Diabetes: Importance of Exercise

Why is exercise important?

Exercise helps keep your child's blood sugar under control. You should make a special effort to plan daily exercise for your child. Young people with diabetes can participate in almost every sport. Many professional athletes have diabetes. Exercise helps people with diabetes (both type 1 and type 2) in the following ways:

• Exercise helps the body burn more sugar. Insulin is more effective during exercise. More sugar and insulin flows in the blood to the muscles during exercise. This causes more sugar to be burned. Exercise usually helps lower the blood sugar.
• Exercise makes you feel better. Children who exercise tend not to tire as easily and feel happier and healthier.
• Exercise helps keep the body in good shape. Lack of activity leads to health problems such as obesity and heart trouble. Exercise helps burn extra calories and helps your child keep a normal weight.
• Exercise helps keep the heart rate (pulse) and blood pressure lower. People who exercise have healthy hearts and the heart doesn't have to pump as hard. Low blood pressure helps prevent heart problems as well as other complications of diabetes such as eye and kidney problems.
• Exercise helps keep blood fat levels normal. Many children with diabetes have high levels of the blood fats (cholesterol and triglycerides). High blood fat levels can lead to early aging of blood vessels. Exercise and good blood sugar control are the best ways to reduce blood fat levels.
• Exercise helps the body become more sensitive to insulin. Insulin receptors are the places where insulin attaches to cell membranes to allow sugar to pass into the cell, The number of receptors increases as a result of regular exercise. This makes the body more sensitive to insulin, the insulin can work more efficiently, and usually a lower daily dose is required.
• Exercise helps normal blood circulation to the feet. Exercise can help blood circulation to the feet and prevent foot problems.

Exercise is particularly important for children who have type 2 diabetes or who may develop type 2 diabetes. If your child is overweight, strategies for weight loss are eating less (particularly fast food and high-fat food) and exercising more. The risk for developing type 2 diabetes can be reduced by more than half if these two principles are followed.

Which kinds of exercise are best?

The best exercise is one your child likes. It is easier to form a habit of exercising if your child enjoys the activity. Your child needs to choose an aerobic exercise. Only aerobic exercises help the heart. Aerobic exercises include most continuous activities (such as jogging, walking, swimming, or bicycling) that are done for a period of 30 minutes or longer. When activities such as weight lifting are done in short bursts with rests in between, they are considered strength-building exercises, not aerobic exercise.

Boxing is the only activity that is discouraged for children with diabetes. This is because eye injuries are common in boxing and eye problems are a possible complication of diabetes. Also, the high incidence of brain damage makes boxing dangerous for people with or without diabetes.

Careful diabetes management to prevent low blood sugar levels is important in all sports. It is especially important for sports in which there is an associated danger (for example, scuba diving). Fortunately, dangerous activities are not generally used for daily aerobic activity.

How do I help my child get started?

When beginning a new exercise program, it is always best to start slowly. Gradually extend the time and amount of exercise. This will result in fewer sore muscles and a better chance to continue the program. The best way to make exercise a part of everyday living is to begin early in life. Older children may not be as willing to begin a regular exercise program. Exercise should be part of the normal routine. Many children prefer TV or computer games to exercise and the parent may have to encourage a change in attitude. You can reward your child for good behavior with exercise activities such as skating and swimming. It is helpful if you can have fun with the child in the activity. Jogging, walking, or jumping rope is good for parents too! Whenever a child has a parent's attention and company, that time quickly becomes a reward. A child of any age will soon pick up your good attitude toward exercise. You need to be a good example by exercising regularly, even if it is not with the child.

When should my child exercise?

The best time to exercise will vary with your schedule. Children like to play after school, and most organized sports activities take place then. This is the time that most intermediate-acting insulin has its main effect. Exercise often causes the body's blood sugar level to drop. Extra care to prevent low blood sugar is important. When possible, pick an exercise time, preferably the same time each day, and adjust the snacks and insulin dose to fit the exercise. Remember, you can adjust your child's diabetes management to suit your child's lifestyle. Your child's lifestyle does not have to be adjusted to fit diabetes.

When should my child not exercise?

If your child's urine ketone level is large or moderate, exercise can raise the sugar or ketone level even higher. So, do not let your child exercise when he has urine ketones. Remember to check urine ketones before exercising if your child is not feeling well.

How often should my child exercise?

To improve the health of the heart, your child should have at least 30 minutes of aerobic exercise 5 times per week. The more exercise a person gets, the more fat is burned. Some people burn more calories with their exercise than others. This is partly related to how hard the person exercises. If weight loss is one of the goals for your child, it may be necessary to exercise harder or for a longer period to reach the desired goals.

How can I help my child prevent low blood sugar (hypoglycemic) reactions during exercise?

You can plan the exercise after a meal, reduce the insulin dosage, or take extra snacks to help prevent low blood sugar during exercise. This will take some experimenting with dosages and record keeping. Your child should always carry a source of sugar at all times and have a longer lasting snack nearby. Remember, it is wise to THINK AHEAD about the day's schedule and plan accordingly.