The physician will make exercise choices for your patient based on her type of diabetes, diabetic complications, other medical problems, and her exercise preferences.All exercise plans should spell out the types of exercise to be performed as well as their intensity, duration, and frequency. Exercise should be regular and rhythmic and should use the large muscle groups. Good examples include walking, bicycling, and swimming-isometric exercises that place a safe, steady workload on the heart. Your patient shouldn’t use isotonic exercises such as weight lifting because they make the heart rate and blood pressure rise rapidly.
Your patient should begin her exercise program with a warm-up of at least 5 minutes, gradually increasing her heart rate. She should then move on to 5 to 7 minutes of
stretching to further increase her heart rate. Stretching also improves the flexibility of muscles that may be impaired by glycated muscle collagen.
Next comes the training period, which consists of 20 to 30 minutes of aerobic activity within your patient’s target heart rate. A person who hasn’t exercised in some time or who has never exercised may have to start with sessions of 5 to 10 minutes and gradually increase them to 30 minutes.
After aerobic activity, your patient should spend 10 to 15 minutes cooling down. The intensity of exercise is gradually decreased to allow her heart rate and blood pressure to slowly return to baseline. During the cooldown your patient should perform muscle-strengthening exercises for 5 to 10 minutes followed by stretching and relaxation for about 5 minutes.
Glucose tolerance declines after 24 hours withÂout exercise, so your patient should exercise at least 3 days a week. Achieving continuous, improved glucose control requires even more frequent exercise. If your patient is trying to lose weight, she may have to exercise 5 or 6 days a week.