Page 596 - fbkCardioDiabetes_2017

572 Diabetes and Exercise
(Prevention in Special Population)

One should stop exercise when he/she has faint * Headache/chest pain
pain/feel shortness of breath.
* Sudden calf pain/swelling

Be prepared to treat hypoglycemia: * Pre term labour
* If you experience hypoglycemia: * Decreased fetal movement
* Have 15-20 gms of fast acting carbs9glucose tab- * Amniotic fluid leakage
lets, a piece of fruit, soft drinks, regular soda)
rd
nd
During your 2 and 3 trimesters , don’t expect to
* Avoid exercising alone/in remote areas. be able to achieve the same level of exercise per-
formance as you did before pregnancy. During later
* Wait for 15-20 minutes and check your blood glu-
cose again. mages of pregnancy, a brisk walk is n sufficient to
reach a moderate level of intensity in doing exercise
* After you feel better, eat regular meals &snacks to .During exercise, it is best to avoid sudden change
keep blood glucose level up. of direction, bouncing ,and high impact. Women may
become less stable and susceptible to falls, so one
Remember: should play safe in terms of balance in later stages
Patient should always carry a source of carbohydrate of pregnancy.
with him carry a source of carbohydrate with him
during exercise (an apple, orange juice, a piece of After delivery:
fruit)./always wear a diabetes identification bracelet * Regular exercises are recommended to strengthen
while exercising. the muscles of pelvic floor.
* Exercise patterns in diabetic patients:
Exercising during pregnancy with diabetes:
Of course, no woman wants to do anything might * Aim is to do the following types of activity :
be harmful to her baby, so safety is the first option. * Aerobic activity at relative moderate intensity for
Women are recommended to engage in 30 minutes atleast 150 minutes(2 hours and 30 minutes) a week.
of moderate –intensively, low impact aerobic exer- * Muscle strengthening activity on two or more days
cises 3 times per week. They include brisk walking, a week which work all major muscles groups ( legs
swimming, water exercises, armchair exercises 7 use , hips ,back ,abdomen ,chest, shoulder and arms).
of stationary equipment such as treadmills, bicycles&
ELLIPTICAL TRAINERS. * Flexibility exercises on daily basis.
What type of activity is a diabetic patient adviced to
Activities to be avoided: do?
* High altitude activities (skydiving, mountain climb- Choose exercises , that you can enjoy, such as walk-
ing, scuba diving, weight lifting) exercises are usually ing, cycling, or group fitness classes
not recommended during pregnancy.

* Few reasons to avoid exercise entirely How long (duration)?
Once should do atleast 30 minutes /day to meet the
* Incompetent cervix
recommendations. You can split your sessions to a
* Cerclage minimum of 30 minutes /day.
* Expecting twins/triplets
How often(frequency)?
* Persistent 2 &3 trimester vaginal bleeding.
rd
nd
If you aim to do 30 minutes /day then do this atleast
* Placenta previa 5 times per week so that you can reach a total of 150
minutes a week. Distributes sessions over the week
* Premature labour
and aim to have no more than 2 consecutive days
* Ruptured membranes without physical activity.
* Pregnancy induced hypertension Exercise should
be stopped and physician should be controlled im- Diabetic with peripheral neuropathy :
mediately when if anyone of the following occurs: - Repetitive exercises on insensitive feet can lead to
ulceration and fractures.
* Vaginal bleeding

GCDC 2017