Heart Disease

Type 2 diabetes increases the risk of coronary artery disease, and therefore you should get an evaluation for heart disease prior to starting an exercise program. Older people with type 2 diabetes who are just planning moderate activity such as walking may not need any special evaluation. However, if you were previously inactive and are planning a vigorous exercise program, or you have autonomic neuropathy or previous heart problems, you should get a cardiac stress test. Your doctor may do a test called thallium-201 scintigraphy, which looks for areas of the heart that have insufficient blood flow. You can estimate your risk for heart disease using the ADA Diabetes Personal Health Decisions online questionnaire (see Resources).

Summary

• Exercise has many benefits for people with diabetes. Before embarking on an exercise plan, visit your physician and diabetes educator for guidance on how to exercise safely.

• In type 1 diabetes, you may need to adjust your insulin and carbohydrate intake before, during, and after exercise. You will also need to monitor your glucose levels more frequently.

• During exercise, you usually need less insulin. If you are on a pump you can cut back on the basal insulin. If you are on injections you may need to take additional carbohydrate.

• Several hours after intense or prolonged exercise, your glucose level can go low, so check your glucose and cut back on the basal insulin or eat a snack.

• With exercise training, you will become more insulin sensitive, and you will need less basal and bolus insulin.

• In type 2 diabetes, you may need to cut back on the insulin or oral medicines that can cause hypoglycemia when you exercise.

• If you have complications of diabetes, additional modifications of the exercise plan may be necessary:

• If you have severe peripheral neuropathy and foot deformity, non-weight-bearing exercises like swimming and cycling are safer.

• Avoid vigorous exercise, weight lifting, or boxing if you have active retinal bleeding.

• If you are normally sedentary and plan to start a vigorous exercise program, you may need to get a cardiac stress test.

Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

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