Can physical activity be medicine and have its benefits?

Regular exercise has been shown to improve blood glucose control, reduce cardiovascular risk, contribute to weight loss, improve well-being, stress management, and improvement in lipid profile.

Is there a need for pre-exercise testing?

The American Heart Association recommends having a stress test ECG in patients with previous cardiovascular disease or in the presence of cardiovascular symptoms. Most people with diabetes can start with a walking program without tests. Risks associated with exercise programs in diabetics include the triggering of heart ailments, visual loss, damage to joints or ligaments, and risk of hypoglycemia or even hyperglycemia.

What are the types of exercises recommended for diabetics?

Aerobics involves continuous rhythmic movements of large groups of must, This is also known as cardio. This improves blood glucose, reduces insulin resistance, lowers weight, improves insulin resistance, and has a favourable effect on cholesterol levels. The latest information suggests alternate periods of high-intensity exercises combined with short-lasting intervals of rest.
Of fall and helps in improving gait in spite of established neuropathy Yoga and Tai chi exercises are mild exercises with mixed aerobic, flexibility, and balance exercises. Average daily steps of at least 10,000 are recommended. Reducing sedentary time and increasing physical activity throughout the day is important in the management of diabetes. Methodical prescription of the exercise routine will have better results and satisfaction. Of late, the concept of SMART goals has emerged as a key for successful exercise prescription. SMART is an acronym for SPECIFIC, MEASURABLE, ATTAINABLE, RELEVANT REALISTIC, and TIME-BOUND exercise program.

What are resistance exercises?

This involves using weights, resistance bands, using our own weight as in push-ups and squats. It prevents sarcopenia. It intercedes muscle strength and endurance. Alternate days of resistance training at least 3 times a week are recommended. Resistance training followed by aerobic activity reduces the incidence of hypoglycaemia.

What about flexibility and balance exercises?

Diabetics have increased joint stiffness with restricted mobility Balance training reduces the risk Supervised exercise training is recommended by American Diabetes Association for type 2 Diabetes.

What about exercise in type 1 Diabetics?

This is associated with variable glucose levels during exercises. They are more likely to go into hypoglycemia. A decrease in insulin dose, short sessions of exercise training, frequent carbo-hydrate feeds, and glucose checks are recommended.

What about exercises during pregnancy?

Pregnant females with diabetes
or gestational diabetes should engage in 20 to 30 minutes of exercise on most days of the week. Physical activity and exercise in gestational diabetes are associated with a lower risk of weight gain, reduced risk of pre-eclampsia, and fewer chances of caesarean delivery.

What about exercises for elderly diabetics?

Preventing injuries from falls, dehydration, and hypoglycaemia is important. Resistive exercises are preferable for the elderly and frail. A combination of resistance exercises and aerobic activities is the best for the elderly.

What are the exercise-related complications in diabetics?

This is more common in type 1 Diabetics. Taking a small carbohydrate diet before or in between exercises is significant. Type 2 diabetics have joint stiffness. Exercises need to be individualized and progressed slowly. Caution needs to be taken if outdoor exercises are conducted in hot and humid weather.
A balanced and proper amalgamation of various exercises is the need of the hour for diabetics. There should be inbuilt checks and momentum to help a diabetic to achieve sound health.

Categories : Diabetes

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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