Response to reader

• Exercises for a pregnant woman with diabetes

Dear Dr Gardner:

I am a 39-year-old woman who is diabetic and found out recently that I am pregnant. I want to know what forms of exercise I can do during this time, as I've got the clear from my OB/Gyn that everything is okay.

I usually exercise four times per week but have not done any form of exercise at all recently. I am anxious to restart, but would like to get your feedback.

Dear Reader:

A daily exercise prescription is an important part of a healthy pregnancy. It will help you feel better and reduce many of the discomforts associated with pregnancy. Regular exercise improves your strength, endurance, energy level and your ability and efficiency in insulin use to keep your blood-sugar levels in the normal range. Physical exercise will help to control your appetite, weight and that of the foetus within normal range. Maintaining desirable weight gain is necessary to avoid many of the complications associated with pregnancy and being diabetic.

You can continue to do many of the activities you did prior to your pregnancy. However, avoid those with high risk for falling, jolting, high impact, strain, sudden change in direction or position and holding your breath for long periods. Stationary bicycling, walking, jogging, swimming and low-impact aerobics are excellent exercises you can continue doing during pregnancy.

Exercising frequently, four to five days per week, is recommended to enjoy the blood-sugar lowering advantages of your exercise programme. A warm-up routine, at the beginning, and a cool down of five to 10 minutes, at the end, are absolutely necessary. Avoid exercising for more than 45 minutes each session and limit the strenuous part of the session to about 15 minutes.

Monitor your heart rate

Your heart rate is an important factor you can use to monitor the intensity and duration of your exercise routine. A heart rate of approximately 25 to 30 per cent lower than your exercising heart rate prior to pregnancy, but not exceeding 140 beats per minute, is a good guide. If your workout is too intense, you could experience symptoms of confusion, extreme hunger, blurry vision, shakiness and sweating.

In such a situation you will need to eat a sweetened snack to stabilise your blood sugar. You may also need to eat small snacks between meals if your workout causes you to experience low blood sugar. If you exercise soon after a meal, eat the snack after the workout. However, if you exercise about two hours after the meal, have the snack before you exercise.

Use footwear that fits well to protect your feet from blisters and calluses. Stop exercising if you feel pain, dizziness, shortness of breath, faintness, palpitations, back and pelvic pain or experience vaginal bleeding. Avoid vigorous exercise in hot, humid weather or if you have a fever. The American College of Obstetricians and Gynecologists stresses the importance of drinking fluid prior to, during and after exercise to prevent dehydration during pregnancy.

Dr Kenneth Gardner is an exercise physiologist at Holiday Hills Research Center; email: yourhealth@gleanerjm.com.