Physical activities cannot be the same for every one all the time, in some special cases especially In type 1 diabetes, exercise can worsens hyperglycemia (>300mg/dl) and ketosis. Vigorous activities are best avoided.
Things to be noted in:
Patients on insulin are at risk, added carbohydrate consumption is required if pre-exercise glucose levels are less than 100mg/dl and for patients on other medicines, preventive measures are not required
Vigorous aerobic or resistance exercises- contraindicated and there is a risk of developing vitreous hemorrhage or retinal detachment.
Excess physical activities may lead to loss of protective sensation; also there is a high risk of skin break down, infection and Charcot joint destruction. It is best advised to go for non- weight bearing exercises like Swimming, bicycling, arm exercises etc.
Physical activities here can increase the exercise induced injury and also it can decrease cardiac responsiveness, postural hypotension, impaired thermoregulation, impaired night vision due to impaired pupillary reaction and unpredicted carbohydrate delivery from gastroparesis.
The best solution is to individualize the physical activity according to the cardiac status.
Some Special precaution to be kept in mind
**Feet should be inspected for any cuts blisters and infection
**Avoid exercises in extreme hot and cold climates
**Avoid exercises during periods of poor metabolic control
Benefits of exercise
**Improvement in insulin sensitivity
**Reduction of height
**Reduction in weight
**Improvement in lipid profile
**Improvement in cardiovascular function
**Sense of well being
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