Individualize exercise regimens for patients with diabetes.(Clinical Rounds)

MIAMI -- Not enough patients with diabetes exercise, but even when they do, greater attention needs to be paid to how to best manage the effects of exertion on type 1 vs. type 2 disease, Dr. Dennis A. Cardone said at the annual meeting of the American Medical Society for Sports Medicine.

"More than 50% of diabetics are not meeting exercise goals," said Dr. Cardone, who is in private practice at Pediatric Orthopedics of Southwest Florida in Fort Myers.

In the setting of type 1 diabetes, exercise can often reduce the severity of microvascular complications and improve lipid profiles.

And although there is no evidence that exercise prevents type 1 diabetes, it has been shown to prevent type 2 diabetes.

Dr. Cardone advises diabetics, regardless of their disease type, to use a bracelet or shoe tag that identifies them as diabetic, to exercise with a partner, and to bring snacks and a glucagon kit (complete with instructions on how to use it).

As far as making sure that type 1 disease is well managed during workouts, get a thorough history of what steps patients have taken while exercising in the past. "If they are newly diagnosed, have them do frequent monitoring of their glucose during an initial exercise regimen, and use that information for their exercise and diabetes management plan." And obviously, patients need to choose their form of exercise wisely.

"For risky sports, such as skydiving, scuba diving, climbing, and motor racing, it is common sense: If they have a hypoglycemic episode, the results could be disastrous," Dr. Cardone said.