Three things to consider for exercise for people with high blood sugar: Strength training and intensity control guidelines

Exercise Recommendations and Contraindications for Individuals with High Blood Sugar:

Strength Training is Recommended: Studies by foreign medical researchers on elderly diabetic patients have found that a 15-day strength training program can generally improve their insulin sensitivity, and insulin is the most important factor in regulating blood sugar levels. When the body develops insulin resistance, blood sugar levels rise sharply, increasing the risk of type 2 diabetes. This training can also help distribute abdominal fat more evenly, thus maintaining a relatively stable overall weight.

As people age, their arm strength and overall strength decline. Therefore, strength training is essential for elderly diabetic patients. However, this doesn't mean that only the elderly can do strength training; people of other ages can also engage in it.

Appropriate Exercise Intensity is Recommended: Everyone knows the formula: Exercise Volume = Exercise Intensity × Exercise Duration. This formula also applies to exercise therapy for diabetic patients. Insufficient exercise will not achieve the desired therapeutic effect, while excessive exercise will cause significant fluctuations in blood sugar, leading to a worsening of the condition. Of course, determining the intensity of exercise is a key factor. Due to individual differences, exercise intensity can be flexibly adjusted based on the patient's specific situation: post-exercise heart rate, energy expenditure, tolerance, and the patient's response. There are multiple methods for calculating and measuring exercise intensity. Generally, we judge the relative intensity of exercise based on the corresponding heart rate during exercise: 80% of baseline heart rate indicates high-intensity exercise, 40-60% indicates moderate-intensity exercise, and 20% indicates low-intensity exercise. Another criterion is based on the pulse rate during exercise, which is equivalent to 60% of maximum oxygen consumption. For general diabetes, the effective exercise intensity is 40%-50%.

For a healthy person without any injury or using any antihypertensive medications, the heart may beat slower. After a joint examination with a doctor, if the heart rate has not slowed, then the heart rate cannot be considered an ideal indicator of exercise intensity. In this case, one can exercise at a level that feels moderately strenuous. Moderate intensity means neither too strenuous nor too easy; one should be able to speak freely during exercise. Several possible signs of excessive exercise include:

(1) Inability to speak easily, or even being unable to speak, during exercise.

(2) Pulse exceeding the required range.

(3) Exercise intensity that is too high or very high.

Specifically, endurance exercise for diabetic patients should generally last 15 to 60 minutes, maintaining a suitable heart rate for at least 5 minutes; the duration of medical gymnastics and Tai Chi can be determined based on specific circumstances.

Prevention and management of hypoglycemia during exercise: Exercise can lower blood sugar, but it can sometimes trigger hypoglycemia. To prevent hypoglycemia during or after exercise, diabetic patients should follow these principles:

(1) Avoid exercising when insulin or oral hypoglycemic agents are at their strongest, such as 30 minutes to 1 hour after a short-acting insulin injection; exercise intensity should be kept to a minimum.

(2) The injection site for insulin should also be carefully chosen. For example, avoid injecting insulin into areas requiring vigorous activity, such as the thigh; abdominal injection is preferable. (3) Avoid exercising on an empty stomach:

If fasting blood glucose is higher than 120 mg/dL, moderate exercise on an empty stomach is acceptable.

If fasting blood glucose is lower than 120 mg/dL, it is best to completely avoid exercising on an empty stomach. Consider eating something before exercising, such as a glass of milk or a few biscuits, and warm up 10 minutes later.

(4) For prolonged, high-intensity exercise, such as hiking or mountain climbing, the blood glucose-lowering effect may be more sustained. Therefore, in addition to eating before and during exercise, it is also important to increase food intake after exercise, as the blood glucose-lowering effect lasts longer after strenuous exercise, and hypoglycemia may still occur more than ten hours later.

(5) For moderate to high-intensity exercise or exercise lasting longer, appropriate snacks before or during exercise are absolutely necessary.

(6) Patients who can self-monitor their blood glucose should measure their blood glucose before and after exercise. This allows for timely detection of hypoglycemia and understanding of which type and intensity of exercise lowers blood glucose and its effectiveness. (7) Exercise about 40 minutes after a meal, as blood sugar levels are higher at this time, making hypoglycemia less likely.

(8) If hypoglycemia occurs during or after exercise, follow these steps for self-rescue:

① Stop exercising immediately and eat some food you have with you. Hypoglycemia usually subsides after about 10 minutes of rest.

② If it doesn't subside after 10 minutes, eat some food again.

③ If the effect is still not obvious, confirm that you have diabetes and ask for help from others so you can receive treatment at the hospital as soon as possible.

④ Prepare glucagon injections and carry them with you for emergency use. This is also one of the safer methods.