Diabetes and exercise
Exercise is being increasingly promoted as part of
the therapeutic regimen for diabetes mellitus. In addition to its cardiovascular
benefits, exercise can improve glycemic control by increasing the tissue
sensitivity to insulin due to the weight loss.
Screening before exercise:
Before we conduct an exercise
program to the diabetic patient, they have to undergo detailed medical
evaluation with appropriate diagnostic studies. This aims to screen whether there
is any presence of macrovascular and microvascular complication as it may be
worsened after the exercise program.
The examination of complications
including:
- Cardiovascular system
- Retinopathy
- Neuropathy (autonomic and peripheral)
- Peripheral artery disease
- Nephropathy
Preparation before Exercise and After
Exercise
Table 1: What
we should do before, during and after exercise (Adapted from Canadian Journal
of Diabetes. 2006;30(1):63-71)
Type 1 DM
Type 1 diabetic patient can engaged
with all levels of exercise such as:
- Leisure activities
- Recreational play
- Competitive sport
However there are some
limitations or guideline to do any physical activities among people with type 1
DM. This is to make sure that the beneficial of exercise is achieved without
any problems and complications besides well monitoring blood glucose level.
There are certain types of exercise to avoid
due to complication occur in diabetic patients such as:
·
Heavy
weight-lifting
Ø Extra pressure
on the blood vessels in your eyes ( diabetic patient with eye problem)
·
High-impact
exercises
Ø
Should
be avoided when having nerve
damage.
Type 2 DM
As
we know, exercise gives benefits to both children and adult with type 2
diabetes. In general, your exercise program should
include a balance of:
- DO Aerobic exercise (walking, running and swimming). This can increase your heart rate and deepen the breathing.
- DO strengthening exercise. This is to have better balance and strengthen your bones.
- DO regular stretching. This is to increase your flexibility and can prevent from muscle soreness due to aerobic or strengthening exercises.
Table 2: Summary of exercise prescription for type 2 DM
patient (Adapted from American Heart Association, Thomas
et al, 2009).
Table
3: Things to do for patient that taking insulin injection and ODA should do
before exercise.
# For
GDM
Exercise is not necessary as a part of treatment. However, it may help
to control their blood sugar levels. If
pregnant mother were exercising before, so they should continue it after being
diagnosed by GDM. If they don’t exercise before, ask the physicians. Mostly,
women without complication are able to exercise at least moderately.
Exercise
effects on diabetic patients
Diabetes
mellitus is a type of disease that has grown worldwide. There are certain goals
of exercise for DM patients in terms of improving health and fitness which are:
1)
Cardiovascular endurance
2)
Strength
3)
Body fat composition
Besides that,
by doing an exercise, it also can increased confidence level, socialization and
healthier lifestyle attitude. Table below stated some of physiological effects
of exercise in diabetic patient below:
Table 4: Physiological effects of exercise for diabetic patient.
References:
http://www.simplefitnesssolutions.com/articles/diabetes.htm
http://www.uptodate.com/contents/diabetes-mellitus-type-2-alcohol-exercise-and-medical-care-beyond the-basics
http://www.uptodate.com/contents/gestational-diabetes-mellitus-beyond-the-basics
Tamborlane WV. Triple jeopardy: nocturnal
hypoglycemia after exercise in the young with diabetes. J ClinEndocrinolMetab. 2007;92:815-816.
Thomas et al,. Exercise Training for Type 2 Diabetes Mellitus,
Circulation, 2009; 119: 3244-3262
