MET 101 eBook Tip 47: Managing Blood Pressure and Blood Glucose in MET
One of the most common—and unnecessary—sources of anxiety for Medical Exercise Professionals is knowing when it is safe to exercise a client with hypertension or diabetes. This uncertainty often leads to hesitation, avoidance, or overly conservative programming that limits outcomes.
Here’s the truth: medical providers expect and respect these conversations.
Physicians would much rather answer a clear, professional question about exercise parameters than discover later that decisions were made without guidance. Reaching out to clarify acceptable blood pressure or blood glucose ranges does not signal inexperience—it demonstrates professionalism, risk awareness, and respect for scope.
Every MedExPRO should begin a new client relationship by:
- Obtaining a written referral
- Confirming the diagnosis and ICD-10 code
- Requesting individualized exercise parameters for blood pressure and/or blood glucose
That said, there are general safety thresholds every MedExPRO must understand and be able to explain confidently.
General Exercise Safety Guidelines (When Physician-Specific Limits Are Not Yet Provided)
Hypertension
- Cardiovascular Exercise: Generally limited to ≤160/100 mmHg
- Resistance Training: Generally limited to ≤180/105 mmHg
Diabetes (Blood Glucose)
- Acceptable pre-exercise range: 90–200 mg/dL
- Caution range: >200 mg/dL
- High-risk range: ≥240 mg/dL (exercise only with explicit physician guidance)
It is important to understand that some physicians may still recommend exercise at higher glucose levels due to exercise’s insulin-like effect, which facilitates glucose uptake into skeletal muscle. This reinforces why individualized physician communication always overrides generalized guidelines.
Documentation Is What Turns Safety Into Credibility
Knowing the numbers is only half the job. How you measure, record, and communicate them is what defines you as a Medical Exercise Professional.
Best practice includes:
- Manual blood pressure measurement (sphygmomanometer and cuff) during initial sessions
- Avoiding reliance on automatic cuffs until consistency and accuracy are established
- Witnessed glucose checks performed by the client (pin-prick), with values recorded in the session record
- Transitioning to client self-recording only after demonstrated competency
These metrics are not “vitals for safety only.”
They are Functional Outcome Measures.
When tracked session by session and summarized every 30 days, they become powerful tools for:
- Demonstrating physiological adaptation
- Supporting medical decision-making
- Strengthening referral relationships
- Positioning your services as outcome-driven—not workout-based
Sending structured, professional summaries of these values to the referring physician is one of the fastest ways to distinguish your practice from fitness-based services.
Safety isn’t a limitation in medical exercise. It’s a skill—and one that earns trust, referrals, and long-term professional credibility.
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