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IMPORTANCE OF EXERCISE IN CONTROLLING DIABETES
Regular exercise is especially important for a person with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than diabetics who not exercise regularly. Exercise, generally helps control blood glucose levels because exercising muscle cells use more sugar and oxygen than those at rest. Exercise also helps insulin to work better.

There are two main types of exercise i.e. Aerobic and Anaerobic.


Aerobic Exercise: It is steady exercise over a period of time that causes our body to use more oxygen. It makes our heart and lungs stronger, lowers blood lipids, lowers blood pressure, and used up blood sugar. Aerobic exercises includes walking briskly, cycling, dancing, swimming, Jogging, cross-country skiing, some team sports etc.


Anaerobic Exercise : It consists of short bursts of energy that work one part of the body at a time, such as weight lifting. It builds muscles but does not strengthen the heart and lungs. It uses small amounts of blood sugar, but not enough to have much effect on overall blood sugar levels.
Both types of exercises are beneficial. While aerobic exercise works to lower blood sugar better, the benefits of anaerobic activities such as weight training are important too. For maximum benefit, aerobic exercise should be done 3 to 5 minutes a week, for 20-30 minutes each time. If a person is taking insulin them it is easier to balance his blood glucose levels if he exercise at the same time of day.

 



How Regular Exercise Controls Blood Sugar :

 


Regular Exercise is of great value in patients suffering from both Type-1 and Type-2 diabetes.
Sometimes, it may seem easier to pop a pill or even take a shot than to put on your walking shoes and hit the trail. But the truth is that exercise, in combination with a healthy diet, is one of the best things; the person can do to take care of himself, if he/she is suffering from diabetes. Due to exercise, the glucose is metabolised in the body and thus normal blood sugar level is maintained. Exercise increases the body efficiency, because it increases the tissue sensitivity to Insulin in patients suffering from Type-2 Diabetes. Here more amount of glucose is forced out of the blood stream and into the cells where it is utilized for the production of energy. Hence, this condition reduces the level of glucose in the blood. It has been known that, exercise also increases the demand of muscles for glucose. If the muscles are exercising or in the working order then require more glucose the muscles those are not in working order. Hence, this condition also lowers the blood sugar level.
In addition, to all this, the exercise burns calories which therefore helps in lose weight or maintain a healthy weight. And it is said that in a healthy weight individual, the blood sugar level remains in normal range, particularly in Type-2 diabetes.
Exercise can improve circulation, especially in the arms and legs, where people with diabetes can have problems. Exercise can possibly reduce the amount of medication we need to treat diabetes or even eliminate the need for medication. Exercise also provides us relief from stress, which is the major contributing factor in raising blood sugar levels.
Moreover, exercises reduce weight in case of the obese person. If there is extra body weight then unnecessary strain is put on beta cells, they needed to overwork, and hence the function of Beta cells is impaired for whole life. In some people, exercise combined with a meal plan, can control Type-2 Diabetes without the need for medications.


 

EXERCISE, HYPERTENSION AND DIABETES


Exercise, helps in reducing the high blood pressure. A high blood pressure can lead to a heart attack or stroke. So, an exercise helps in lowering the risk for heart diseases. With all these good things going for it, it’s mind boggling that only a few people get enough exercise or leisure-time physical activity to benefit.Hypertension is more commonly prevalent in a diabetic than in a non-diabetic. It is present in more than 50% of patient with Non insulin dependent diabetes mellitus and may or may not be accompanied by renal damage. Hypertension is a major risk factor for the development of macro/micro vascular disease in diabetics. Although increased cardiovascular risk has been demonstrated in adult diabetic subject with pressure slightly greater than 130/80 mm Hg. The decision to treat mildly elevated levels of blood pressure must rest on clinical grounds in each individual. Isolated systolic hypertension is more common in a diabetic than a non-diabetic and is a risk factor for micro vascular disease, but treatment should be individualised. In diabetics, the high blood pressure may be due to secondary causes, which must be carefully considered and ruled out.
Primary Measures for management of hypertension in diabetics include, Regular Exercise, weight optimization, Cessation of smoking and dietary salt restriction. The drugs to be given to diabetics for hypertension must be carefully thought about because many anti hypertensive drugs shows side effects in diabetic individuals.


