- Monitor glucose levels before, during, and after workouts (glucose levels swing dramatically during exercise)
- Avoid exercise if glucose levels are above 300 mg/dL or under 100 mg/dL
- Inject insulin in sites away from the muscles used during exercise; this can help avoid hypoglycemia
- Drink plenty of fluids before and during exercise; avoid alcohol, which increases the risk of hypoglycemia
- Insulin-dependent athletes may need to decrease insulin doses or take in more carbohydrates prior to exercise, but may need to take an extra dose of insulin after exercise (stress hormones released during exercise may increase blood glucose levels)
- Wear good, protective footwear to help avoid injuries and wounds to the feet
- Some blood pressure drugs can interfere with exercise capacity. Patients who use blood pressure medication should consult their doctors on how to balance medications and exercise. Patients with high blood pressure should also aim to breathe as normally as possible during exercise. Holding the breath can increase blood pressure.
[For more information, see In-Depth Report #29: Exercise.]
Monitoring Glucose (Blood Sugar) and Hemoglobin A1C
According to the American Diabetes Association, people with diabetes should aim for preprandial (before eating) plasma glucose levels of 90 to 130 mg/dL and postprandial (after eating) plasma glucose levels less than 180 mg/dL. Hemoglobin A1C levels should be less than 7%.
Measuring Blood Glucose. In patients being treated with insulin or insulin-producing or sensitizing drugs, it is important to monitor blood glucose levels carefully to avoid hypoglycemia. Different goals may be required for specific individuals, including pregnant women, very old and very young people, and those with accompanying serious medical conditions.
Blood glucose levels are generally more stable in type 2 diabetes than in type 1, so experts usually recommend measuring blood levels only once or twice a day. For patients who have become insulin-dependent, more intensive monitoring is necessary. Usually, a drop of blood obtained by pricking the finger is applied to a chemically treated strip. The glucose level is read on a standard meter or a small, portable digital display device.
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