From the Guidelines
Jogging is not recommended for a type 1 diabetic patient with diabetic neuropathy. Patients with diabetic neuropathy often have reduced sensation in their feet, which increases the risk of undetected injuries, blisters, and foot ulcers during high-impact activities like jogging 1. These injuries can be slow to heal in diabetic patients and may lead to serious complications including infections and, in severe cases, amputations.
Some key considerations for type 1 diabetic patients with diabetic neuropathy include:
- Peripheral neuropathy may be associated with gait and balance abnormalities, making weight-bearing exercises more risky 1
- Limiting weight-bearing exercises and addressing patient foot care is crucial for patients with diabetic neuropathy 1
- Low-impact exercises such as swimming, cycling, and rowing are better options as they put less stress on the feet while still providing cardiovascular benefits
Instead, low-impact exercises such as swimming, cycling, and rowing are better options as they put less stress on the feet while still providing cardiovascular benefits. These activities allow patients to maintain physical fitness, improve insulin sensitivity, and help with blood glucose management without the increased risk of foot trauma. For any exercise program, diabetic patients should monitor blood glucose levels before, during, and after activity, carry fast-acting carbohydrates to treat hypoglycemia, and inspect their feet daily for any signs of injury.
From the Research
Exercise Recommendations for Type 1 Diabetic Patients with Diabetic Neuropathy
The following exercises are considered in the context of type 1 diabetic patients with diabetic neuropathy: bicycle, jogging, rowing, and swimming.
- Jogging: This is a weight-bearing exercise that may pose a risk to patients with diabetic neuropathy, particularly if they have insensitive feet or severe foot deformity 2. However, recent research suggests that weight-bearing activities do not increase the risk of foot ulcers in people with DPN who do not have severe foot deformity 2.
- Bicycle, Rowing, and Swimming: These exercises are generally considered safe for patients with diabetic neuropathy, as they are low-impact or non-weight-bearing activities that can help improve physical fitness without putting excessive stress on the feet 3, 2.
Considerations for Exercise Prescription
When prescribing exercise for type 1 diabetic patients with diabetic neuropathy, it is essential to consider the individual's overall health status, including the presence of any other complications such as autonomic neuropathy, retinopathy, or nephropathy 3. A stress test may be necessary before prescribing exercise programs, especially for patients with autonomic neuropathy 3. Additionally, monitoring of blood pressure, heart rate, and blood glucose during exercise is crucial to ensure safe participation 3.
Exercise Benefits and Risks
Exercise can have numerous benefits for patients with diabetic neuropathy, including improved physical fitness, glycaemic control, and body weight reduction 4. However, it is also important to consider the potential risks, such as plantar injury, particularly in patients with insensitive feet or severe foot deformity 4. Protective footwear and supplemental non-weight-bearing exercises may be recommended to mitigate these risks 4.