Diabetes and Health: What type of Exercise should I Do?

Blood Glucose Meter Diabetic Finger Test Diabetes

Before starting an exercise program, adults need to talk to their doctor. Meeting with a trained professional to develop the right exercise program would be a step in the right direction. Exercise programs need to be individualized, based on a person’s preferences, fitness level and daily schedule. A person’s age, body weight, and any medical problems need to be considered when evaluating the type of exercise. For children, exercise needs to be fun and a positive example from parents is essential.

Gone are the days when we hear “No pain, no gain” yelled across the gym. The focus on the intensity of exercise has changed over the past decade. The benefits of more moderate exercise versus intense exercise is now being promoted by health professionals. This new way of thinking that can only help to ease regular exercise into the life of a person with diabetes. Moderate exercise is easier on blood sugar control than intense activity because it generally requires significantly less energy in the form of glucose. Moderate exercise has less of an impact on blood glucose levels.

Many questions arise when a person with diabetes is considering an exercise program – Is moderate exercise sufficient for people with diabetes ? How intensely should people exercise to get the most advantage ? How intensely can they exercise ? Briefly, the answer is: It depends on the individual.

A rule of thumb: moderate exercise can be defined as: If you can’t speak while you are exercising, you are probably exercising too hard. Also, learn to monitor your heart rate, by counting the pulse in your neck.

Moderate physical exercise may have some distinct advantages over intense exercise.

1.It’s easier to do, especially for sedentary people. A brisk walk is more appealing than an aerobic class.

2. There are many benefits and fewer risks of injury and/or episodes of low blood glucose as there may be when doing intense exercise.

3. The more you exercise the more you benefit. Moderate exercise can be continued over a longer time period and gives as much health advantage, as short bursts of intense exercise.

Exercise, particularly intense exercise, can dramatically complicate blood sugar management and this may be why studies have shown that people with diabetes are even less likely than people without diabetes to take on intense exercise such as running, skiing, bicycling. Even if a person with Type 1 diabetes was to be completely consistent in all areas – exact same food at exact same time, exact same insulin dose, same intensity of exercise, there are still many ups and downs in blood sugar control. The degree of complexity in this approach would increase anxiety and frustration. Add this to the list of reasons given by most people who don’t exercise, “not enough time,” “too tired,” “boring” and people with diabetes could feel even less positive about exercise.

Despite the fact that a person with Type 1 diabetes may experience the lows to the highs, exercise experts conclude that the many benefits of exercise are enough to recommend exercise to people with Type 1 diabetes. People with Type 1 diabetes can make exercise really work for them in terms of blood sugar control and can use exercise to improve blood sugars. The individual needs to have a clear understanding of how their body responds when they exercise, to avoid the risk of hypoglycemia. This means a lot of monitoring, a lot of repetition, a lot of experimenting with responses and action. A basic understanding of the dynamics of blood sugar regulation, along with a careful course of trial and error can improve the odds for success, and actually improve glycemic control. However, it is much more challenging for someone with Type 1 than someone with Type 2 diabetes. Dozens of world class athletes have Type 1 diabetes. It took hard work and determination, obstacles they were prepared to overcome.

People with complications of diabetes can still exercise their bodies as long as they also exercise with common sense. For example, people with retinopathy may need to avoid straining exercises such as weight lifting, intense impact from pounding and jarring sports activities. Moderate exercise can still be a part of a person’s day even with long term complications.

TYPE 2

Most cases of Type 2 diabetes begin with insulin resistance – a condition in which the body’s tissues don’t use insulin effectively to turn glucose into energy. In other words, it takes an increasing amount of insulin to keep the blood sugar levels in check. Initially the pancreas may secrete increasing amounts of insulin to compensate, but eventually, it fails to keep up and high blood glucose levels result.

Exercise can greatly enhance blood glucose control in people with Type 2 diabetes, especially in the early course of the disease. Exercise causes the body’s tissues to use more blood glucose and increases insulin sensitivity.

Research has conclusively shown that regular exercise can also significantly reduce a person’s risk of developing Type 2 diabetes. Studies have shown that people who exercised regularly had roughly one-third less chance of developing Type 2 diabetes than those who were sedentary. Other studies have shown that people with impaired glucose tolerance, who are at greater risk for developing Type 2 diabetes, may reduce their risk of developing diabetes by about 50%, even with modest amounts of exercise.

The improvement that you see from these studies approaches the improvement that you see with many new drugs which can be expensive and may have significant side effects. There is definite evidence that lifestyle changes could prevent many cases of Type 2 diabetes.

Resistance training, exercises which use muscle strength to work against a resistive load, is becoming an important part of exercise programs. Most people with Type 2 diabetes have relatively low muscle mass for their body weight and it’s mainly muscle that uses up glucose levels. Building muscle increases the use of glucose and raises the way your body burns calories. The more muscle you build, the more calories you expend, even just sitting, and the easier it is to maintain your weight.

  • Grit is stamina. Grit is sticking with hard things over time. Grit is perseverance. Good article Sudeep.