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Work it out

Not all exercises are for everyone

That exercise is beneficial for diabetics is not news. However, exercise can be a tricky thing when your body is hosting an anarchic dance between blood sugar, drugs and insulin. And not all exercises are for every diabetic.

Diabetes stamps its mark on virtually every organ in the body and can put limitations on activity. For example, coronary artery disease (CAD) is common in longstanding diabetics; overly strenuous exercise, when you have unrecognised and untreated CAD, can precipitate chest pain, heart rhythm abnormality or even a heart attack.

Retinal abnormalities are also more likely in diabetics. Such people are at risk for retinal and vitreous bleeds and retinal detachment when they do strenuous activity like lifting weights or exercises that involves breath holding.

Pre-exercise assessment is vital for all diabetics before they take up a new programme of exercise activity. This evaluation must include a neurological examination to detect peripheral nerve damage, a retinal exam and cardiac evaluation. Some might even need an exercise stress test to detect hidden cardiac disease. Exercise and glucose levels: patients on sulphonylurea tablets or insulin must monitor sugar levels before exercise. Sugar levels above 250 mg/dl require correction before exercise. Levels below 100 mg/dl demand a restorative snack before exercise. They may also require a reduction of drug dose. Hypoglycaemia is a real risk for exercising diabetics, and diabetics should learn to recognise its symptoms. They should always carry some biscuits or chocolates during exercise. They should also wear a bracelet identifying them as diabetic: this will help physicians and emergency personnel institute corrective measures promptly when a diabetic is found unconscious.

RAJIV M

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