Although most people with diabetes can exercise safely, exercise involves some risks. To shift the benefit-to-risk ratio in your favour, take these precautions: Have a medical exam before you begin your exercise programme, including an exercise test with EKG monitoring, especially if you have cardiovascular disease, you are over 35, you have high blood pressure or elevated cholesterol levels, you smoke, or you have a family history of heart disease.

Discuss with your doctor any unusual symptoms that you experience during or after exercise such as discomfort in your chest, neck, jaw, or arms; nausea, dizziness, fainting, or excessive shortness of breath; or short-term changes in vision.

If you have diabetes-related complications, check with your health care team about special precautions. Consider exercising in a medically supervised programme, at least initially, if you have peripheral vascular disease, or kidney problems.

Those with peripheral neuropathy should not run, jog, or walk long distances without the approval of their doctors, and those with retinopathy should check with their eye doctor before initiating an exercise programme.

Learn how to prevent and treat low blood glucose levels (hypoglycemia). IF you take oral agents or insulin, monitor your blood glucose levels before, during, and after exercise.

If you have type 1, and your blood glucose is above 250 milligrams per deciliter, check your urine for ketones, Don't exercise if ketones are present, because exercise will increase your risk of ketoacidosis and coma.

Always warm up and cool down.

Don't exercise outdoors when the weather is too hot and humid, or too cold.

Pay special attention to proper footwear. Inspect your feet daily and always after you exercise.

If you have any questions related to diabetes feel free to contact the diabetic department at King Edward Memorial VII Hospital.

Chris Johnson, diabetic educator at KEMH works with diabetics daily.