People living with diabetes should have increased awareness of their risk of cardiovascular disease – including heart attack and stroke- as they are three to four times more likely to develop cardiovascular disease than those who do not have diabetes.

If you have had a heart attack or heart surgery, it is important to be active as part of your recovery. This will help you to reduce your risk of more heart problems and will help you to stay healthy physically and emotionally. It can also help you to:

• recover better from a heart attack or other heart problems
• reduce your risk of more heart problems
• reduce your blood glucose levels
• feel more confident, happy and relaxed
• manage your weight more easily
• improve your cholesterol levels
• have lower blood pressure
• have stronger bones (reduce osteoporosis)
• improve your long-term health

You may be fearful of re-starting physical activity after a heart attack or heart surgery. However, provided you stick to the program given to you in hospital and don’t overdo it, the benefits of physical activity outweigh any risks. Regular moderate intensity physical activity is a vital part of your return to everyday life. You are far more likely to injure your muscles and joints than have a heart attack during physical activity. Being aware of the warning signs may increase your confidence when returning to exercise.

Warning signs to look out for when exercising

All people with diabetes should be given a written action plan to use if they experience heart-related symptoms during physical activity.

Be aware that some people may not experience any of these symptoms.

Below are some symptoms to look out for:

• Discomfort or pain in the centre of your chest (angina) — this can often feel like a heaviness, tightness or pressure
• Discomfort in these parts of your upper body – arm, shoulders, neck, jaw, back

You may also experience other signs and symptoms:

• feel short of breath
• feel nauseous
• have a cold sweat
• feel dizzy or light-headed

Safety tips:

• Start any physical activity at a low level of intensity. If you want to do more intensive physical activity, build up slowly over a number of weeks
• Be active when you’re feeling well
• Don’t overdo it
• Avoid physical activity if you feel unwell, tired or sore from previous activity
• Avoid physical activity straight after meals or after alcohol
• Be active within comfortable limits – you should never find physical activity ‘hard’
• If you want to begin a program of more intensive physical activity or start to do competitive sports, talk to your doctor
• If your doctor has prescribed medicines to relieve your angina, take this medicine with you when you are doing physical activity
• Always carry hypo treatment if you are taking insulin or certain diabetes medications that can cause your blood glucose levels to go too low. If a hypo occurs, stop what you are doing and treat it immediately. For more information see the hypoglycaemia information sheet

How much physical activity should I do?

How you feel is the best guide to what the safe level of physical activity is for you. However, the more you can do the better. The Heart Foundation recommends you very gradually build up to 30 minutes or more of moderate-intensity physical activity (such as brisk walking) on most, if not all, days of the week. If it is easier you can split this up into shorter amounts, such as three 10-minute walks. For some people other medical conditions may prevent them from doing 30 minutes per day of physical activity – discuss this with your doctor. If you have diabetes complications, such as diabetic retinopathy (eye disease), there may be some forms of physical activity that you are advised not to do – discuss this with your doctor.

Initially it is important to continue with the physical activity you started while you were in hospital. Then talk to your cardiac rehabilitation health professional or doctor about when you can start other activities.

Cardiac Rehabilitation

The Heart Foundation and the World Health Organisation recommend people who have had a heart attack, heart surgery, coronary angioplasty (heart vessels unblocked), angina or other heart or blood vessel disease attend an appropriate cardiac rehabilitation and prevention program. Cardiac rehabilitation programs complement the advice your GP and/or cardiologist give you. There are cardiac rehabilitation programs available at hospitals and also community health centres.

Once you have completed cardiac rehabilitation, the Heart Foundation offers a program called Heartmoves. You can also purchase the Heart Foundation Heartmoves DVD which offers a low-to-moderate intensity exercise program designed to be safe for people who are at risk of heart disease or who have chronic heart conditions.

For more information:

• Please see the Heart Foundation’s physical activity after heart attack and heart surgery information sheet
• Speak to your GP or Cardiologist about joining your local hospital or community health centre’s cardiac rehabilitation program
• Call the National Heart Foundation Heartline on 1300 362 787 or visit the Heart Foundation website
• Speak to a Diabetes Educator at Diabetes Australia – Victoria on 1300 136 58