Exercise & Diabetics

Type 1 or juvenile diabetes and exercise

Physical exercise is a key method for people with diabetes to not only manage their blood sugar but also to help prevent damage from some of the side effects of having diabetes. The steps a person with diabetes takes to improve overall fitness will can be greatly beneficial, because regular exercise helps lower blood sugar levels and keep them in target range.

The Benefits Physical exercise is important for everyone's health and well-being, but it's especially important for people with diabetes. For everyone, regular exercise produces such important benefits as cardiovascular fitness, improved muscle tone and strength, lower blood pressure, help with weight control, positive effects on mood and stress, and the development of self-confidence and self-esteem. "But physical fitness and a sense of well-being may be even more essential for people with type 1 diabetes than they are for anyone else," says exercise physiologist Gary Scheiner, M.S., C.D.E., head of Integrated Diabetes Services, in Wynnewood, Pennsylvania. "The steps you take to improve overall fitness-even if they're only small steps-will often result in improved diabetes management."

The reason? Regular exercise helps lower blood sugar levels and keep them in a target range. In working harder, the body uses more glucose to produce energy and improves the way insulin works. Blood glucose levels are lowered and insulin requirements are reduced. The benefits are great, but there are challenges. People with Type 1 diabetes must be careful about when, how long, and how intensely they exercise, and they must take steps to avoid hypoglycemia--going too low--during or after the activity.

People with type 1 diabetes, the American Diabetes Association's current position statement on exercise says, should avoid exercise if their levels are more than 250 mg/dl and they have ketosis - high levels of acidic substances called ketones in their blood - or if their level is over 300 even if they don't have ketosis.

Before strenuous exercise, it's also a good idea to check your blood glucose and your feet for cuts or blisters. During exercise, stop immediately and take three glucose tabs if you feel an insulin reaction coming on. After exercising, check your level and feet again.

Achieving the Goal Success in any physical activity for a person with diabetes begins with proactive diabetes management. Avoiding hypoglycemia is a goal people can realize through good planning and constant vigilance. Good planning means monitoring glucose both before and after exercise, always having glucose tablets or a high-energy snack on hand for unexpected lows, and drinking extra water to prevent dehydration. The diabetic exerciser must coordinate exercise with diet and insulin therapy, making adjustments in insulin dosing or snacking. Keeping a record is important because each person has his or her own unique response to exercise that can be observed through daily treatment adjustments, and because different types of exercise have different effects on blood sugar.

Information to record includes blood sugar readings, foods eaten, the amount of insulin taken before exercising, the nature and length of the activity, and how the person performed and felt during and afterwards.

Many diabetics suffer from obesity and fat around the middle. Working 30 minutes a day at least 5 days a week on a treadmill or elliptical trainer will help to reduce the visceral fat and make diabetes management much more successful.

Having a treadmill or elliptical machine in the home reduces excuses related to preparation , traveling and weather. Also, it allows you to watch TV or listen to music while not snacking. If you get into the habit of walking on a treadmill instead of snacking while watching TV, you will be amazed at the results you get and how much easier it will be to both manage your blood sugar and avoid diabetes complications.

Type 2 or adult onset diabetes.

For those with type 2 diabetes there is an enormous body of research documenting the benefits of exercise.

A major benefit of exercise is its effect on the heart and the associated reduction in death from heart disease. In addition to lowering the risk of heart disease in type 2 diabetes, exercise helps to decrease the chances of developing diabetes. This can be especially important for those with borderline diabetes. In one study, the risk of developing diabetes was reduced by 24% (based on an energy expenditure of 2000 calories per week through exercise). The mechanism for this benefit is that exercising muscles are more sensitive to circulating insulin. They thus take up blood sugar more easily and use sugar more effectively. Research has shown that even short term aerobic exercise improves the sensitivity of muscles to insulin.

There is a compelling association between diabetes and the location of fat in the body. It has been known for a long time that people with increased internal belly fat (the classic round belly person ) have a higher risk for insulin resistance, high cholesterol, and high blood pressure. This triad of diseases is part of a disorder called " Syndrome X." what is of particular concern is that in some people who are not overweight by definition, internal belly fat may still be high, as visualized with special imaging tests of the abdomen.

In addition to its benefits on muscle insulin sensitivity, aerobic exercise also improves blood cholesterol levels and blood pressure control. This benefit occurs regardless of weight loss. In one study, people with type 2 diabetes on a 3 month exercise program reduced their triglyceride levels by 20%, increased their good cholesterol (HDL) by 23%, and decreased their blood pressure to better levels too! Wow! Time to get on that treadmill or elliptical trainer

The benefits of exercise in patients with diabetes, and in those at high-risk for developing type 2 diabetes (and those with Syndrome X), may include the following:

  • Reduced heart disease
  • Prevention of diabetes in those at high risk
  • Improved muscle sensitivity to insulin
  • Better blood sugar control
  • Better blood cholesterol profiles
  • Better blood pressure control
  • Potential weight loss
  • Improved general sense of well being

So get started today. Walking on a treadmill or using an elliptical machine will get you on your way to more effective glucose management in a very short period of time.

Exercise disclaimer:
Always check with your doctor before beginning a new exercise program or changing your exercise routine significantly. This is especially important if you have been sedentary for a long time , are overweight, have a high risk of coronary heart disease or some other chronic health problem.

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