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Diabetes: Importance of Exercise

What is diabetes?

Diabetes is a problem with the way the body uses digested food for energy. When your child eats, the body changes the food into sugar. Blood carries the sugar to the body’s cells, where the cells use the sugar for energy. If your child has diabetes, sugar cannot get into the cells and stays in the blood instead. This causes high level of sugar in the blood. Too much blood sugar can damage your child’s blood vessels and organs.

Why is exercise important when my child has diabetes?

Exercise helps keep your child's blood sugar under control in the following ways:

  • It 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. Your child’s body burns more sugar, which means your child’s blood sugar usually gets lower.
  • Your child will feel better. Your child will have more energy and tire less easily. Studies have shown that exercise can make people feel healthier and happier by helping them keep normal levels of the brain hormones that affect mood.
  • It helps keep the body in good shape. Exercise helps your child burn extra calories. If your child is overweight, it can help your child lose weight and keep a normal weight. It also keeps the muscles and bones strong.
  • It helps keep the heart rate and blood pressure lower. People who exercise have healthier hearts. It’s easier for the heart to pump blood throughout the body. Normal blood pressure helps prevent stroke and heart, eye, and kidney problems.
  • It helps keep blood fat levels normal. Many people with diabetes have high levels of blood fats (cholesterol and triglycerides). High blood fats can lead to early aging of blood vessels. Exercise and a healthy diet are the best ways to keep blood fats low.
  • It helps your child have normal blood flow to the feet. This can help prevent foot problems.

How do I get my child’s exercise program started?

The best way to make exercise a part of everyday living is to start early in life. Older children may not be as willing to start a regular exercise program. Many children prefer TV or computer games to exercise. You may have to encourage a change in attitude. Make exercise part of the normal routine. Try to be a good example by exercising regularly yourself. Make exercise activities like skating and swimming a reward for your child. It helps if you can have fun with your child in the activity. Jogging, walking, or jumping rope is good for parents, too! A child of any age will soon pick up your good attitude toward exercise.

Here are some things to do or think about as you get started:

  • Make sure you discuss plans for a new exercise program with your child’s healthcare provider before it’s started.
  • It’s always best to start a new exercise program slowly. Your child can slowly increase how long and how hard he or she exercises.
  • If your child is taking insulin or other diabetes medicine, ask your provider when the blood sugar needs to be checked. Also ask how doses of insulin may need to be adjusted before and after exercise.
  • Protect your child’s feet during exercise. Make sure your child’s socks and shoes fit well. Check your child’s feet every day. Watch for blisters, warm areas, or redness. If your child has any kind of sore on the feet, see your child’s provider right away.

Which kinds of exercise are best?

The best exercise is exercise your child enjoys. It’s easier to form a habit of exercising if your child enjoys the activity. Some of the exercise should be aerobic because it helps the heart. During aerobic exercise your child breathes faster and more deeply. Aerobic exercise uses large muscles, like the muscles in the legs and arms, and gets the heart beating faster. Some examples of aerobic exercise are walking, jogging, swimming, and bicycling.

Children with diabetes can play almost every sport. Boxing is the only activity that is discouraged. This is because eye injuries are common in boxing, and eye problems are a possible complication of diabetes.

Strenuous activities, such as weight lifting and jogging, are discouraged if your child has severe eye problems related to diabetes because these activities increase the pressure in the eyes. If your child has eye problems, make sure you talk to your child’s healthcare provider before your child starts a new activity.

If your child has nerve damage or foot problems, it’s also best to avoid walking long distances and treadmill or step exercises. Activities like bicycling or swimming are safer in this case.

When should my child exercise?

The best time to exercise depends on your child’s schedule. If your child is taking insulin or other diabetes medicines that can lower blood sugar, you need to take precautions against the blood sugar getting too low during exercise. Think ahead and make changes in your child’s snacks and doses of insulin or other diabetes medicine to help prevent low blood sugar. Try to pick a regular exercise time and adjust snacks and medicine doses to fit the exercise. Check blood sugar after 15 minutes of exercise and, whether your child is still exercising or finished, check it again after 30 minutes of 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.

