Diabetes and Exercise-Exercise Program

The exercise program should be aimed at achieving and maintaining a healthy weight. Accordingly, one should target an energy expenditure of 700-2000 calories per week through the various exercises that they may choose.

• Aerobic exercise, involving large muscle groups, for 30 minutes a day is beneficial, while resistance exercises (weights, elastic resistance bands, or strength training machines) can be an option for people with low cardiac risk

Before commencing any physical activity the following parameters need to be given consideration:

• Intensity of exercise: How intense should the physical activity be? This generally depends on the tolerance of an individual.
• Frequency of exercise: How many days in a week should an individual exercise? Generally, 5 days in a week is preferred, unless one needs to lose weight, in which case it should be more. Exercise done for a short duration must be done more often. For example, one can take three brisk 10-minute walks, one shortly after each meal. Since keeping blood glucose within the target range is the aim, the duration between two exercise sessions should be less than 3 days. Diabetics on insulin should be regular with exercise since the blood glucose levels can increase on the days exercise is not performed.

• Duration of exercise: This refers to how long an individual exercise session should last. This is normally related to the intensity of the exercise. High intensity exercises should be of shorter duration and vice versa. It is not advisable for an individual to indulge in long exercise sessions as blood glucose levels may fall below the desired range.
• Timing of exercise: When should exercise be done? The health care team and the patient together usually should decide this aspect and this depends on the individual's daily routine. However, exercising immediately after major meals (breakfast, lunch, and dinner) should be avoided. Exercising during peak insulin action (for those on insulin) is not recommended. This depends on the type of insulin being used and hence it is best to check with the doctor.