The first step in any activity program is to see your doctor. Tell her you're planning to get active. Ask her to do a medical exam to see how fit you are, and what level of exercise is safe for you. Then, get detailed advice about how to get started, what limits to set for yourself and what to watch out for.

Whatever physical activity you choose, remember to start slowly. At first you may just want to walk for a few minutes three or four times a week. After a few weeks, you may feel like increasing your level of activity.

Also, keep in mind that physical activity doesn't have to take place in a gym. Walking to the corner store, playing tag with the kids or even gardening all count.

Types of exercise
Physical activity is often broken down into three types of activity:
aerobic, flexibility and strength building. Each has certain advantages. As a rule, it's best to try and build a physical activity program that combines all three types of activity.

Aerobic activities raise your heart rate, increase your pulse and breathing rates, and make you feel warmer. This type of activity is especially good for your cardiovascular system.

Some activities help you build flexibility. These are the "stretching" exercises like yoga, tai chi or even simple calisthenics. Flexibility exercises help keep your muscles and joints limber.

Strength training builds muscle. It includes activities like weight lifting, isometric exercises and push-ups. This type of exercise is important because it makes you stronger. It also helps burn off calories more effectively.

Exercise: how long, how
often, when to check your blood glucose
How long and how often you exercise depends on your age, level of fitness, the severity of your diabetes and so on.

As a general rule, people need to be active for between 30 and 60 minutes a day, every day. If 60 minutes of physical activity a day seems like a difficult goal, don't be discouraged. Even a little exercise is better than none at all. You can build up your level of activity over a period of weeks until you reach the targets you and your diabetes care team have set. Also, you can reach your daily target by doing several shorter spurts of activity rather than one solid session.

Exercise usually lowers blood glucose levels. When you're active, your body burns glucose for energy. At the same time, it also uses insulin more efficiently. The net result can be quite a sharp drop in blood glucose levels. For this reason, it's important to check your blood glucose before you exercise, especially if you take insulin or diabetes pills.

When you're planning a bout of physical activity, it's best to check blood glucose levels twice: once about half an hour before you start your activity and once more just before you start. If your blood glucose levels are lower on the second reading, you may need a snack to boost them before you start to work out. You should not begin to exercise if your blood sugar is low or higher than 200 mg/dl.

While you're exercising, you should check your blood glucose every half hour. That way, if it starts dropping you can stop what you're doing and have a snack before levels get too low.