Sahasranam Kalpathy is a Senior Cardiologist who has had his degree in Cardiology from India and has been practicing for the past 45 years.
What Exercises should a Diabetic Do?
Diabetics should undertake regular exercise. A structured exercise program may be advocated to them. The exercise should be regular and sustained. The participation in regular physical activity improves the blood sugar levels, prevents or delays the onset of diabetes in adults and those in the Pre-diabetic range, positively affects the fats in blood, blood pressure, cardiac events, quality of life and mortality. All diabetics should be encouraged to avoid a sedentary life style and engage in physical activity.
What are the immediate effects of exercising.
- During exercise, the muscles, especially the large muscles of the body take up glucose for energy generation the intensity and duration of exercise directly increases the amount of glucose burnt. This tends to reduce the blood glucose levels. This reduction remains for hours even after the person has stopped exercising. Insulin in the body helps the muscles to uptake glucose to be converted to energy.
- During exercise, the liver increases the production of glucose and this reduces the glucose stores in the liver.
- The blood levels remain lower in persons even 24 hours after exercise.
- A combination of Aerobic and Resistance exercises is more effective than either alone.
- Exercises like Yoga and Tai-chi also give similar results.
What are the long-term effects of exercising
- A chronic exercise regimen increases the effectiveness of insulin (Insulin Sensitivity) and reduces insulin resistance.
- Regular exercise tends to increase the muscle mass of the individual and more muscle in turn can increase the glucose uptake by the muscles.
- The muscles also start to use fat for energy generation leading to reduction of fat in the body.
- Regular exercise tends to reduce the level of ‘Bad Cholesterol’ (LDL) in blood and increase the levels of ‘Good Cholesterol’ (HDL) in blood.
- A slight reduction in blood pressure has been noticed in regular exercisers.
- Death due to diseases of the heart and blood vessels is noted to be less in regular exercisers.
- Regular exercise helps in reducing and maintaining the weight of the individual.
- In normal adults with risk factors for diabetes like a strong family history and in Pre-diabetic individuals, exercise prevents or delays the onset of diabetes.
- Regular exercise has its psychological benefits too. The quality of life of the individual improves, depressive symptoms are reduced, and there is a psychological well-being. It improves memory, improves the sleep pattern of he patient and is said to make the patient feel happier.
However, if the patient is beginning to exercise for the first time, the elderly person should have a pre-exercise evaluation by a physician to rule out any adverse effects which may occur by undertaking the exercise regimen. The evaluation considers the age of the patient, the duration of diabetes, presence of joint or muscle problems, additional risk factors if any etc. The physician may ask for a full evaluation of the heart with an ECG and Echocardiography if he feels so.
What exercises a diabetic should do
The types of exercises recommended for a diabetic are given below. According to the age and convenience, the patient may undertake whichever exercise regimen that suits him. However, a combination of these exercises is recommended for optimum benefit.
Aerobic Exercise. “Aerobic” means, ‘with oxygen’. It means that breathing controls the amount of oxygen that reaches the muscles. This type of exercise mainly improves cardiovascular conditioning. Examples of aerobic exercise include brisk walking, swimming, cycling, rowing, dancing etc.
The recommendation is that at least 150 minutes of aerobic exercise per week should be done. This can be 30 minutes daily for at least 5 days a week. Alternatively short periods of aerobic exercise of 10 minutes each for 3 to 4 times a day can be done.
The exercises should be of moderate intensity. Always start slow and increase the speed of the exercise as days go by. One should always warm up for five minutes before the exercise and cool down at the end.
Resistance Exercise. Here the muscles are made to contract against an external resistance leading to increase in strenghth, size and power of the muscles. The muscles are made to work against a force or weight. Gym based exercises and home based resistance exercises may be done. They should be supervised initially by a competent person or trainer. Free weights like dumbbells, barbells or kettlebells can be used. Resistance bands (‘Theraband’) which provide resistance during stretch may be used. They are simple, need no equipment and can be carried anywhere by the patient during travel. They are available in various colors according to the variable resistance offered. One’s own weight can be used for resistance as in pushups or squats.
It is recommended that Resistance training be done at least twice a week on non-consecutive days. The exercises should involve major groups of muscles of the upper and lower body and the core muscles of the body. Usually, 10-15 repetitions are enough to improve muscle power, tone and strength.
Balance Exercises. Balance control is needed for a person to move independently without fear of falling. This ability decreases with aging and in diabetics due to involvement of the nervous system, this may be impaired further. Hence exercises to improve balance become important especially to prevent falls in them.
These are simple exercises. They are Standing on one leg, Tandem walking, Rising from a chair without holding the armrest, and Squats are some of the balance exercises. Some patients may need to hold on to a chair or the wall initially while training. Yoga exercises also incorporate balance training in them. These are simple exercises and can be done at home. They are useful in diabetics with involvement of the nerves.
Flexibility Training. Improving the flexibility of joints is also an important part of exercising. This prevents injury and falls in the elderly. Stretching of various muscle groups should be performed. It is better to perform these exercises under supervision initially. They can be performed at home. Yoga and Tai-chi offer excellent flexibility exercises.
Daily activities. In addition to the structures exercise regimens, the person should be encouraged to be as active as possible during the day. Using the stairs instead of the elevator, walking to the nearby store, walking the dog, gardening, standing up and switching on the TV or fan are simple chores where the person is encouraged to be active. The sedentary time should be reduced. The person should be encouraged to get up and walk if he is sitting for long. A 15-minute walk after meals is beneficial.
To motivate the individual to move and exercise, there are apps available which can be downloaded into their mobile phones. These apps measure the number of steps taken per day. Smart watches are also available which can keep record of the daily step count.
Some Practical Tips on Exercising.
- Choose some exercise which you enjoy and like. A willing friend or partner helps to
- keep the person motivated to exercise.
- Have a smart goal when you exercise – time the duration, or fix the number of steps you will take a day.
- Have a regular schedule for your exercise. Some persons find it easier to exercise in the morning hours whereas others may prefer the evening.
- Do not exercise in the hot sun.
- Drink plenty of liquids while exercising.
- Wear shoes that are properly fitting and comfortable. Use cotton dress and socks.
- Wash your feet after exercising and check your feet for any sores or injuries frequently.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2022 Sahasranam Kalpathy