On average, adults in the United States take about 5,700 steps per day. To be considered active, the general recommendation for adults is to accumulate, through all daily activities, 10,000 steps per day. Between 5,000 and 7,000 daily steps is considered low activity, and between 7,500 and 10,000 is viewed as “somewhat active.” Purchasing and wearing an accurate pedometer can help you assess your current level of activity and what you need to do to move up a category.
Maintaining blood glucose control
Aerobic activities typically cause a drop in blood glucose level, so if you plan to exercise one to two hours after a meal, you may need to reduce the dose of oral medicine or insulin you take with that meal. If you are going to exercise more than two hours after a meal, you may need to eat a snack beforehand to prevent hypoglycemia (low blood glucose). Checking your blood glucose level before and after exercising is the best way to determine what adjustments to make in your diabetes regimen to accommodate the effects of the exercise.
If your blood glucose is above 300 mg/dl, you should approach exercise cautiously. If you have Type 1 diabetes and your blood glucose is above 250 mg/dl, you should check your blood or urine for ketones, the presence of which may indicate that your body does not have enough insulin available to use glucose for energy. If no ketones or only a trace of ketones are present, it is OK to exercise, as long as you feel well. However, you should check your blood glucose again after 15 minutes and stop exercising if it has risen, because of the risk that it will continue to rise. If more than a trace of ketones are present, treat your blood glucose and wait until the ketone level goes down before exercising.
Dehydration can have a negative effect on your blood glucose level, heart function, and athletic performance, so you should consume adequate amounts of fluid both before and after exercise. Drink about 8 ounces (one cup) of water prior to starting each walking session, and bring a water bottle with you on your walks so you can sip as you walk, particularly on hot days.
Preventing foot injuries
Numbness in the feet due to diabetes-related nerve damage (neuropathy) can make it difficult to tell if you’ve injured your feet during exercise, and walking on an injury can cause it to turn into a more serious problem. When you exercise, wear shoes designed for walking that fit well and are comfortable and socks that wick moisture away from your feet. Socks made from wicking fabrics such as Dri-Fit, Coolmax, and Sorbtek can help prevent blisters. Wearing a sock liner (available at many hiking shops) inside a regular sock can also help prevent blisters by reducing friction. After exercise, always check your feet for redness or blisters and call your doctor if any foot problems develop.
Setbacks are inevitable when pursuing a long-term goal, so remember to be flexible and to not get discouraged if you don’t always meet your daily goals. If it’s raining or too cold, you may not be able to walk outside. Instead, walk at the local mall or choose a different activity such as swimming, stair-stepping, or cycling for an equal amount of time. You will still get an aerobic workout, and cross-training (doing a different activity) can help to prevent repetitive-strain injuries.