 

EXERCISE, CHOLESTEROL AND DIABETES


Exercise can help reduce the cholesterol of diabetics. Hence, by lowering the cholesterol level in diabetics, the risk for heart disease like heart attack or stroke is also reduced in them. Exercise lowers the elevated blood cholesterol by increasing the amount of high-density lipoproteins (HDLs), which are mainly responsible for removing cholesterol from the blood stream. Exercise also reduces the triglycerides and bad type of low-density lipoproteins in the blood and thus lowers the blood pressure, which in turn minimizes or decreases the risk of heat attacks in diabetics. Atherosclerosis is also prevented by Exercise in Diabetic people. No hardening of arteries occurs, if a diabetic person performs regular exercise.
Nowadays, cholesterol has become the number one public health issue nationwide. The US National Institute of Health has described high cholesterol as an epidemic. This really no surprise because it has been observed that heart disease kills many people every year and the elevated cholesterol level is the main causative factor in them. In order, to prevent this the National Institute of Health has given certain Cholesterol treatment guidelines. By following the preventive programs the preventive programs or getting proper treatment, the patients cholesterol level decreases considerably and thereby reducing the occurrence of more serious diseases. Statins are the family of drugs most commonly used to treat high cholesterol. But there are certain controversies in using them. Such as Statins and their herbal source and red rice yeast may cause muscle damage and in some cases it may be fatal even.



SELECTING YOUR EXERCISE


It is people is out of shape or have been recently diagnosed as having diabetes, and then he/she should see his doctor before starting an exercise program. Doctor can best guide about the type of exercises that are good for him depending on how well the diabetes is controlled. Moreover, doctor can choose an enjoyable physical activity that is perfect for his current fitness level.
Before making choice of an exercise program for the patient doctor should check the sensation in patient’s feet. He should check patient’s feet for any cut; sores, bruises, blisters, or any provide tips to the patient that is about the best care of his feet. Doctor should advise to the patient, the use of special shoes, if required.While choosing an exercise, person should keep in mind that it should put undue stress on his feet. Hence, exercises like walking, swimming or bicycling must be the appropriate choices. Person should try to avoid activities like running or jumping that could injure his feet. Patient should remember to warm up and cool down before and after exercising and he/she should always wear comfortable footwear. During walking or jogging, person should be very sure that his shoes fit well and are designed for the activity, which the person is performing. Person should be alert for blisters. Person should wear and shoes for a bit of each day until they are comfortable and are not as likely to cause blisters. Person should always remember to wear soaks. Diabetics should choose light exercises. They should not choose strenuous exercise as it may elevate blood pressure in them. If a patient has foot problem, then he should choose swimming or biking rather than jogging because it is easier on the foot. After making final choice of the exercise, the person should begin the exercising activity, slowly with a low impact. Such as if a person has to do walking then he should start with five minutes and add a bit of time each day.
Exercises like diving, parachuting and mountain climbing are not recommended for people with diabetes. Because, during performing these exercises, hypoglycaemia can occur which can lead to serious complications.
 


 

WHY WALKING WINS


Diabetics can cut down their risk of dying prematurely by just getting up and walking. These have been found by several researchers. Their study found that the diabetic people who walked at least two hours a week had nearly a 40 percent reduction in death from all causes. Many studies have shown the health benefits of regular physical exercises including a decrease in the risk of developing diabetes. But little research has been done on the effect of exercise on people who already have the disease. In this study investigators from the Centers for Diseases Central and Prevention looked at nearly 3,000 adults with diabetes. All were questioned about their exercise habits through surveys administered in the community. Participants were followed for eight years. When compared with individuals who did not exercise, those who reported at least two hours a week of walking had a 39 percent lower death rate overall and a 34 percent lower death from cardio vascular causes. Even better results were seen for those who walked three to four hours a week. Therefore, these findings support the current recommendations that brisk walking on a regular basis is key health behaviour for persons suffering from Type-2 Diabetes mellitus. This regular daily walk will prevent the deposition of fat and maintain normal blood circulation particularly in the extremities.



