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TYPES OF EXERCISE FOR PEOPLE WITH DIABETES
Sprinting
This is an example of the ‘quick burst’ type of exercise. Sprinting is not the type of exercise for the unfit older amateur to choose. You need a lot of energy in a very short time. This can be provided beforehand by rapidly absorbed carbohydrate, such as a glucose drink. More rapidly absorbed and some slowly absorbed carbohydrate will be needed afterwards. A small insulin reduction may be necessary.
Marathon running
This is an example of endurance exercise. A marathon runner builds up to a distance of many miles by gradually increasing training runs over a long period of time.
If you take up this type of running you need to consider how far you usually run and at what time of day, and reduce your insulin accordingly. You will need slowly absorbed carbohydrate food and some instant energy before you start. The instant energy, for example in the form of slightly salted glucose drinks, will need to be repeated at frequent intervals along the track, probably every one or two miles, to top up your energy and fluid supplies. After the race you will have to take more rapidly absorbed and plenty of slowly absorbed carbohydrate to counteract late falls in glucose.
Water sports
There is no reason why people with diabetes should not go swimming. Swimming exercises the whole body. If you go to a pool regularly you can increase the number of lengths or widths that you swim gradually, so it is a good exercise for the older diabetic.
The risk is that the exercise will make you hypoglycemic and that you will become unconscious and drown, but this is preventable. First, never swim alone and do not go out of your depth if the person with you is not capable of rescuing you from deeper water (in any case, it is better to choose a companion who can swim). Second, immediately before entering the water, you must ensure that you have eaten enough to fuel your swim, but not overfilled your stomach. Eat a high fibre meal about one to two hours before swimming and have some rapidly absorbed carbohydrate, such as glucose, just before you enter the water. Carry glucose with you in the water; hard-boiled candies can be knotted into a plastic bag pinned to your bathing suit. Hypostop glucose gel comes in a small polythene bottle which is water-resistant and can be carried in a pocket in your bathing suit. If you are in the water for a long time, have a snack halfway through.
People with diabetes are prone to cramp, and this may be reduced by drinking bitter lemon or tonic, both of which contain quinine. The possibility of cramp is another reason why you should not swim alone. Do not allow yourself to get chilled; cold and hypoglycemia do not mix.
If you have not been swimming before, or not recently, check your blood glucose level before and after swimming to see what effect this exercise has had on you.
Swimming in the sea is more hazardous. It can be done by diabetics, but you must take all the precautions described above and remember the added dangers. Never go far from land out of your depth, especially where there are big waves or unknown currents.
*84/102/5*
