How to implement a exercise therapy for diabetics

An essential element in the treatment of diabetes mellitus is physical exercise. Here are basic suggestions on how to implement this important therapeutic tool.

The Intensity

The effort exerted during exercise should be moderate: not too little or – most importantly—not too much.

When exercising, it is very important to start slowly, and gradually reach a moderate, steady pace. At a steady pace, rough indicators that you are exercising effectively and safely are a slightly increased breathing (rate and depth) as well as a slightly increased heart rate. The strenuousness of exercise should be in order to be considered moderate, which differs greatly between individuals, according to age, weight, previous training, and skill. Brisk walking at a speed of 4 to 5 km/ hour is an example of an advisable effort after appropriate training for the majority of adults.

The Duration

Regular exercise should be a life-long habit. The daily dose of exercise should be at least 1 hour, but may last much longer. In fact, there is no limitation to the duration of exercise provided its intensity is light to moderate.

The Time

Any time of the day is good. A smart solution is to include exercise in your daily routine, such as going to the market or grocery on foot or bicycle. If the daily dose of exercise is split into two or four segments, the beneficial effect is retained, and this type of program may be easier to continue in the long run.

Type of Exercise

The best choice is aerobic exercise that can be performed on a daily basis. A possible alternative is a sport that can be practiced with low to moderate effort (eg. bowling, table tennis, golf, bicycling on level ground, swimming, rowing, dancing, or gym classes). If you have a problem using your legs, you should learn some kind of exercise that can be performed while sitting or lying, and progressively increase its duration up to half an hour, once or twice a day.

Caveats

Grossly obese people should delay starting an exercise program until they have lost the first 3 kg. Exercise may decrease blood sugar below normal levels (hypoglycemia), especially if you are taking drugs that lower blood glucose (tablets and/or insulin). Therefore, always carry sugar and other starchy foods when exercising, and be ready to take them as soon as you feel weak or “strange.” Ask your doctor’s advice on the possibility of reducing your drug dosage before entering a program of regular exercise.

It is, at any rate, better not to exercise when:

• You are sick;
• You feel any kind of pain, eg. in your chest, joints, or legs (if you feel pain when you are exercising, stop immediately and have a checkup before starting again.);
• Your blood glucose is persistently very high (above 17-20 mmol/L, or 300-350 mg/dL, exercise may worsen diabetes control;
• You feel tired;
• You feel breathless.

Physical exercise is good for health and general well-being. In particular, it helps lower blood glucose level, and can therefore be considered an excellent treatment for diabetes (especially type-2, non-insulin-dependent diabetes). Moreover, it helps you lose weight, when required, and, in doing so, supports this other cornerstone of the treatment of type 2 diabetes.

(Bukisa)
Photo: CityNews.
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