Exercise Testing for Diabetics

After giving you a general overview of exercise testing with my last post, I want to focus specifically on exercise testing and diabetes in this one.

When beginning an exercise program at light-to-moderate intensity exercise, individuals with DM or prediabetes might not need an exercise test if they are asymptomatic and low risk for CVD (as determined with tables 1 and 2 from the previous post). However, it is certainly in your best interest to receive physician guidance anyways. You should be tested before performing moderate-to-vigorous exercise if you have one or more of the following:

• age >35yr
• Type 2 DM >10yr
• Type 1 DM >15yr
• total cholesterol >240mg/L
• blood pressure >140/90
• smoking
• family history of coronary artery disease in parent or sibling <60yr
• presence of microvascular disease
• peripheral artery disease
• autonomic neuropathy

If you have any serious heart problems, you MUST see your doctor before beginning absolutely any kind of physical activity. One big issue with diabetic patients is that, sometimes, ischemia (lack of blood flow to a tissue) goes undetected. Therefore, it is of utmost importance to see your doctor annually so your CVD risk factors can be assessed.

The last issue I would like to discuss is intermittent claudication, which is the pain that occurs in a muscle with an inadequate blood supply that is stressed by exercise. Diabetics are at an increased risk for developing intermittent claudication. Detailed symptoms of this disorder include pain that does not occur with standing or sitting, is reproducible from day to day, is more severe when walking up stairs or a hill, and is often described as cramping that disappears a couple minutes after exercise is finished. Patients with intermittent claudication are at an increased risk of developing coronary artery disease.

To summarize, it is very important for diabetic patients to receive physician guidance and clearance for exercise in order to prevent more serious cardiac disorders from developing.

Thanks for reading!

-Emalee

Information for this blog came from the ACSM's Guidelines for Exercise Testing and Prescription, 9th edition (2014).