Introduction:
Regular physical activity has many positives and benefits for human health, especially those with diabetes. It is one of the basic elements for regulating blood glucose levels, and the quality of exercise varies according to age, sex, health status and individual ability.

Benefits of Physical Activity for People with Diabetes:

• Lowering and regulating blood glucose levels and fats.
• Reducing the resistance of the body's cells to insulin.
• Increasing the number of insulin receptors; thus, optimizing the insulin use in the body.
• Reducing the amount of medication used by the patient.
• Strengthening and building body and muscles.
• Helps to lose weight and maintain the ideal weight.
• Improving psychological state.

Physical Activity and Blood Glucose:
The effect of physical activity on blood glucose depends on:

• Blood glucose level before starting physical activity.
• Intensity and activity duration.
• Any change in insulin doses.

Duration and Frequency of Physical Activity:

• Experts recommend moderate intensity sports activities for at least 30 minutes on 5 or more weekdays (e.g., brisk walking, swimming, cycling, climbing stairs, basketball, and volleyball)
• Starting by doing what can be done, that is, starting with ten minutes a day and then looking for ways to do more until you reach 150 minutes a week of physical activity.
• Determining the right time, for example:

30 minutes continuous for 5 times a week.
15 minutes continuous for 10 times a week.
10 minutes continuous for several times a day.

Physical Activity in Ramadan:
Notes when checking blood glucose levels before physical activity:

• If blood glucose is less than 100 mg/dL:

You should eat a snack (15-20 grams of carbohydrates) before starting exercises to avoid hypoglycemia.

• If blood glucose is 240 mg/dL or more:

• Ketones must first be detected:

• When ketones exist: Rest and lack of physical activity are recommended.
• When no ketones exist: Physical activity can be done as usual.

Instructions when starting physical activity:

• Starting gradually and then increasing the duration and intensity of the activity to reach the required and appropriate rate for each individual.
• The body should be prepared for physical activity, starting with warmup-up exercises for 5 to 10 minutes, and ending with relaxation exercises for 5 to 10 minutes.
• A rest time of 30 to 90 seconds should be set aside when needed.
• Physical activity should not be practiced in the event of illness or injuries resulting from sports.
• The doctor should be consulted before practicing any activity.

Precautions when practicing physical activity:

• Carrying an identification card indicating that the person has diabetes.
• Drinking sufficient fluids before, during and after exercise to prevent dehydration that may disturb blood glucose levels.
• Carrying a can of sweetened juice or pieces of sugar or candy; to be used in case of low blood glucose levels.
• Carrying a backup snack as well if physical activity will last more than half an hour.
• Not injecting insulin into the areas of the body that the patient will use during the exercises, because the use of the insulin-injected place in the performance of the exercises accelerates its absorption, which may expose the person to a bout of hypoglycemic shock, for example: Avoid injecting insulin into the thigh if the patient will walk.
• Your doctor may allow you to reduce your insulin dose before you exercise if needed.
• Avoid physical activity at times when insulin is at its peak.
• When using the insulin pump, temporary pumping can be programmed.
• blood glucose level should be measured before, during and after physical activity, and monitoring should continue every half hour if physical activity takes longer, for rapid intervention when the blood glucose level is low.
• Wearing proper sneakers and taking care of the feet.

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