HOW OFTEN SHOULD A PERSON EXERCISE


Person should try to exercise at the same time every day and for the same duration. This will help him controlling his blood sugar. It is mainly recommended to exercise at least three times a week for about 30 to 45 minutes. But if a person does not have at least 30 minutes to exercise then they should break their routine into shorter intervals. They could perform exercise for 10-15 minutes in the morning before going for job. Then they should take a 10-15 minutes walk at lunch time. Then again they can perform exercise for 10-15 minutes in the evening.


 

HOW MUCH EXERCISE


It has been noted that a sedentary life style increases the chances of becoming overweight and developing a large number of chronic diseases. Exercise or regular physical activity helps many of the body’s systems function better and keeps a host of diseases at bay. The physical exercises improve the chances of living longer and living healthier. It also prevents developing heart diseases or developing certain cancers like that of colon and breast cancer. It also prevents and helps in controlling Type-2 diabetes. Despite of all such beneficial effects, the person should fix up the time for exercise. He should not overexert himself. Hence, Regularity, intensity and duration of exercise are very important. It is recommended half an hour of continuous aerobic exercise. During this exercise, the heart goes up for a few minutes and a drop of sweat appear. This is all what is generally required. Person should stop exercising at once, if he feels any sort of discomforts like pain in the chest, neck or any other body part.


PRECAUTIONS


No doubt, exercises are very good for people suffering with diabetes but certain precautions should be taken during performing them. Straining or overexertion during exercising should be avoided. If after stopping the exercise, the breathing and pulse rate do not come to normal then it proves that the person has got overstrained and this may lead to a condition known as hypoglycaemia that is reduction in blood sugar level.
During exercising, person should not wear tight clothes. He should wear loose, comfortable clothes and the types of clothes he wear should suit the weather. In summers, generally lightweight and light coloured clothes are preferred. If a person is exercising then care should be taken that he is having his regular meals, that is sufficient quantity of carbohydrates are provided in his diet. Otherwise, hypoglycaemia may occur.
Patient should not keep on exercising continuously, in a condition if he finds blisters or cuts in his feet. Exercise should be immediately stopped until the healing of feet occurs.



LISTEN TO YOUR BODY: WHEN NOT TO EXERCISE


If the person’s blood sugar level is above 300 mg/dl, then he/she should not exercise. Due to exercise the blood glucose level may be raised. It is because when the person performs exercise, then he liver releases the glucose, which has been stored in it in the form of glycogen.If a person is ill or suffering from any infection, then also exercising should be stopped, till the person gets well. It is because during sick condition, the blood sugar levels are already very difficult to control and further exercises may worsen the condition.
The presence of ketone, in the urine, also indicates that one should not perform exercise. It is because when we exercise, we usually burn glucose and fat. So when fats are burned in order to provide energy, they release certain by products like ketones. Enough insulin in our blood means that little quantity of ketone can be used as fuel. But when there is less amount of insulin, then ketones get deposited up and they are excreted into urine. Hence, presence of ketone in urine indicates that our body does not have sufficient quantity of insulin maintain the blood sugar level under normal range.
If the person, experiences, tingling or pain or numbness in his legs then also he should stop exercising.
During certain, climatic changes like in extreme, hot or cold weather, there is increased chance of diabetics for developing hypoglycemia and moreover, due to cold weather in diabetics skin cracks may occur due to impaired circulation and neuropathy. If the patient feels dizziness, nausea or short of breath then he should not exercise. Moreover if he/she suffers from the problem of blurred vision then also they should stop exercising.

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