Diabetes and Exercise
As such most medical programs have been recommending regular exercise programs for some patients as a curative and preventive measure. Exercising involves the performance of physical activities which are defined as total repetitive, planned skeletal muscles movements which are carried out with energy expenditure.
According to Polikandrioti (130), the use of exercises as part of medical therapy has been recognized as an important step towards treating diabetes 1 and 2, which are diseases related to the regulation of blood sugar. Diabetes mellitus is caused by serious disorders of the metabolic system which result in hyperglycemia. The disorders causes are multi-factorial and they could involve genetic causes, environmental causes and life style (a sedentary life style).
The resultant hyperglycemia causes various long and short term complications to the patients that suffer from diabetes. There are two diabetes disorders which diabetes 1 and 2. This categorization is based on what causes the identified disorder. Type 1 diabetes is alternatively referred to as (I.D.D.M) insulin dependent diabetes mellitus is caused by an auto-immune process that destroys insulin producing cells (Î² cells) within the pancreas, thus leading to low levels of insulin production.
On the other hand, type 2 diabetes alternatively known as non-insulin dependent diabetes condition is caused by low insulin secretion by the pancreas which controls the metabolic process which carbohydrates, fat and protein undergo. Type 1 diabetes occurs due to a complete lack of insulin whereas; type 2 is characterized by a combination of resistance to the action of the secreted insulin within peripheral tissues and decreased secretion. This generally leads to an increase in blood glucose whenever the concentrations levels go beyond 180-200 mg.dl/l.
This causes excess urination, thirst and loss of weight. A part from these short term effects the condition has some other severe long term effects which include cardiovascular system problems, thrombotic microangiopathy, blood vessel constriction, autonomous and peripheral neuropathy and peripheral angiopathy-just to mention but a few. The condition is highly associated with premature death and morbidity mainly from cardiovascular system complications such as myocardial infarction and vascular stroke (Annan, 17).
The medical field has been cognizant of the benefits of exercise on patients having type 2 diabetic conditions for a long time since Aristotles observation which showed that diabetes symptoms improve in a significant manner after physical activities. In past few decades research findings on exercise and diabetes indicate that a structured and regular exercise program conducted under supervision of medical and exercise professionals should be included in diabetes treatment because it can help in reducing chances of having diabetes and in treating the condition.
Such exercise programs exert influence on the tolerance and control of glucose, requirements of insulin and the sensitivity of insulin (Polikandrioti and Dokoutsidou, 217). A well structured regular, program of exercise helps the body in responding to insulin and thus improving the blood sugar regulatory mechanism. Exercising also offers additional benefits through the prevention and reversal of metabolic and physiological related abnormalities which are associated with the condition.
These abnormalities include reduction of blood pressure, management of weight, low capacity for physical work and inappropriate lipid profile. The exercises help in burning calories and cutting weight to a healthy level. They also reduce cholesterol and high blood pressure which are implicated in most heart problems. The exercises highest benefit is the control it has over blood sugar regulation. Exercises use up and lower blood levels of sugar thus reducing the need for medication in the regulation of blood sugar.
A good exercise program may even eliminate the need for sugar regulatory medication. Additionally, the exercises improve the metabolism of fats and proteins as well as the action of insulin. Muscle strength and flexibility is improved during exercises and it also has positive effects on the cardiovascular system. All these positive effects generally contribute to the increase of a patients life expectancy. Engagement in physical activities also has a positive impact on the patients mental state through the increase of the human body energy and development of a positive self esteem which leads to the decrease of depression.
Depression and stress are actually some of the contributory factors that lead to diabetes or aggravate the condition through raising blood sugar levels, therefore; the reduction of these factors helps prevent or reverse the condition. However, before engaging in any physical activity there is a need for a comprehensive medical examination which should look at the renal, nervous, visual and cardiovascular systems. These systems may be affected by exercises in patients with diabetes due to some other complications that may arise (Annan, 17).
There is a need for the development of a personally tailored exercise based on the condition or state of an individual, therefore; no single exercise program can be administered to a group of patients. Prior to enrolling into any exercise program patients should get diagnosis in microalbuminaria, retinopathy, autonomic and peripheral retinopathy in order to avoid any complications in the future.
Exercise structures should undergo modification to fit the needs of an individual. The American College of Sports Medicine describes Intensity, frequency and duration as the basic factors of consideration when selecting exercise programs as prescriptions meant for diabetic patients. According to Polikandrioti (130), the recommended levels of measure of these elements are a frequency of 2-4 days of exercise in a week, in durations of 20-60 minutes with an intensity of 50%-80% VO2 max or (HRR) heart rate reserve.
