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While the insulin-dependent diabetes mellitus (IDDM) does not have its origin in physical inactivity, but in genetics, systematic physical exercise can produce big benefits in the individual who suffers from this disease, allowing lengthen life expectancy, equivalent to that of a sedentary non-diabetic.
The realization of physical exercise, you must maintain the balance between glucose and insulin ingested exogenous, otherwise can lead to the production of ketone bodies, which involves damage to aircraft and various body organs.
Then, the work of the coach is to implement an exercise program, controlling blood sugar levels (blood glucose levels) and Ketonuria (presence of ketone bodies in the urine).

Exercise and insulin exogenous: acute response
It is important to consider the relationship between the two.

1 .- The type of insulin will determine when the hormone begins to act. Insulin action has delayed its highest rise between 7 and 10 hours and the fast-acting insulin between 2 and 4 hours after a subcutaneous injection. We recommend that the patient does not coincide with the exercise periods of action by the highest risk of hypoglycemia. It’s better to be made within 2 hours of eating a meal.

2.-The site of injection of insulin.
Insulin is absorbed faster when placed on sites whose musculature acting in the exercise.
The insulin injections before physical activity, are placed in the extremities that they will not be used (to the abdomen and cycling races,
And thighs to practice rowing and canoeing).

3 .- Form to administer insulin and effects on blood sugar levels:
The subcutaneously is the classical pathway. It can be used through injections divided during the day or in single dose. Another alternative is the infusion pump for reduced costs. With the latter system has been observed that the profiles of insulin and glycemia are similar to those of subjects
during normal sporting practices.

4 .- The relationship between diet, exercise and insulin.
the last meal is the one that keeps the closest relationship to physical activity in the observation of blood sugar levels. It is advisable to perform 2 hours before exercise to prevent hypoglycemia

5 .- Magnitude of the duration and intensity of exercise
In diabetics insulin has been proven that the same exercise carried out with the same intensity during the same period of time in front of a stable food intake, reproduces the fall of blood sugar levels in a similar manner on different days. Situation to facilitate the practice of physical activity scheduled.

Points to consider prior to exercising

1. Consider the exercise plan:
• Duration and intensity of exercise to perform
• It is a very usual or unusual exercise.
• The exercise is suitable level of physical condition.
• caloric expenditure estimated.

2. Consider the insulin regimen:
• Scheme Should lowered insulin usual?
• interval between injections of insulin and exercise.
• Should changed the injection site? –

3. Consider the schedule of meals:
• Interval between last meal and the beginning of the year.
• Should eat a pre-collation exercise?
• Should ingested carbohydrates during exercise?
• Do you need extra food after exercise?

4. Checking blood sugar levels
• If it is greater than 250 mg / dl
• If Ketonuria is negative, exercise can be done.
• If Ketonuria is positive, take insulin and not realize until the exercise Ketonuria is negative.

Considerations to prevent hip E hyperglycemia exercise

• Eat 1 to 3 hours before exercise.
• Eating carbohydrate supplements every 30 minutes during vigorous exercise-and long (10-15 g. H C per 30 minutes ck exercise).
• Receive insulin at least one hour before exercise. If required, plus 250 mg and there cetonemia% (+).
• Recognize individual responses to different types of glycemia exercise.
• Avoid making exercise during periods of maximum activity of insulin.
• Know the signs and symptoms of hyperglycemia and hiccups.
• army with a partner.

It is essential that coaches and physical education teachers take into account the precautions outlined in order to prevent severe risks.

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