Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 20 years and a Certified Diabetes Educator for more than 15 years. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.

There are many schools of thought about how much exercise is enough. I go by the rule of exercising at least three times a week for 40 to 50 minutes at a time. You should try to give your body a rest day in between bouts of vigorous activity.

One thing is for certain: exercise helps keep blood sugars in better control if you follow some simple guidelines.

1. Remember that the longer you are exercising, the more frequently you should test your blood sugar to reduce the risk of hypoglycemia. Long hikes, for example, require careful planning with appropriate high protein snacks, as well as glucose tablets and a lot of water. A good well-balanced meal prior to hiking will help keep you balanced throughout the day. Don’t just think that rapid acting carbohydrates are the key to a pre-exercise meal; you also need protein and even some fat to make your energy supply last longer. Snacks are generally recommended when your blood sugar falls to 100mg/dl; I actually like to tell my patients to snack if they are at 120mg/dl or below to give them a larger safety net. Each person has different needs and different tolerance for exercise, so what works well for one person may not work for another.

2. Timing of exercise is another important consideration. If exercise occurs first thing in the morning, the risk of hypoglycemia may be lower because liver and muscle glycogen stores get replenished overnight. If you exercise before eating breakfast, there is sometimes a risk of blood sugars going too high because eating actually gives the metabolism a jump-start. Exercise in the evening or late afternoon carries a higher risk of hypoglycemia overnight because the effects of exercise on blood glucose can last for several hours.

3. Proper snacking or eating before exercise is important to maintain good balance in blood sugars. If exercise is less than 45 minutes, 15 grams of carbohydrate is recommended 15 to 30 minutes before activity. Some good food choices are turkey on whole wheat bread, fruits, nuts, and milk. Endurance athletes such as marathon runners have much higher carbohydrate requirements, sometimes as much as 10 grams/kg!

For planned exercise for those who use insulin, follow these guidelines:

  1. Delay activity for 1 to 2 hours after pre-meal insulin.
  2. Reduce pre-meal insulin depending on duration of exercise.
  3. Reduce basal insulin dose.

These are generalities, and your healthcare team will help you plan appropriately so you can exercise safely. Remember that the best health advice must come directly from your own doctor or educator. The more information you have about how to stay safe, the better experience you will have.

Now, get to it!