming for at least 150 minutes per week. Try

• walking briskly
• hiking
• climbing stairs
• swimming or taking a water-aerobics class
• dancing
• riding a bicycle outdoors or a stationary bicycle indoors

• taking an aerobics class
• playing basketball, volleyball, or other sports
• in-line skating, ice skating, or skate boarding
• playing tennis
• cross-country skiing
• Do Strength Training
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• Doing exercises with hand weights, elastic bands, or weight machines three times a week builds muscle. When you have more muscle and less fat, you’ll burn more calories because muscle burns more calories than fat, even between exercise sessions. Strength training can help make daily chores easier, improving your balance and coordination, as well as your bones’ health. You can do strength training at home, at a fitness center, or in a class. Your health care team can tell you more about strength training and what kind is best for you.
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• Stretch
• Stretching increases your flexibility, lowers stress, and helps prevent muscle soreness after other types of exercise. Your health care team can tell you what kind of stretching is best for you.
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• Can I exercise any time I want?
• Your health care team can help you decide the best time of day for you to exercise. Together, you and your team will consider your daily schedule, your meal plan, and your diabetes medicines.
• If you have type 1 diabetes, avoid strenuous exercise when you have ketones in your blood or urine. Ketones are chemicals your body might make when your blood glucose level is too high and your insulin level is too low. Too many ketones can make you sick. If you exercise when you have ketones in your blood or urine, your blood glucose level may go even higher.
• If you have type 2 diabetes and your blood glucose is high but you don’t have ketones, light or moderate exercise will probably lower your blood glucose. Ask your health care team whether you should exercise when your blood glucose is high.
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• Are there any types of physical activity I shouldn’t do?
• If you have diabetes complications, some kinds of exercise can make your problems worse. For example, activities that increase the pressure in the blood vessels of your eyes, such as lifting heavy weights, can make diabetic eye problems worse. If nerve damage from diabetes has made your feet numb, your doctor may suggest that you try swimming instead of walking for aerobic exercise.
• When you have numb feet, you might not feel pain in your feet. Sores or blisters might get worse because you don’t notice them. Without proper care, minor foot problems can turn into serious conditions, sometimes leading to amputation. Make sure you exercise in cotton socks and comfortable, well-fitting shoes designed for the activity you are doing. After you exercise, check your feet for cuts, sores, bumps, or redness. Call your doctor if any foot problems develop.
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• Can physical activity cause low blood glucose?
• Physical activity can cause low blood glucose, also called hypoglycemia, in people who take insulin or certain types of diabetes medicines. Ask your health care team whether your diabetes medicines can cause low blood glucose.
• Low blood glucose can happen while you exercise, right afterward, or even up to a day later. It can make you feel shaky, weak, confused, grumpy, hungry, or tired. You may sweat a lot or get a headache. If your blood glucose drops too low, you could pass out or have a seizure.
• However, you should still be physically active. These steps can help you be prepared for low blood glucose:
• Before Exercise
• Ask your health care team whether you should check your blood glucose level before exercising.
• If you take diabetes medicines that can cause low blood glucose, ask your health care team whether you should change the amount you take before you exercise have a snack if your blood glucose level is below 100
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• During Exercise
• Wear your medical identification (ID) bracelet or necklace or carry your ID in your pocket.
• Always carry food or glucose tablets so you’ll be ready to treat low blood glucose.
• If you’ll be exercising for more than an hour, check your blood glucose at regular intervals. You may need snacks before you finish.
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• After Exercise
• Check to see how exercise affected your blood glucose level.
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What should I do before I start a physical activity program?

Check with your doctor. Always talk with your doctor before you start a new physical activity program. Ask about your medicines—prescription and over-the-counter— and whether you should change the amount you take before you exercise. If you have heart disease, kidney disease, eye problems, or foot problems, ask which types of physical activity are safe for you.

Decide exactly what you’ll do and set some goals.

Choose:

• the type of physical activity you want to do
• the clothes and items you’ll need to get ready
• the days and times you’ll add activity
• the length of each session
• your plan for warming up, stretching, and cooling down for each session
• a backup plan, such as where you’ll walk if the weather is bad
• your measures of progress
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Find an exercise buddy. Many people find they are more likely to do something active if a friend joins them. If you and a friend plan to walk together, for example, you may be more likely to do it.

Keep track of your physical activity. Write down when you exercise and for how long in your blood glucose record book. You’ll be able to track your progress and see how physical activity affects your blood glucose.

Decide how you’ll reward yourself. Do something nice for yourself when you reach your activity goals. For example, treat yourself to a movie or buy a new plant for the garden.

What can I do to make sure I stay active?

One of the keys to staying on track is finding some activities you like to do. If you keep finding excuses not to exercise, think about why. Are your goals realistic? Do you need a change in activity? Would another time be more convenient? Keep trying until you find a routine that works for you. Once you make physical activity a habit, you’ll wonder how you lived without it.