The Importance of Physical Activity if You Have Diabetes

Engaging in physical activity is crucial for individuals with diabetes! Fortunately, becoming more active is not as difficult as you may have thought. In people with diabetes and pre-diabetes, physical exercise adoption and maintenance are essential for blood glucose control and general health.

Increased Physical Activity Is Beneficial

Maintaining an active lifestyle can help you manage your diabetes. Exercise has been demonstrated to;

●  Reduce mortality and cardiovascular risk

●  Boost endothelial function and the lipid profile.
●  Enhances insulin sensitivity. Patients with IDDM typically have higher insulin resistance than those without diabetes, although this is not exclusive to them. In comparison to healthy controls, approximately 50% of IDDM patients are obese and have larger hip and waist circumferences.

●  Eligible co-morbidities that are frequently linked to obesity diminish the advantages of optimal metabolic regulation. Diabetes patients must control their body weight to lower their risk of cardiovascular disease (CVD).

●  Exercise is beneficial for reducing weight, waist circumference, serum insulin levels, and fasting glucose plasma levels.

●  When compared to continuous exercise and a control group that does not exercise, high-intensity training helps improve measures of insulin resistance. Notably, people with metabolic syndrome or type 2 diabetes experienced the biggest effects. Compared to the non-exercising control group, the DMT2/MS group exhibited a noteworthy decrease of 1.3 kg in body weight, as well as a drop of 0.92mmol L−1 in fasting glucose and 0.47% (5mmol L−1) in HbA1c. Cardiorespiratory fitness also increased in comparison to the two controls. How to Benefit From Exercise The objective is to engage in moderate-intense physical activity for 150 minutes each week. Attempting to get in at least 20 minutes of exercise each day is one approach to this. Incorporate exercises that target all of the major muscle groups (chest, shoulders, arms, legs, hips, back, and belly) at least two days a week.

Several examples of physical activities with moderate intensity are:

●  Strolling quickly
●  Cleaning the house
●  Cutting the grass
●  Swimming Riding a bike
●  Engaging in Sports These exercises target your big muscles, raise your heart rate, and force you to breathe more forcefully—all crucial components of overall fitness. Stretching improves your flexibility and keeps your body from hurting after physical activity.

Blood Glucose Management during Physical Activity

General guidelines for physical activity or exercise routines for individuals with diabetes mellitus are:

●  Keeping track of blood sugar levels before, during, and following exercise.

• Food, such as glucose tablets or juice, should be consumed if blood glucose is less than 100 mg/dL. It is advised to consume 15 to 30 grams of rapidly absorbed carbohydrates 15 to 30 minutes before exercise. If you test your blood sugar while exercising, you might need to eat more during the workout. Patients should consume slowly digested carbohydrates, including trail mix, granola bars, or dried fruit, right after exercise because they run the risk of developing late hypoglycemia.
• If the level of hyperglycemia is significant (more than 250 mg/dl), then excessively strenuous exercise should be avoided.
  ●  Patients with type 2 diabetes who are receiving insulin or oral hypoglycemic rarely experience hypoglycemia. It is not necessary to consume additional carbohydrates.
• Inject insulin into a place other than the muscle to be worked out and use it 60 to 90 minutes before activity to avoid increased insulin absorption. For instance, provide injections into the arms during a cycling workout and the abdomen during a combined arm and leg activity.
• Wear comfortable, well-fitting athletic shoes and cotton socks when engaging in physical activity.
• Check to determine if your activity has altered your blood glucose level afterward.

Short-Term Effects of Physical Activity

● Type 2 Diabetes:

Insulin sensitivity rises with exercise: Those on oral hypoglycemic medications have lower blood glucose levels after physical activity. According to studies, blood glucose concentrations did not alter in patients who were fasting, but they did drop in individuals who exercised after eating.

● Type 1 Diabetes

Individuals on an insulin regimen with well-controlled diabetes: Exercise is associated with higher serum insulin concentration because it raises body warmth and blood flow, which increases absorption from subcutaneous depots. An end to exogenous insulin is not possible. Therefore, compared to normal people, these patients have a substantially greater decline in blood glucose levels.

Individuals with inadequate metabolic regulation and diabetes: There is a paradoxical rise in blood glucose levels following physical activity.

Long-Term Effects of Physical Activity

Due to the patient’s advanced age and often higher body mass index, they have a reduced capacity for activity. The reason for the reduced exercise capacity has been attributed to the reduction in skeletal muscle oxidative capacity caused by mitochondrial dysfunction. Many abnormalities in the metabolism of glucose cause patients to become insulin resistant.

• Reduced expression and functionality of glucose transporters and insulin receptors.
• Lower activity of some enzymes inside cells.
• Reduced maximum oxygen uptake when working out. An exercise regimen increases insulin sensitivity, muscle capillary recruitment, and mitochondrial enzyme activity. An extra advantage of resistance training in addition to aerobic exercise is improved insulin sensitivity.

References:

1. Donnelly, J. E., Smith, B., Jacobsen, D. J., Kirk, E., Dubose, K., Hyder, M., Bailey, B., & Washburn, R. (2004). The role of exercise for weight loss and maintenance. Best practice & research. Clinical gastroenterology, 18(6), 1009–1029.

2. Devlin J. T. (1992). Effects of exercise on insulin sensitivity in humans. Diabetes care, 15(11), 1690–1693. https://doi.org/10.2337/diacare.15.11.1690

3. Hamasaki H. (2016). Daily physical activity and type 2 diabetes: A review. World journal of diabetes, 7(12), 243–251. https://doi.org/10.4239/wjd.v7.i12.243.

4. Borhade MB, Singh S. Diabetes and Exercise. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

Available from: https://www.ncbi.nlm.nih.gov/books/NBK526095/

5. https://www.wvdhhr.org/bph/cvd/page4.htm#:~:text=Regular%20physical%20activity %20prevents%20or,the%20benefits%20of%20physical%20activity%3F