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The American Diabetes Association states that a graded exercise (or stress) test may be helpful if you are beginning a moderate- to high-intensity physical activity program, particularly if you are at high risk for cardiovascular disease, based on one of the following criteria:

• Age over 35 years
• Age over 25 years and you have had Type 2 diabetes for more than 10 years or Type 1 diabetes for more than 15 years
• Presence of any additional risk factors for coronary artery disease, such as high blood pressure, high blood-fat levels, or family history of heart disease
• Presence of microvascular disease, including retinopathy (diabetic eye disease) or nephropathy (diabetic kidney disease)
• Peripheral vascular disease (poor circulation to areas of the body outside the heart and brain, such as the legs, feet, arms, kidneys, or stomach)
• Autonomic neuropathy (damage to nerves that control automatic functions in the body)

Adapted from American Diabetes Association: Clinical Practice Recommendations 2004. Physical Activity/Exercise and Diabetes. Diabetes Care 27:S58–S62, 2004.

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