Exercise is one of the most important weapons in the arsenal against diabetes. Regular physical activity helps to control blood sugar and lessens the risk of diabetes-related complications like heart disease.

Cardiovascular exercise helps type 2 diabetics reduce the amount of medication needed and helps type 1 diabetics become more responsive to their insulin medication. Cardiovascular exercise is any kind of exercise that is “aerobic” or that makes you breathe a little harder and makes your heart rate go up.

It is usually rhythmic in nature like walking, jogging, cycling, or swimming. Sports like badminton and tennis or recreational activities like dancing and golf (no cart) are also appropriate. Most diabetes experts recommend exercising five times a week for at least 30 minutes at a moderate intensity. This means you are breathing somewhat hard but you can still say a few short sentences.

All people with diabetes need to follow exercise guidelines to stay safe when they exercise. Type 1 diabetics should take further precaution by coordinating closely with their doctor to avoid dangerous fluctuations in glucose and insulin levels.

• Always carry a quick and rapid source of carbohydrate (juice or candy) in case you develop hypoglycemia. If you are working out in a gym, do not leave it in your locker. Carry it with you at all times.

• Hypoglycemia can occur four to six hours after exercise. Avoid exercising late at night since this might make your blood sugar levels drop while you are sleeping.

• Avoid exercising during periods of peak insulin activity.

• Exercise one to two hours after a meal and before peak insulin activity.

• Consume a carbohydrate snack before and during prolonged exercise.

• Take care when exercising in extreme weather conditions. Hot weather can speed up insulin absorption, while cold weather can slow down insulin absorption.

• Check blood sugar before exercising. If under 100 mg/dl, eat a carbohydrate snack like a banana or whole wheat bread. If more than 300 mg/dl, do not exercise. If between 250 and 300 mg/dl, test for ketones. If positive, don’t exercise. Some experts also suggest blood glucose monitoring during and after exercise.

• Keep a record of blood glucose levels, exercise duration and intensity, and any physical symptoms. This will show your doctor a pattern to determine how much food or insulin is appropriate to the kind and amount of exercise you are doing.

• Inject in the abdomen instead of your arm or thigh to prevent absorption difficulties.

• Recognize warning signs. If you feel faint, dizzy, or confused, stop immediately and take some juice or glucose tablets.

• Drink water before, during, and after exercise. Dehydration can raise blood sugar.

• Identify yourself. A diabetes identification bracelet or shoe tag should be clearly visible, especially if you’re exercising alone.

• Do a post-workout foot check. Impaired sensation in your feet may prevent you from feeling an injury, and left untreated, it could cause serious problems. If you have peripheral neuropathy, avoid exercises that are hard on your feet, such as running and tennis. Try swimming or cycling.

• Protect your eyes. If you have retinopathy, avoid exercises that significantly raise heart rate and blood pressure (such as heavy lifting and jogging) or that put you in an upside-down position (such as some yoga moves).