Diabetes and Exercise

Importance of Exercise is mentioned in all ancient books and Ayurveda. Physicians like Shushrata and Charak have mentioned the benefits of exercise especially in Diabetic patients.

According to them they have advised horse riding, long brisk walks and wrestling for obese diabetic patients. Participation in above sports and all other sports reduces blood sugar levels.

Every person should consult his physician before joining any exercise programme. Exercise programme is different for each individual and it depends upon many factors like age of patient and associated high blood pressure and other problems. If Physician advises you to undergo some investigations like E.C.G. etc., then you must undergo these investigations.

Exercise should be performed five days in a week, 40-45 minutes each day one should start exercise gradually and increase it slowly.

Certain points to remember­

• Exercise should be performed on an empty stomach.
• One should wear loose and comfortable clothes (dress).
• One should avoid lifting of heavy weights.
• Avoid exercise in extreme hot or cold climate.

Precautions for Exercise

• If one is over 40 years of age.
• If one has never participated in strenuous physical activity since younger days.
• If one is over weight.
• If one is a heavy smoker.
• If one has high blood pressure or is suffering from angina.

Evaluation by a physician and complete health checkup including E.C.G. are essential prior to undertaking any exercise programme for the above mentioned people. Persons with diabetic foot and peripheral vascular disease, should avoid running, and choose cycling or swimming for exercise.

In the presence of retinal involvement (retinopathy), diabetics should avoid exercise associated with increased abdominal pressure or sudden acceleration or trauma to head and lifting of weight. In the presence of hypertension, avoid heavy weight lifting and choose exercise that involve lower limbs, i.e.walking.

One should observe the following precautions during exercise:

• Start with warm up exercises.
• One should not exercise straight after eating.
• Exercise should not be done under extremes of temperature.
• It is unwise to exercise if one has some infection or common cold.
• One should not participate in competitive programmes (game, matches, etc.) unless fully trained or has been practising earlier in the field.
• If chest pain occurs during exercise, one should stop exercise immediately and consult a doctor.
• If one is restarting exercise after a break of 2 weeks or so, one should start slowly.

Advantage of Exercise

Regular Exercise prevents risk factors for heart attack and high blood pressure.

• Fat and cholesterol levels fall with regular exercise.
• It gives you feeling of well being.
• Utilisation of calories helps to control weight.
• Reduces weight.
• Helps in controlling blood sugar.

Precautions before Exercise

If you have heart or joint problems or are very overweight or have never exercised much before, it is particularly important that you talk to your doctor. If you develop chest or leg pains during exercise it is important to stop exercising and tell your doctor.

• Walk upstairs instead of taking a lift.
• Don't sit down when you are waiting for bus or train. But stroll about instead.
• Play more actively with your children or gra,ndchildren. Take your dog for longer walks.
• Wear comfortable, well-fitting shoes and socks for exercising.
• Cool down at the end of the session by gradually decreasing your level of exercise over 5-10 minutes.

What Type? How to Achieve Target? What Precautions?

Aerobic exercises are ones that use your heart, lungs, arms, and legs. By working these parts of your body, you can improve your blood flow, reduce your risk of heart disease, and lower your blood pressure. You can also lower your LDL cholesterol (bad cholestrol) and triglycerides and raise your HDL cholesterol (the good cholestrol).

When you do aerobic exercises, you breathe harder and your heart beats faster. This builds your endurance and increases your energy. You may find that aerobic exercises help you sleep better, make you feel less stressed, balances your emotions, and improves your sense of well-being.

Aerobic exercise is not only good for your heart but is also good for your diabeties. Aerobic exercise makes your Insulin work harder and faster, reduces your body fat, and helps you lose weight. If you don't exercise already, your doctor may advise you to start.

What to do Before you Start

Check with your doctor before you start any exercise. Your doctor may want some tests to see how your heart, blood vessels, eyes, feet, and nerves are doing. Your blood pressure, blood fat levels, glycohemoglobin levels, and body fat might also be checked. Your doctor or nurse can tell you how to adjust your diabetes­care plan for exercise.

What Aerobic Exercises to do

Some exercises may make heart, eye, feet, or nerve problems worse. Your doctor may like to do some test to check your heart and blood vessels, before advising what kinds of exercises are safe for you to do. Pick from these exercises a few you think you might enjoy. Then learn the right way to do each exercise. Here are some examples of aerobic exercises:

• Aerobic classes
• Bicycling
• Dancing
• Jogging
• Jumping rope
• Rowing
• Running
• Skating (roller, ice, in-line)
• Skiing (downhill, cross-country)
• Stair climbing
• Swimming
• Walking

How Long and How Often to Exercise

If you are just starting to exercise after a long time of little or no activity, go for 5 minutes. Build up to short bouts of exercise that add up to at least 30 minutes a day. For example, you might try brisk walking or stair climbing for 10 minutes three times a day or for 15 minutes twice a day.

Exercising for less than 15 minutes a day is not likely to improve your health. Gradually build up to 20 to 60 minutes of continuous aerobic exercise three to five times a week. The 20 to 60 minutes of aerobic exercise does not include your warm-up and cooldown.

A warm-up will slowly raise your heart rate, warm your muscles, and help prevent injuries. A cooldown will lower your heart rate and slow your breathing. Warm up for 5 to 10 minutes before aerobic exercise, and cooldown for 5 to 10 minutes after aerobic exercise. As a warm-up or a cool down, you could gently stretch, walk, or slowly bicycle.

How Hard to Exercise

Your doctor, nurse, or exercise specialist can tell you how hard to exercise by giving you a number. The number is a percentage. It may be as low as 40 per cent or as high as 70 per cent. It is a percentage of your capacity for exercise (your maximum aerobic capacity). There are a few ways to figure out your maximum aerobic capacity. Here's one easy way.

Subtract your age from 220. The answer is your maximum heart rate. For example, if you are 40, your maximum heart rate is 180. To exercise at 60 per cent of your maximum aerobic capacity, keep your pulse at 108 beats per minute (180 x 60% = 108). A nurse can show you how to take your pulse.

When to Exercise

A good time to exercise is I to 3 hours after you finish a meal or snack. The food you have eaten will help keep your blood glucose level from falling too low.

Do not Exercise when

• Your blood glucose level is over 300mg/dl.
• Your insulin or diabetes pills are peaking.
• You have ketones in your urine.
• You have numbness, tingling, or pain in your feet or legs.
• You are short or breath.
• You are ill.
• You have a serious injury.
• You feel dizzy.
• You have pain/tightness in your chest, neck, shoulders, or Jaw.
• You have blurred sight of blind spots.