IMPORTANT EXERCISE TIPS FOR DIABETIC PATIENTS

Diabetes is one disorder wherein lifestyle modification (physical activity and healthy eating) plays as important a role as medications to control sugar. Regular exercise could bring about a change from “medical management” to “lifestyle management” in patients with Type 2 diabetes.

A Regular exercise regimen in the diabetes-afflicted helps in the better control of blood sugar and reduces the demand for medication by 20%.

Exercise is often advised as the only form of therapy for diabetic patients when the sugar level is between below 200 to 250 mg/dl, provided there are no complications like:

Damage to the blood vessels of the eye or retinopathy
Damage to the nerves and circulation to extremities or, neuropathy
Problems with kidneys or nephropathy
Heart related problems such as – angina

Diabetes and Benefits of Exercise

Regular exercise reduces the demand for medication by 20% in diabetics and checking the blood glucose levels before and after exercise can be a motivator to continue the exercise regimen. The benefits of exercise for diabetes are many and include:

Control of blood glucose levels: Glucose is the source of energy in our body. Physical activity utilizes the glucose and helps to reduce the blood glucose levels. Physical activity also decreases the insulin resistance. A few studies have also indicated that activity increases the insulin receptors in the red blood cells. All this together helps to keep the glycosylated hemoglobin (three-month average of blood glucose levels) levels normal.

Improved cardiovascular function: Individuals with type II diabetes are more prone to cardiovascular diseases (hardening of arteries, heart attack, and stroke). Exercise increases the cardio-respiratory fitness by

Lowering the blood pressure
Lowering the bad cholesterol (triglyceride)
And increasing the good cholesterol (HDL)

Psychological benefit: Physical activity is associated with an increased sense of well-being, a positive attitude and improved quality of life.

Weight control: Physical activity helps obese/overweight individuals to lose weight and also helps them to maintain a healthy BMI.

Exercise Program for Diabetes Patients

Diabetics should plan out the intensity, frequency, duration and timing of the exercise. The exercise program should be aimed at achieving and maintaining a healthy weight. Accordingly, one should target an energy expenditure of 700-2000 calories per week through the various exercises that they may choose.

Aerobic exercise, involving large muscle groups, for 30 minutes a day is beneficial, while resistance exercises (weights, elastic resistance bands, or strength training machines) can be an option for people with low cardiac risk.

Before commencing any physical activity, the following parameters need to be given consideration:

Intensity of exercise: How intense should the physical activity be? This generally depends on the tolerance of an individual.
Frequency of exercise: How many days in a week should an individual exercise? Generally, 5 days in a week is preferred, unless one needs to lose weight, in which case it should be more. Exercise done for a short duration must be done more often. For example, one can take three brisk 10-minute walks, one shortly after each meal. Since keeping blood glucose within the target range is the aim, the duration between two exercise sessions should be less than 3 days. Diabetics on insulin should be regular with exercise since the blood glucose levels can increase on the days exercise is not performed.
Duration of exercise: This refers to how long an individual exercise session should last. This is normally related to the intensity of the exercise. High intensity exercises should be of shorter duration and vice versa. It is not advisable for an individual to indulge in long exercise sessions as blood glucose levels may fall below the desired range.
Timing of exercise: When should exercise be done? The health care team and the patient together usually should decide this aspect and this depends on the individual’s daily routine. However, exercising immediately after major meals (breakfast, lunch, and dinner) should be avoided. Exercising during peak insulin action (for those on insulin) is not recommended. This depends on the type of insulin being used and hence it is best to check with the doctor.

Exercise Phases

The exercise regimen in diabetics should include warm-up phase, aerobic and cool down phase.

Warm up phase

This phase is the first 5-10 minutes at the start of the exercise and comprises low intensity, easy movements. For example, if one wishes to jog, walking prior to that is the warm up phase. Stretching and bending exercise before a game of badminton or tennis or golf for 5 to
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