Clinical Hub,Patient Education,Health and Nutrition Facts For You,Diabetes, Endocrine

Diabetes: Guidelines for Exercise (260)

Diabetes: Guidelines for Exercise (260) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Diabetes, Endocrine



Guidelines for Exercise

Regular physical activity and exercise are part of a healthful lifestyle. Exercise can
also help people with type 1 and type 2 diabetes. Exercise can improve the health
of people with diabetes by:

ξ Decreasing the risk of heart disease by improving heart health through aerobic
activities (walking, jogging, swimming, dancing, etc.).
ξ Improving cholesterol levels by decreasing the LDL (“bad”) cholesterol and
increasing the HDL (“good”) cholesterol.
ξ Reducing blood pressure.
ξ Strength training can improve blood sugar control and may decrease the amount
of medicines a person needs by:
o Increasing lean body mass, or the amount of muscle.
o Improving insulin resistance and helping muscles to use blood sugar
o Achieving and maintaining a healthy weight.
ξ Reducing the risk of diabetic complications. This may include neuropathy
(nerve damage), retinopathy (eye damage), and nephropathy (kidney damage).
ξ Improving strength, self-image, feeling of well-being and overall quality of life.

Starting an exercise program
ξ Check with your doctor before starting an exercise program.
ξ Choose aerobic activities that you enjoy and fit them into your lifestyle. Some
examples include:
o fast walking
o jogging
o swimming
o skiing
o cycling
o jumping rope
o aerobic dance
o water-aerobics
ξ Slowly increase the frequency (how often), intensity (how hard) and duration
(how long) you exercise to a goal of at least 150 minutes (2 ½ hours) per week.

Before Exercise
It is best if blood sugar is in good control before exercise. If a person exercises
when their blood sugar is high:
ξ Blood sugar and ketones will increase.
ξ Muscles will not be able to use the blood sugar for energy.
ξ The liver will make more sugar to meet the needs of the muscles.
ξ The increased sugar from the liver will increase the blood sugar even more.

Exercise Plan
An exercise plan includes how long, often, and how much a person would like to
exercise to meet their goals. Each of these areas is based on a person’s current
activity level, age and goals. The American College of Sports Medicine (ACSM)
ξ Duration: At least 150 minutes per week. This may be 30 minutes per day
and can be divided into 10-minute intervals. For weight loss people may
need to exercise for 60-90 minutes.

ξ Frequency: At least 5 days per week. For good blood sugar control
exercising daily is best.

ξ Intensity – Use personal heart rate goals and perceived effort to gauge
intensity. It is best to slowly increase and decrease the heart rate. Use the
equation below to find your target heart rate for 60-80% intensity:

Target Heart Rate at 60% intensity = (220 – Age) x 0.6
Target Heart Rate at 80% intensity = (220 – Age) x 0.8

Use the table to the left to measure your
perceived effort, or exertion. It is best to
exercise near an 11-13 rating on the perceived
exertion scale (PES).

Perceived Exertion Scale
7 Very, Very Light
9 Very Light
11 Fairly Light
13 Somewhat Hard
15 Hard
17 Very Hard
19 Very, Very Hard


Guidelines for Persons with Type 1 Diabetes
The risk of high blood glucose (hyperglycemia) and low blood glucose
(hypoglycemia) during exercise is a concern for persons with type 1 diabetes.
Hyperglycemia can occur if the blood sugar is high before exercise.
Hypoglycemia can be caused by:
ξ Too little food before exercise.
ξ Exercise when insulin is peaking.

Persons with type 1 diabetes need to:
ξ Check blood glucose levels before and after exercise, and possibly during.
ξ Do not exercise if blood glucose is greater than 250 mg/dl.
ξ Exercise after meals and snacks.
ξ Inject insulin into non-active muscle group and ask doctor if you need to adjust
insulin to support regular exercise.
ξ Always carry identification that shows you have diabetes and a fast-acting
sugar source during exercise, such as glucose tablets or hard candy.

Guidelines for Persons with Type 2 Diabetes
Persons with type 2 diabetes need to:
ξ Monitor blood glucose levels before and after exercise.
ξ If your blood glucose is greater than 250 mg/dl, do not exercise until it is under
ξ If you use insulin or take pills, always carry a fast-acting sugar source with you
such as glucose tablets or hard candy.


Guidelines for Nutrition during Exercise

Type of Exercise If blood glucose is… Increase food intake by…
Short duration
30-45 minutes
IE: walking, an easy bike
Less than 100 mg 10-15g Carbohydrate per hour
(1 fruit or 1 starch serving)
100mg/dl or above Not necessary to eat more
Moderate intensity
30-60 minutes
IE: Tennis, swimming,
jogging, cycling, golfing,
Less than 100 mg 20-50g Carbohydrate per hour
(2 fruit or 2 starch with 1 meat
and 1 milk serving)
100-180 mg/dl 15g Carbohydrates per hour
(1 fruit or 1 starch serving)
180-250mg/dl Not necessary to eat more
Vigorous intensity
60+ minutes
IE: Football, hockey,
soccer, swimming, snow
shoveling, etc.
Less than 100 mg/dl 50g Carbohydrates per hour
(2 starch, 1 fruit, 1 milk and 1-
2 meat servings)
100-180mg/dl 25-50g Carbohydrates per
(2 starch or 2 starch, 1 fruit
1 milk serving)
180-250mg/dl 10-15g Carbohydrates per
(1 fruit or 1 starch serving)

Teach Back:
What is the most important thing you learned from this handout?
What changes will you make in your diet/lifestyle, based on what you learned today?

If you are a UW Health patient and have more questions please contact UW Health at one of the
phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s
Hospital (AFCH) can be reached at: (608) 890-5500

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770

Your health care team may have given you this information as part of your care. If so, please use it and call if you have
any questions. If this information was not given to you as part of your care, please check with your doctor. This is not
medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health
needs are different, you should talk with your doctor or others on your health care team when using this information. If you
have an emergency, please call 911. Copyright © 2/2015 University of Wisconsin Hospitals and Clinics Authority. All rights
reserved. Produced by the Clinical Nutrition Services Department and the Department of Nursing. HF#260