Diabetes, also termed as ‘high blood sugar’, is a chronic non-communicable disease that affects many people. There are two types of diabetes, Type 1 and Type 2, with the latter being more common. Exercise and physical activity are very important in controlling diabetes. The best results are usually seen when exercise is supplemented with medication and dietary changes.
Type 1 diabetes occurs when the body fails to produce the insulin it needs to maintain blood sugar levels and so needs an external source (about 10-15% of diabetics). Type 2 Diabetes, the body fails to produce enough insulin and the cells do not readily respond to the insulin secreted. The symptoms of diabetes are increased urination, thirst and hunger, unexplained weight loss, fatigue, blurred vision and/or sores that do not heal.
Treatment
Type 1 diabetics need insulin and close monitoring of blood sugar levels and diet. Type 2 diabetics are mostly managed with diet, exercise and weight loss. If this is unsuccessful after a few months, then medications are used. Insulin is only used in type 2 diabetics if adequate blood sugar control cannot be achieved. Independent of the type of diabetes, a low-fat and carbohydrate-controlled diet (more complex carbs, less simple carbs) is recommended.
Pre-Exercise Programme Checklist
Before starting and exercise programme, Diabetics should ensure they have reasonable blood sugar control. The heart, blood vessels, feet and eyes should all be healthy and functioning.
Benefits of Exercise
Exercise is medicine for diabetics. Type 1 diabetics who exercise, have improved insulin sensitivity, improved blood lipids (fats), decreased resting heart rate and blood pressure, decreased body weight and reduced risk of coronary heart disease and other cardiovascular diseases.
Exercise decreases the risk of type 2 diabetes. Regular aerobic and resistance training can also reverse various defects in metabolism of fat and glucose (sugar) that occur in type 2 diabetics, this will also improve the HbA1c (an indication of blood sugar levels) and decrease the need for diabetic medications. Benefits mentioned for Type 1 diabetics are also seen in type 2.
Exercise and Diabetes
Adults should aim to achieve at least 30 minutes of continuous or intermittent (sets of 10 minutes), moderate aerobic activity (brisk walking, jogging, swimming, cycling) on five or six days of the week for a total of 150 minutes. Resistance training (body weight, bands, dumb/bar/kettle bells) sessions should be two to three times per week.
Special care must be taken in those taking insulin. Exercise and insulin both independently assist cells to take up blood sugar. Type 1 diabetics will have to lower insulin dosage prior to exercise.
When blood sugar levels are greater than 11 mmol/L (300 mg/dL), postpone exercise and take insulin. If it is lower than 5.5 mmol/L (100 mg/dL), take a pre-exercise snack (sports drink, fruit, glucose tablet).
Diabetics should measure their blood sugar level before and after exercise. If the session is long, then it should be measured during the activity. If you cannot do a measurement before a session, then the activities should be of short duration and low intensity and you should have a glucose supply ready.
