Managing diabetes with exercise: Six tips for nerve pain

What kind of exercise is safe - and fun if you have nerve pain from diabetes? And how can you stay motivated after that first flush of inspiration fades?

"It depends on where you're starting", says Dr Dace Trence, an endocrinologist at the University of Washington Medical Center in the US. "For the person who has been doing nothing, you would certainly want to start doing something that's comfortable and enjoyable and can be maintained”, she says.

Many diabetic people suffer from diabetic nerve pain, known as diabetic neuropathy, in their feet, legs, arms or hands. A study in the US showed that exercise can significantly help to control peripheral neuropathy. The four-year study, which was published in The Journal of Diabetes Complications in 2006, showed that people who had a brisk, one-hour walk on a treadmill four times a week, slowed down the rate by which their nerve damage worsened.  

When it comes to managing a lifelong condition like diabetes, it makes sense to think long-term. It’s all about lifestyle changes to protect yourself from diabetic nerve damage. Becoming more active can help you control blood sugar levels, feel good and lighten the load on painful feet and legs, especially if you’re overweight. These tips can help you start an exercise plan and stick to it.

Before you start: Safety first

• If you have nerve pain, check with your doctor that it’s fine to start any new form of exercise. You don’t want to make diabetic neuropathy worse and most diabetic people are at higher risk of heart and circulation problems, so your doctor may want to check your heart, eyes and feet.
• Be cautious about exercising if your blood sugar is over 14 mmol/l, says Trence. While some people may have a blood sugar level a little higher or lower than this, it is an approximate number above which you should watch and see what your body does, she says.
• Check your blood sugar before and after exercise to see how your body and medicines respond to different kinds of activity.

Tip 1. Choose low-impact exercise

Knowing you are doing something safe - especially if you have painful neuropathy or loss of sensation,  removes one barrier to exercise which is fear. Choose something that is low-impact or even non-weight-bearing, says Trence. This could be aerobic classes where you’re sitting in a chair or using an exercise ball. Other options include:

• Swimming. Water supports your muscles, bones and joints as you swim, which is especially helpful if you are overweight or have diabetic nerve pain in your feet. Swimming has been a favourite with exercise experts over the years as it avoids the pounding on your feet, knees and hips that you get from a high-impact sport like jogging.
• Yoga. Trence thinks yoga is wonderful, particularly for people who need to be more controlled in their movements and who should not be pounding on the pavement.
• Cycling. This is a safe low-impact sport, as long as you don’t fall off the bike. You can either cycle outside and enjoy the fresh air and scenery, or you can use an exercise bike at home or in a health club.