The best recommended exercise type should be aerobic in nature. Aerobic exercises may take various forms, but the basic factor which defines this type of exercises is the fact that these exercise activities use a lot of oxygen and the person engaged does not have to get out of breadth when exercising. They involve continuous rhythmic muscle movements that lead to burning a lot of calories to the extent that fats are also burned out. Research shows that an appropriate program of exercise should have moderate intensity of aerobics, which could involve walking, skipping, dancing, running, cycling and swimming-just to mention but a few.
Diabetics with neuropathy are advised to avoid aerobics such as jogging and high impact aerobics, because repetitive exercising on feet which are insensitive may cause fractures and ulceration (Loganathan et al. 80) Diabetics with retinopathy are advised to avoid any exercises which may raise their blood pressure, strenuous exercises that may result in retinal detachment or vitreous hemorrhage, and activities that change eye pressure such as deep sea diving and any others that may put eyes below the level of the heart.
Diabetics with nephropathy should engage in moderate intensity aerobics and avoid high intensity aerobics that raise blood pressure for a longer time(Polikandrioti and Dokoutsidou, 219). Diabetics with high blood pressure should avoid aerobics that involve the upper part of the body such as the lifting of weight, because the strain placed on eth upper part of the body may further increase the pressure. Resistance training which involves high intensity should be avoided by patients with proliferative hypertension or retinopathy.
Aerobics constitute a better choice of exercises because they are greatly lauded as fat and high calorie burning exercises that not only control blood sugar, but also burn fats to control weight to healthy levels. They also increase lung capacity and endurance because they are performed over a lengthy period of time. Conclusively, the best types of exercises are aerobic in nature. This is because they have other additional benefits apart from blood glucose regulation such as weight control, cardiovascular system improvement through lung capacity expansion and heart exercising that strengthens valves.
They also reduce body fat (Cholesterol), increase stamina, relieve stress and enhance better sleep. These exercises reduce sugar levels in a better manner than anaerobic exercises. However, it is worth noting that no single exercise structure, program or type of exercise may be recommended for more than one diabetic patient without considering their whole health status through a comprehensive health check which will determine other secondary medical conditions as well as the potential resultant effects that certain exercises may cause(Loganathan et al. 82).
It is also worth noting that anaerobic exercises which involve short spurts of energy consumption are also good for patients with diabetes 2. These exercises help build the muscle mass which increases the capacity to expend blood glucose through working the high muscle density which will help consume a lot of sugar in form of burnt calories. Anaerobic exercises are also known to build up insulin sensitivity which is a positive thing for type 2 diabetics. Additionally, any exercise program should take into consideration factors such as education level, age, experience and the patients familiarity with exercises and exercising.
Hypoglycemia is perhaps the most common risk associated with the aftermath of exercising in diabetics. The risk may occur during or after the exercise. This problem may be prevented through monitoring of blood glucose levels before and after exercises, this should also involve consideration of carbohydrates consumption and insulin levels in exercising limbs (Tiarks, Fletcher &Taylor, 888-890)
In order for the exercise program to yield some positive results there should be strict adherence to the program. Additionally, according to literature under-active or sedentary lives may cause diabetes onset. Therefore, active participation in at least 30 minutes for three days in a week is sufficient cut the risk of getting the condition by 30% percent.
Annan, Francesca,. The connection between better health and exercise in diabetes; The Journal of Practice Nursing, volume number 22, issue number 1, 2011
Loganathan, Rajprasad. Searls, M. Yvonne. Smirnova, V. Irina and Stehno-bittel, Lisa. Exercise-induced benefits in individuals with type 1 diabetes; Physical therapy reviews Journal, volume 11, DOI 10.1179/108331906X99056, 2006
Polikandrioti, M. Exercise and diabetes mellitus, Health Science Journal, volume number 3, issue number 3, ISSN: 1108-7366, 2009
Polikandrioti, Maria. And Dokoutsidou, Helen. The role of exercise and nutrition in type II diabetes mellitus management Health Science Journal, volume number 3, issue number 4, 2009
Tiarks, Jakesa., Fletcher, P. James and Taylor, J. David. Impact of Physical Therapist-Directed Exercise Counseling Combined With Fitness Center-Based Exercise Training on Muscular Strength and Exercise Capacity in People With Type 2 Diabetes: A Randomized Clinical Trial. Physical Therapy Journal Volume number 89, issue number 9, 2009
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