Information Specifically for Type II Diabetes

 

Non Insulin Dependant Diabetes Mellitus (NIDDM) requires special care when preparing to begin an exercise program. But before any Type II Diabetes patient begins an exercise program, it is very, very important to undergo a detailed medical evaluation with appropriate diagnostic studies. This examination should carefully screen for macro and microvascular complications, which might be worsened by an exercise program.

There are some very important precautions that the diabetic must be aware of:

 

When Not To Exercise:

Patients in poor control (blood glucose over 240 mg/dl) to avoid worsening the hyperglycemia.

Patients with retinopathy to avoid increased pressure in the eye leading to further eye damage.

Patients with sensory neuropathy in feet.(jogging or running)

Some very important safety rules are:

Be sure to wear the proper shoes, socks, and clothing while exercising. This will avoid infection caused by blisters and chafing.

Test blood glucose before exercising.

Before exercise, eat a snack that was not already included in meal planning.

Carry sugar to treat hypoglycemia.

Restore control before exercising if hyperglycemia or ketonuria is present.

Exercise with someone else.

Decrease insulin dose for prolonged activity (i.e., swimming) when extra food is not desirable.

 

Why do insulin reactions sometimes occur hours after exercising?

During periods of strenuous exercise, the body consumes substantial amounts of muscle and liver glycogen. It can take up to 24 hours to replace this glycogen; during this time the blood glucose level may drop.

To prevent an insulin reaction, eat extra carbohydrate foods (for example, bread, crackers, or juice) after exercising

If the blood glucose is high after strenuous exercising, avoid taking extra insulin right away. During the cool down, the blood sugar will fall on its own. Extra insulin may cause a severe insulin reaction!

 

REMEMBER: The care of diabetes uses a team effort involving the patient, the physician, and the diabetes education staff where the patient receives medical care. This Module cannot-and was not meant to-replace this team effort.

This is a chart of blood sugar levels that will help out a lot with insulin intake, when to exercise and when not to, and how much to increase by.

Blood Sugar (g/dl)

Activity

<80-100

100-180

180-300

>300

Low to moderate activity (e.g., slow walking, bicycling, 1/2 hr.)

Add 10-15 g

No food increase

No food increase

No food increase

Moderate activity (e.g., 1 hr. swimming, cycling, jogging)

Add 30 g or 10-15 g/hr.

Add 10-15 g/hr.

No food increase

Discontinue exercise

Strenuous activity (e.g., raquetball, football)

Add 45-50 g + SBGM

Add 30-40 g

Add 15 g/hr.

Do not exercise

Half day

As above. Also decrease insulin dose by 10% of total dose.

All day

As above. Also decrease insulin dose by 20%.

 

 

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