Diabetes mellitus and exercise: application of research to activity planning.

Current research shows that the response to exercise is not identical for insulin dependent and non-insulin dependent diabetic clients. Contrary to what has been practiced, exercise cannot be prescribed in a general way for these individuals. Exercise offers benefits in weight reduction, lowered blood pressure and changes in lipoprotein profile for non-insulin dependent diabetics. For the insulin-dependent person, regularity of exercise must be emphasized to achieve stable metabolic control. Depending on the severity of the pathology, exercise may provoke microvascular and neurological changes or altered absorption of insulin. Illustrative of the known risks are triggering of angina pectoris, foot damage and persistent elevation of blood glucose. Optimally designed exercise programs are based on life style and are preceded by exercise stress testing for determination of cardiovascular fitness.