A disciplined life is key for all diabetics in terms of regular exercise at least 150 minutes per week. A right mix of isotonic (jogging, running, swimming etc) and isometric (push-ups, weight and muscle training) exercises get you the maximum benefits. Diabetics are more inclined to lose muscle mass and muscle tone, particularly with increasing age and duration of diabetes, so they must combine yoga and stretching exercises with regular walking.

Diabetics should be very cautious when participating in extreme sport. It is advised to get a cardiac check-up done if you are over 30 years to rule out any underlying cardiac disease before starting training. If the patient is well controlled on oral medications it’s easy to undergo physical training to build stamina to carry out extreme sports. Get your medication dose adjusted from the physician to avoid hypoglycaemia or low sugar. For patients on insulin, particularly Type 1 diabetics, it is more challenging to perform extreme sports and they need to have a continuous glucose monitoring system like the Freestyle Libre, or if possible an insulin pump to avoid hypoglycaemia episodes and to adjust the insulin dose as per need. Type 1 diabetics are prone to ketoacidosis too. Patients on insulin should not engage in high-risk activities unless they have got clearance from their treating physicians. Patients with diabetic kidney or eye disease should avoid extreme sport as it can worsen the problems.

In general, all diabetics should have a healthy and balanced diet with proper proportion of complex carbs, protein and fats. Any kind of extreme diet should be avoided. For patients doing extreme sports or heavy muscle training I recommend extra protein intake and advise them to see a dietitian. Maintain good hydration throughout the activity.

Also read: Despite diabetes, no sport is too extreme for these athletes

Type 1 patients and Type 2 on insulin need to monitor their sugar more frequently before, during and after extreme sport activity to avoid the highs and lows of sugar. They should carry their first-aid kit with insulin, glucose meter, glucose tablets etc always to avoid major issues.

Diabetes is a disease of discipline and nothing can replace good discipline if you want to avoid the majority of complications. The best time to learn discipline is childhood, so kids with diabetes should be taught the rules of eating and exercise right from the beginning. Any kind of extreme sport in kids expose them to risk of injury and disability so it must be carefully supervised by experts and parents.

Dr Satendra Kumar Multani is Consultant Endocrinologist & Diabetologist at Prime Medical Centre at Reef Mall in Deira.