Diabetes is a complicated disease that affects more than 14 million people in the United States alone, with about 90 percent of the diabetic population stricken by Type II (adult onset) diabetes. Exercise can be extremely helpful if you have diabetes, whether or not you are insulin dependent. However, never exercise if you have high blood sugar plus ketones. Diabetes ketoacidosis can result.

Exercise Benefits
Exercise offers everyone a whole host of health benefits, from greater mobility and improved cardiovascular functioning to stress management and disease prevention. Diabetics who stay physically active have fewer diabetic complications than their inactive counterparts.

Exercise can lower your blood sugar level, helping to eliminate the need for insulin. It decreases your appetite and helps your own insulin work better. Furthermore, exercise burns calories and leads to weight loss, which is particularly important if you have Type II diabetes.

Starting an Exercise Program
Before getting started, always consult your physician, who will want to give you a complete physical exam, which may include a stress test. The doctor can also help you design a program that suits your diabetes treatment plan. Then, wear a medical alert identification bracelet or necklace, or carry an identification card when you exercise.

Avoiding Hypoglycemia
Because diabetes patients are at risk for hypoglycemia, you should check your blood sugar level prior to exercise. If your level is low (under 70 mg/dl) or you are exercising more than one hour after a meal, you may need to decrease your insulin or have a light snack beforehand to avoid a reaction. An insulin reaction could make you feel faint, dizzy, sweaty or confused.

High carbohydrate foods (like bagels, crackers, sports drinks or fruit juice) are best. Eat a heavier snack (like yogurt or half a sandwich) if the activity is high intensity and lasts more than one hour in length.

In case of a reaction, you should always have a fast-acting sugar source (such as candy bars or fruit juice) with you when you exercise. Continue to monitor your blood glucose level after exercising, too, since a drop can occur up to 24 hours later.

Exercise Guidelines
The American College of Sports Medicine and the American Diabetes Association recommend a combination of aerobic activity, muscular fitness exercise and stretching exercises for those with diabetes.

Endurance and Stamina Building
Suitable cardiovascular/aerobic exercises include walking, swimming, bicycling and aerobic classes done at a moderate pace. Perform them three to five times per week for an optimal length of 20 to 40 minutes, making sure to warm up and cool down sufficiently. If you can only exercise for five minutes in the beginning, that is fine. The duration can be progressively increased each week by one or two minutes.
As you progress, increase the frequency to five to seven times per week. This will promote a sustained increase in insulin sensitivity and facilitate weight loss and weight maintenance. Glucose should be monitored frequently during exercise (every 15 minutes for beginners, less often for experienced participants), immediately after exercise, and four to five hours after exercise.
It is important to drink plenty of caffeine-free, calorie-free, alcohol-free fluids before, during and after exercise. This is especially true if you have hyperglycemia, since the body loses fluid in an effort to eliminate additional blood glucose.
If you have Type II diabetes with a high morning blood sugar, you might benefit from exercising after 4 p.m., which might stop the liver from producing excess sugar during the night. Exercising in the morning may prevent nighttime hypoglycemia.
If you have elevated blood glucose after meals, short walks after eating may prove helpful. For too-high blood glucose levels before meals, engage in activity prior to eating.

Muscular/Skeletal Fitness
Muscular fitness exercise improves both muscular and skeletal fitness for increased strength, endurance and toning. If you have retinopathy or hypertension, you should not use heavy weights, lift above your head or hold your breath.

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