Diabetes is a growing problem in the United States. An estimated 29 million Americans (9.3% of the population) currently have diabetes, and by 2050, the Centers for Disease Control and Prevention predict that number will rise to as many as one in three adults. As a health and fitness professional, you likely work with clients who have type 2 diabetes. To kick off Diabetes Awareness Month, here are six important factors to consider when working with clients with type 2 diabetes.
1. Obtain Medical Clearance
According to the American College of Sports Medicine’s Risk Stratification Criteria, clients with a known metabolic disease should receive a medical exam prior to engaging in physical activity. This step is often overlooked among those with type 2 diabetes because it has become so common. While exercise will benefit individuals with type 2 diabetes, certain medical precautions may be required. Obtaining medical clearance before exercise ensures that both you and your client stay safe.
2. Monitor Blood Sugar
At the onset of exercise, the body breaks down stored glycogen for energy, and muscle cells become more receptive to glucose. In individuals with diabetes, the ability to uptake glucose is compromised, which can lead to more extreme blood-sugar responses to exercise. With very high-intensity exercise, the liver may break down glycogen more rapidly than the muscle cells can uptake it, causing an initial increase in blood glucose levels. In other cases, blood glucose levels may fall too rapidly, putting individuals at risk for low blood sugar or hypoglycemia.
Monitoring blood sugar before, during and after exercise can help ensure clients avoid dangerous complications. Exercise should be postponed or discontinued if blood glucose levels fall below 100 mg/dL or rise above above 300 mg/dL or 250 mg/dL with the presence of ketones. It’s important to remind clients to pay careful attention to blood sugar levels in the few hours after exercise as well, as post-exercise hypoglycemia can also occur due to the body’s increased susceptibility to insulin.
Be prepared for bouts of hypoglycemia with fast-acting carbohydrate sources such as juice or raisins. Additionally, encourage clients to stay adequately hydrated, as blood glucose is negatively impacted by dehydration.
3. Track Changes
As described earlier, type 2 diabetes is characterized by an impaired sensitivity to insulin, making the cells of the body less able to utilize glucose. For this reason, exercise is an excellent way to combat type 2