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Diabetes mellitus is a disorder of carbohydrate and fat metabolism that is due to an absolute or relative lack of insulin. Two types of diabetes mellitus exist: (a) Insulin dependent diabetes, also known as Type I, and (b) Non-insulin dependent diabetes, also known as Type II.
  • Type I diabetes is due to a failure of the pancreas to secrete insulin. A combination of insulin injections, careful glucose monitoring, balanced diet, and exercise are necessary to manage the disease.
  • Type II diabetes results from an impaired insulin function and can usually be controlled by a combination of diet, exercise, and medications.

In each type of diabetes, exercise of any kind has been recognized as a vital component of the management regimens for individuals with the disorder.

Before beginning an aquatics program, plans for physical activity should be discussed with a doctor and health care team. A physical exam is recommended prior to beginning a new exercise regimen of any kind.

The following recommendations should be considered for individuals with diabetes when participating in an aquatics program:

  • Monitor blood glucose levels before, during (if active for a long time), and after exercise.
  • Be certain to adjust insulin dosages, both long acting and short acting insulin, accordingly. Check with physician or nurse educator on proper dosage changes.
  • Wear aqua-shoes or aqua-socks in the water since injuries to the feet can lead to serious complications in individuals with diabetes.
  • Be sure to examine feet regularly, especially when contacting various ground surfaces (inside and outside pool area).
  • Be aware of prolonged sun exposure. Glucose levels may be affected by heat and may cause hyperglycemia in some individuals with diabetes.
  • Do not exercise if blood glucose level is greater than 250 mg/dl or less than 70 mg/dl. These extremes of glucose levels can worsen during physical activity and may do more harm than good. Wait until levels are regulated before returning to activity.
  • Resistance training, also referred to as strength training, is safer and better for individuals with diabetes when a lightweight program (strict form, proper breathing patterns, high number of repetitions instead of low reps, high weights) is followed.
  • High intensity aquatics programs are best avoided for most people with diabetes since a high intensity training program temporarily increases blood pressure, posing a hazard to anyone who has untreated advanced retinopathy and/or causing undue strain on the hearts of individuals with cardiovascular disease.
  • When aquatics training is used as the specific exercise regimen, a minimum of 35-45 minutes of activity, 3-4 days per week is recommended. Listen to your body to decide your individual duration and intensity of aquatics exercise.
  • Be aware of the signs and symptoms of hypoglycemia and know how to treat insulin reactions.
    • Signs and Symptoms
      • Headache
      • Increased perspiration - may be difficult to note in an aquatics environment
      • Hunger
      • Rapid heartbeat
      • Blurred vision
      • Disorientation
      • Shakiness
      • Dizziness
      • Fatigue
      • Change in level of consciousness
    • Treatment
      • Glucose tablets
      • Candy
      • Juice
      • Any form of simple sugar
      • Glucagon shot

***If a hypoglycemic reaction occurs in the pool, remove individual from water and treat with glucagon shot, or if individual is capable of swallowing, treat with form of glucose most easily digestible for the individual.***


Booher, J.M., & Thibodeau, G.A. (1994). Athletic injury assessment (3rd ed.). St. Louis: Mosby-Year Book, Inc.

Braunstein, J.B. (1999). Body sculpting 101: Resistance training. Diabetes Forecast, 53(5), 33-35.

Braunstein, J.B. (1999). Putting the fun back into exercise for our at-risk kids. Diabetes Forecast, 52(11), 31-32.

Sherrill, C. (1998). Adapted physical activity, recreation, and sport: Crossdisciplinary and lifespan (5th ed.). St. Louis:McGraw-Hill.

This page was created by Joanne Zippay,
Masterís student in Adapted Physical Education
at Texas Womanís University
as part of the requirements for"Aquatics for Special Populations", Huettig, Summer 2000

page last updated 1/3/2017 1:00 PM