This document discusses exercise guidelines and considerations for clients with diabetes. It defines the two main types of diabetes - type 1 where the body does not produce insulin and type 2 where cells are resistant to insulin. Exercise is beneficial for both types as it enhances glucose usage in muscles, improving blood sugar control. The document recommends low impact activities like cycling, walking and water aerobics from 20-60 minutes, 4-7 days per week at 50-90% of maximum heart rate. It stresses being aware of signs of hypoglycemia as exercise can lower blood sugar for hours after. Clients should check blood sugar before, during and after exercise and always have a carbohydrate snack available.

1. SPECIAL POPULATION
PRESENTATION: CLIENTS
WITH DIABETES
By Justin Bailey

2. WHAT IS DIABETES?
 Diabetes is a metabolic disorder in which the body does not
produce enough insulin (type 1) or the body cannot respond
normally to the insulin that is made (type 2).
 An estimated 23.6 million children and adults in the U.S. have
diabetes and 1.6 million new cases are diagnosed each year.

3. TYPE 1 DIABETES
 Type 1 diabetes or insulin dependent diabetes is typically
diagnosed in children, teenagers and young adults. With type 1,
specialized cells in the pancreas called beta cells stop producing
insulin, causing blood sugar levels to rise, resulting in
hyperglycemia (high levels of blood sugar.
 So basically…..individuals with type 1 do not produce enough
insulin to control their blood sugar levels, and if not controlled
before, during, and after exercise, blood sugar levels can rise or
fall rapidly and cause hyperglycemia and hypoglycemia, with
the latter leading to weakness, dizziness and fainting.

4. TYPE 2 DIABETES
 Type 2 diabetes or non-insulin dependent diabetes is associated with
obesity, particularly abdominal obesity. Individuals with type 2
diabetes usually produce adequate amounts of insulin; however
their cells are resistant to the insulin.
 Basically…..those individuals have the insulin present, but it cannot
transfer adequate amounts of blood sugar into the cell to use, which
can also lead to hyperglycemia (high blood sugar).
 Hyperglycemia is associated with a number of diseases associated
with damage to the kidneys, heart, nerves, eyes, and circulatory
system and some of the symptoms include increased thirst and/or
hunger, frequent urination and headaches or blurred vision..

5. THE GOOD NEWS!
Exercise training is effective in both type 1 and type 2 situations
because it has similar action to insulin by enhancing the usage of
circulating glucose by exercising your muscles. Research has
shown that exercise actually improves a variety of glucose
measures, including improved glucose tolerance and even a
decrease in insulin requirements!

6. EXERCISE GUIDELINES
 Low impact activities are best for these types of clients such as
cycling, treadmill walking, low impact or step aerobics.
 Walking is highly preferred for these clients however care must be
taken when recommending walking. They can develop blisters or
foot microtrauma that can result in foot infection.
 Swimming or water aerobics would also be a great low impact
workout for these types of clients.
 Excessive plyometric or higher intensity training is not
recommended.

7. FIT COMPONENTS
 Depending on the workouts the clients is doing, they are able to
exercise anywhere from 4 to 7 days a week. (Frequency)
 With these clients, you want to have them exercising from 50% to
90% of their maximum heart rate. Stage 1 of cardiorespiratory
training (adjusting the percentage to 40% to 70% if need be)
progressing to stages 2 and 3 based on a physicians approval.
(Intensity)
 The duration of the workouts should range from 20 minutes to 60
minutes

8. THINGS TO CONSIDER….
 Exercise exerts an effect similar to that of insulin, which puts the
client at risk for exercise-induced hypoglycemia, so be aware of
the signs and symptoms of hypoglycemia.
 Hypoglycemia may occur several hours after exercise, so for
those who have been recently diagnosed, glucose should be
measured before, during and after exercise.
 Exercising in excessive heat, such as here in Phoenix, can mask
signs of hypoglycemia, so be very aware of your situation and
the actual symptoms that your client may or may not be
showing.

9. ONE LAST THING…
 Advise your client to always have some sort of snack or quick
source of carbohydrate available during the exercise. These
clients can sometimes drop in blood sugar very quickly so to
avoid sudden hypoglycemia, having a snack available is highly
recommended.

10. THE END!