WARNING!
If you have high blood pressure, preterm labor, placenta previa, heart or lung disease or a baby that is not growing well, you should consult your physician before engaging in any exercise program. Always use good judgment!

Diabetes and Exercise

Many pregnant women with diabetes (either gestational or pre-existing), wonder if they should exercise? The answer is YES! Exercise can benefit overall fitness, help control diabetes, and can be done safely during pregnancy.

What are the benefits of exercise during pregnancy?

The potential benefits of exercise are many. Some of these benefits are specific to diabetes, while others are more general to pregnancy. Here are just a few of them:

1. Blood sugars are usually lowered by regular, aerobic exercise. Exercise makes the body more sensitive to insulin whether made by the body or injected and this effect may last for up to 24-hours. In women who do not have diabetes, exercise can decrease the risk of developing Gestational Diabetes.
2. Diabetics not currently taking insulin may be able to avoid it altogether or at least lower their chances of needing injections during the third trimester. If insulin is currently taken, the dose can usually be lowered with exercise.
3. Exercise will reduce excess weight gain during pregnancy, weight that sometimes stays after labor and delivery!
4. Regular exercise can help reduce feelings of tiredness. Proper rest is also important, but exercise actually increases overall feelings of well-being and can reduce the discomforts of pregnancy.

What type of exercise should I do?

• Before exercising, 5 - 10 minutes should be spent stretching in order to warm up the muscles and minimize the risk for ligament injury or muscle cramping.
• Aerobic exercise will be most beneficial to blood sugar levels. This type of exercise includes walking, stationary cycling, swimming or aqua-exercise, low-impact aerobics, and other exercises utilizing large muscle groups done for an extended period.
• Daily exercise for 15-60 minutes is recommended. Less frequent exercise (3-4 days a week) can also benefit control of blood sugars and increase fitness levels, but blood sugars may be harder to control on rest days.
• Non-weight bearing forms of exercise should replace others as the pregnancy progresses to provide optimal comfort and safety, for example from running to swimming. When walking, wear flat shoes with cushioned soles. A 3 - 5 minute cool down period (exercising at a lower pace) should follow exercise to prevent dizziness or fainting.
• Exercise should be performed at easy to moderate intensity. A practical measure of intensity is the "talk test." If a conversation cannot be carried on with someone else while exercising, then the exercise intensity is too hard!

Helpful Hints

Someone who has led a sedentary life before pregnancy should not suddenly begin a strenuous exercise program. Instead, good judgment must be used, with slow increases in the activity level.

• Avoid exercise in the heat, excessively prolonged bouts of activity (more than an hour without a break) or exercises that may restrict blood flow to the fetus (such as heavy weight training). If exercising when it is hot, restrict activity to less than 30 minutes, or take cooling off rest periods.
• Drink plenty of cold fluids (without caffeine) to keep hydrated. Fluid intake should begin before feeling thirsty.
• Exercising should stop immediately if there are feelings of dizziness, fainting, palpitations, or the body feels too hot.
• Make sure blood sugars are monitored and eat additional carbohydrate snacks as needed to prevent low blood sugars. Watch out for low blood sugars that can occur after exercising as well! It is preferable to exercise after eating a snack or a meal.
• Balance can be compromised in the later stages of pregnancy, so avoid exercise such as cycling outdoors, skiing or horseback riding. Opt for a stationary cycle, treadmill, walking or swimming instead.

Where can I exercise?

• At home: Several exercise videos are available for pregnant women, which allow exercising in the privacy of home. These include prenatal aerobics, calisthenics, and yoga videos. Check out the local video 
• At the gym: Many gyms offer low-impact aerobics or aqua-aerobics classes for pregnant women. They will often allow limited memberships for the term of the pregnancy. If a complication develops which prevents exercise, they will often issue a credit for the time missed.
• Also, check out local recreation centers and the YMCA. Ask if any of the instructors/trainers are certified to work with pregnant women.

Recommended reading:

Sheri Colberg, Ph.D."The Diabetic Athlete, Prescriptions for Exercise and Sports" Human Kinetics, U.S., 2001.