How often and how long should my child exercise?

Ask your healthcare provider to prescribe a plan for starting an exercise program. It should include the types of exercise, how long your child should exercise, and how often. If your child is just starting an exercise program, the exercise shouldn’t last too long at first.

To help your child’s heart stay healthy, it’s good to have at least 2 hours and 30 minutes of moderate aerobic exercise each week. For example, your child might exercise 30 minutes a day, 5 days a week. It’s best not to go more than 2 days in a row without aerobic exercise.

The more exercise your child gets, the more fat your child will burn. If weight loss is one of your child’s goals, your child may need to exercise harder or for a longer time to reach the goal.

Each exercise activity should start with a warm-up. Your child can do something for 5 to 10 minutes that slowly increases the heart rate, such as walking. Gentle stretching before and after exercise can help prevent cramps and stiffness. Finish the exercise with a cool-down by slowing the activity for 5 to 10 minutes before stopping.

Ask your child’s healthcare provider what kind and level of exercise is best for your child.

When should my child avoid exercise?

If your child has type 1 diabetes, vigorous physical activity should be avoided if urine or blood tests are positive for ketones. If the urine ketone level is large or moderate, exercise can raise the ketone level even more. Check the urine for ketones before exercise if your child is not feeling well or the blood sugar is staying higher than 240 milligrams per deciliter (mg/dL). Your child can usually still exercise when blood sugar is high as long as he or she feels well and there are no ketones in the blood or urine.

Avoid exercise when it’s very hot or very cold. Ask your child’s healthcare provider if there are other times when your child should not exercise—for example, when your child feels sick or has a fever.

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

A low blood sugar (hypoglycemia) could happen during or after exercise. There are several ways your child can manage blood sugar and exercise:

  • Plan to exercise after a light, high-protein snack.
  • Exercise after a meal but wait at least 30 minutes after eating so your child can digest the food first.
  • Lower the insulin dose before exercise.
  • Keep extra snacks handy to help prevent low blood sugar during exercise.

You and your child will need some practice with adjusting the amount of food he or she eats before exercise, how long to wait before exercising, and how much to decrease doses of insulin or other diabetes medicine. Keep good records so you can see what works best. Take these records to visits with your child’s healthcare provider so you can get help making adjustments.

Here are some things that might help.

  • Often the best time to exercise is 1 to 3 hours after eating a meal.
  • Check blood sugar before and after exercise. Your child may need to eat a carb snack (at least 15 grams of carbohydrate) before exercise if blood sugar is less than 100 mg/dL. Test blood sugar again 15 to 30 minutes later. Your child’s provider may recommend that your child not exercise until the blood sugar is higher than 100 mg/dL. Blood sugar may keep being lower than usual for several hours after exercise. Until you learn how your child’s body is reacting to a new exercise program, blood sugar needs to be checked more often than usual until bedtime, just to be sure it’s not getting too low.
  • Avoid exercising when insulin is working at peak level, which means it’s keeping the blood sugar at its lowest level. Your child’s provider can tell you when your child’s type of insulin is working at its peak.
  • Learn how your child’s blood sugar responds to different exercise conditions.
  • Know what to do if the blood sugar is low or gets low when your child is exercising.
  • Always carry a source of sugar, plus a longer lasting snack of some carbohydrate and protein--for example, nuts, peanut butter, or cheese and crackers.

Remember, it’s wise to think ahead about the day's schedule and plan accordingly. Be sure to ask your child’s healthcare provider if you have any questions about managing your child’s blood sugar levels, the doses of insulin or other diabetes medicine, and the timing of exercise.

Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2013-02-11
Last reviewed: 2013-02-09
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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