Weight Loss and Exercise

Maintaining a healthy weight (including losing weight, if necessary) and exercising regularly are important factors in all aspects of diabetes-related health.

How does exercise benefit people with diabetes? Exercise can have many good effects among people with diabetes. Being active can help control blood glucose and blood cholesterol (raising “good” HDL and lowering “bad” LDL), keep weight within a healthy range, and help prevent heart and blood flow problems, which reduces risk of heart disease and nerve damage.

How much exercise is needed? For diabetes-related health, and general health, the recommended about of exercise is 30 minutes per day, at least five days per week. Recommended intensity is moderate; walking briskly, mowing the lawn, dancing, swimming, or bicycling are examples of moderate-intensity activities.

What precautions should people with diabetes take when planning an exercise program? Speak with your doctor about the types of activities that are safe for you and the appropriate intensity. Special exercise-related considerations among people with diabetes include heart, foot, and eye problems and high blood pressure. If necessary, your doctor will help you choose activities that accommodate any limitations you may have.

How does exercise affect blood glucose levels? Your doctor can also help you understand how exercise may affect your blood glucose levels and how to take precautions to keep levels in a safe range. For example, exercise may lower blood glucose levels too much, causing hypoglycemia (a condition where symptoms include shakiness, weakness, confusion, irritability, and hunger). The risk of hypoglycemia may be higher in people who take insulin or other oral medications. Hypoglycemia can be prevented by checking blood glucose before exercise—if it’s below 100, eat a small snack.

Your doctor can also talk with you about precautions like bringing food and glucose tablets with you when you exercise and eating properly prior to exercise. He or she can discuss insulin use and exercise, as dosage may need to be changed before beginning an exercise program.

Exercise can also raise blood glucose levels, so it’s important to avoid exercise when levels are high (above 300, or a fasting blood glucose above 250).

Other precautions include wearing cotton socks and properly fitting shoes; checking your feet for sores, blisters, cuts, or other injuries; and drinking enough fluids, as dehydration can affect blood glucose.

Healthy Diet

To make healthy food choices, consider these guidelines:

  • Eat smaller portions.
  • Eat less fat and cook food using lower-fat methods.
  • Limit foods high in saturated fats and trans fats (including fatty meats, fried foods, whole milk, nondairy creamers, stick margarine, shortening, some salad dressings, sweets, and crackers).

Replace less-healthful choices with the following types of foods:

  • Whole grains (including oatmeal and whole-grain rice, breakfast cereal, breads, and tortillas)
  • A variety of fruits and vegetables (fresh or frozen and dried fruit and 100 percent fruit juice)
  • Good vegetable choices include dark green varieties (broccoli, spinach, Brussels sprouts), orange varieties (carrots, sweet potatoes, pumpkin, winter squash), and beans and peas.

Cut back on high-sugar foods like:

  • Fruit-flavored drinks
  • Soda
  • Tea or coffee with sugar

Cut back on salt (in cooking and at the table) and in foods like:

  • Canned and packaged soups
  • Canned vegetables
  • Pickles
  • Processed meats

Gestational Diabetes

Gestational diabetes can occur in pregnant women. It develops late in pregnancy and usually goes away after the baby is born. Gestational diabetes remains a health concern, however, because it raises a woman’s risk of developing type 2 diabetes within five to 10 years by 40 to 60 percent. Women who have had gestational diabetes may be able to help prevent type 2 diabetes by maintaining a healthy body weight and staying physically active.

Other Types of Diabetes

In addition to type 1, type 2, and gestational diabetes, there are other types of diabetes. And sometimes a person exhibits characteristics of more than one type; in type 1.5 diabetes (latent autoimmune diabetes in adults), for example, a person will show signs of both type 1 and type 2. Additional types of diabetes include those caused by genetic defects of the insulin-producing cells in the pancreas, genetic defects of insulin action, damage to the pancreas, excess amounts of certain hormones, and medications that reduce insulin action.

Prevalence

Incidence of diabetes appears to on the rise. The Centers for Disease Control and Prevention (CDC) estimates that one in three people in the United States born in 2000 will be affected by diabetes. And by 2050 the CDC projects that diagnosis of diabetes will have increased by 165 percent.

Diabetes Among Women

In addition to gestational diabetes, there are several ways in which diabetes affects women differently from men. Women with diabetes tend to have a more-serious risk of heart disease, and in the event of a heart attack, women have lower survival rates and those who survive have a poorer quality of life. As well, risk of blindness is greater for women with diabetes than men.

Women with diabetes who wish to become pregnant need to make special considerations, as pregnancy can affect insulin levels and diabetes-related eye and kidney problems. Pregnant women need to be especially careful about keeping blood glucose levels as close to normal as possible in order to protect themselves and the baby.

Resources

National Diabetes Education Program

American Diabetes Association

The Centers for Disease Control and Prevention

National Diabetes Information Clearinghouse

American Dietetic Association

American Heart Association

Sources

National Diabetes Information Clearinghouse. www.diabetes.niddk.nih.gov. Accessed May, 2010.
Diabetes Public Health Resource. The Centers for Disease Control and Prevention Web site. http://www.cdc.gov/diabetes/. Accessed May, 2010.