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Diabetes And Exercise

by Compiled by GymLink.com.au (Health & Fitness Resource)

Diabetes or diabetes mellitus is a metabolic disorder characterised by hyperglycaemia (high blood glucose levels) caused by impairment in insulin secretion and/or action. Exercise is an important factor in the prevention and management of diabetes.

About Benefits
One of the major problems associated with diabetes is a poor response of the body's tissues to insulin. This is called 'insulin resistance'. It has been clearly demonstrated that regular physical activity can improve the body's sensitivity to insulin and helps to reverse insulin resistance. Studies indicate that an active lifestyle greatly reduces the risk of developing Type II diabetes and may lead to people with Type I diabetes requiring reduced dosages of insulin.

Regular exercise assists in weight reduction or maintenance which is an important issue in managing Type II diabetes. Exercise also has a positive effect on the health of the heart and reduces the risk of developing blood vessel damage. Harmful levels of cholesterol, high blood pressure and the risk of dangerous blood clot formation can all be reduced by regular exercise.

Considerations
Type I diabetes
  • It is important for people with Type I diabetes to avoid hypoglycaemia or hyperglycaemia during or after exercise.
  • As blood glucose levels often fall during exercise, the general approach is to increase carbohydrate intake (by taking complex carbohydrate before exercising and some simple sugar/food that is easily digested and contains a mixture of simple and complex carbohydrate during exercise that is expected to last more than an hour) and to reduce insulin dosage operating at the time of exercise.
  • Check blood glucose levels before, during (if prolonged) and after exercise and adapt your diabetes exercise management plan accordingly.
  • It is important not to reduce insulin dosage too severely, as excessive hyperglycaemia and ketosis may occur.
  • Avoid giving the insulin injection in a limb that will be involved in the activity, as exercise will accelerate absorption of the insulin dose.
  • Avoid exercise if the blood glucose level is high (e.g. above 15-20mmol/L).
  • Recognise that late hypoglycaemia may occur in the 15 hours or so after exercise. It may be necessary to reduce the dose of insulin operating during this time.
  • If possible, exercise with a person who understands your condition and the steps to take should hgpoglycaemia occur.
  • Drink plenty of fluids before, during and after exercise and avoid overheating.

    Type II Diabetes
  • People with Type II diabetes are less likely to suffer hypoglycaemia or hyperglycaemia, although these problems can still occur in this group of Diabetics. It is therefore important to monitor blood glucose levels.
  • An individual's response to exercise will depend on the type of drugs they are taking to manage Type II diabetes. In some cases, insulin dosages may need to be adjusted and carbohydrate increased.
  • If possible, exercise with a person who understands your condition and the steps to take should hgpoglycaemia occur.
  • Drink plenty of fluids before, during and after exercise and avoid overheating.

    OTHER CONSIDERATIONS
  • As people with diabetes have an increased risk of heart disease, it is important to have a cardiovascular assessment prior to commencing an exercise programme.
  • It is vitally important that people with diabetes who are planning to increase or start physical activity do so in a way that does not cause damage to the feet. Ulcers, blisters or other breaks in the skin of the feet can be dangerous for people with diabetes. Middle aged and elderly people should be especially careful and it may be advisable to avoid exercises such as running, which causes stress to the feet. Exercise which places less weight on the feet such as swimming or riding an exercise bike are ideal. Brisk walking is an excellent type of moderate exercise if good footwear is worn. It is a good idea to see a Podiatrist for advice regarding the state of the feet and the best footwear before starting an exercise Programme.
  • People with proliferative retinopathy should avoid vigorous activity (especially non-aerobic activity involving sudden stress) as rises in blood pressure may increase the risk of an eye haemorrhage.
  • People with diabetes who require insulin injections or those on medication that cannot be interrupted for the day should seek advice from their Doctor before participating in "risky" sporting activities (e.g. motor car racing, hang gliding, solo yachting, scuba diving etc).

    Health Care
    The considerations listed under the DESCRIPTION heading above are general guidelines for exercising safely if you have diabetes. Individual response to exercise will vary among people with diabetes, so it is important to see your Doctor before starting or increasing the intensity of any exercise programme.