Physical Exercise

Assessment of physical activity

Review :
		activity at work, and in getting to and from the workplace
		physical activity practice and opportunities in domestic activities and hobbies
		the possibility of formal physical exercise on a regular basis
		Examples:
			brisk walking 30 min per day
			active swimming for 1 h three times a week

Management

Advise that physical exercise :
		can benefit insulin sensitivity, blood pressure, and blood lipid control
		should be taken at least every 2-3 days for optimum effect
		may increase the risk of acute and delayed hypoglycaemia
Manage physical exercise using :
		formal recording of levels of physical activity
		identification of new exercise opportunities ( see box above ), and encouragement to develop these
		appropriate self-monitoring, additional carbohydrate, and dose adjustment of glucose lowering therapy for those using insulin or insulin secretagogues
		warnings :
	about delayed hypoglycaemia, especially with more prolonged, severe, or unusual exercise for those using insulin therapy that alcohol may exacerbate the risk of hypoglycaemia after exercise about risks of foot damage from exercise need to consider ischaemic heart disease in those beginning new exercise programmes

Dietary management, physical activity, and drug therapies are partners in the battle to achieve and maintain low risk blood glucose, blood lipid and blood pressure levels

Therapy for High Blood Glucose Concentrations

Assessing Blood Glucose, Blood Lipid, and Blood Pressure Control

-	Blood glucose control assessment levels
-	Blood lipid control assessment levels
-	Blood pressure control assessment levels

Providing Nutritional Advice

Physical Exercise

Therapy for High Blood Glucose Concentrations

-	Using oral glucose-lowering drugs
-	Insulin therapy in Type 2 diabetes

Therapy for Abnormal Blood Lipid Concentrations

Therapy for Raised Blood Pressure

Managing Arterial Risk Factors