Prenatal exercise: Safety first While we can't answer questions personally, we will do our best to address as many as possible in future columns.

Before You Start

Although most people with diabetes can exercise safely, exercise involves some risks. To shift the benefit-to-risk ratio in your favor, take these precautions:

  • Have a medical exam before you begin your exercise program, including an exercise test with EKG monitoring, especially if you have cardiovascular disease, you are over 35, you have high blood pressure or elevated cholesterol levels, you smoke, or you have a family history of heart disease.
  • Discuss with your doctor any unusual symptoms that you experience during or after exercise, such as discomfort in your chest, neck, jaw, or arms; nausea, dizziness, fainting, or excessive shortness of breath; or short-term changes in vision.
  • If you have diabetes-related complications, check with your health care team about special precautions. Consider exercising in a medically supervised program, at least initially, if you have peripheral vascular disease or kidney problems. Those with peripheral neuropathy should not run, jog, or walk long distances without the approval of their doctors, and those with retinopathy should check with their eye doctors before initiating an exercise program.
  • Learn how to prevent and treat low blood glucose levels (hypoglycemia). If you take oral agents or insulin, monitor your blood glucose levels before, during, and after exercise.
  • If you have type 1 and your blood glucose is above 250 milligrams per deciliter, check your urine for ketones. Don't exercise if ketones are present, because exercise will increase your risk of ketoacidosis and coma.
  • Always warm up and cool down.
  • Don't exercise outdoors when the weather is too hot and humid or too cold.
  • Pay special attention to proper footwear. Inspect your feet daily and always after you exercise.
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