Resources to Guide Exercise Specialists Managing Adults with Diabetes

Grant Turner, Scott Quigg, Peter Davoren, Renata Basile, Sybil A McAuley, Jeff S Coombes, Grant Turner, Scott Quigg, Peter Davoren, Renata Basile, Sybil A McAuley, Jeff S Coombes

Abstract

Exercise is an important element to optimize health and well-being, though navigating exercise safely can be challenging for exercise specialists working with people with diabetes. Measuring glucose levels before an exercise session assists in the determination of whether exercise is safe for a person with diabetes. A number of organizations have recently developed guidelines to provide exercise and diabetes recommendations based on glucose levels and other relevant factors. However, there are limited easy-to-use resources to assist exercise specialists to determine whether exercise should be started and continued by people with diabetes. The type of diabetes, pre-exercise glucose level, medications and their timing, recent food intake and general sense of wellness all warrant consideration when determining the approach to each exercise session. An expert group was convened to review the published literature and develop resources to guide exercise specialists in assessing the safety of an adult with diabetes starting exercise, and indications to cease exercise, based upon glucose levels and other factors. Contraindications to people with diabetes starting or continuing exercise are (1) glucose < 4.0 mmol/L; (2) glucose > 15.0 mmol/L with symptoms of weakness/tiredness, or with ketosis; (3) hypoglycaemic event within the previous 24 h that required assistance from another person to treat and (4) feeling unwell. To optimize diabetes and exercise safety, recommendations (stratified by pre-exercise glucose level) are provided regarding carbohydrate ingestion, glucose monitoring and medication adjustment.

Keywords: Exercise; Glucose level; Hypoglycaemia; Type 1 diabetes; Type 2 diabetes.

Conflict of interest statement

The authors, Grant Turner, Scott Quigg, Peter Davoren, Renata Basile, Sybil McAuley, and Jeff Coombes, declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Type 1 Diabetes Exercise Action Plan. A distinct PDF of this figure can be viewed in Additional file 1
Fig. 2
Fig. 2
Type 2 Diabetes Exercise Action Plan (on insulin and/or sulphonylureas). A distinct PDF of this figure can be viewed in Additional file 2
Fig. 3
Fig. 3
Type 2 Diabetes Exercise Action Plan (lifestyle controlled or treated with diabetes medications—other than insulin and/or sulphonylureas). A distinct PDF of this figure can be viewed in Additional file 3
Fig. 4
Fig. 4
Type 1 Diabetes Decision Tree: for use by an exercise specialist with diabetes knowledge. A distinct PDF of this figure can be viewed in Additional file 4
Fig. 5
Fig. 5
Type 2 Diabetes Decision Tree: for use by an exercise specialist with diabetes knowledge. A distinct PDF of this figure can be viewed in Additional file 5

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Source: PubMed

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