Diabetes is growing and we want to examine how Diabetes and Exercise interact. Because of its hereditary and family nature plus the severity of complications, which can lead to disability, Diabetes should be included in the large group of social ills. Much has been done for this disease and more should be done; hopefully the concept of diabetes as a social disease should not remain a mere verbal expression but should become an incentive to effective and efficient support.
Diabetes is growing both because of increased life expectancy, and because of the possible marriages between diabetics with some likelihood that their offspring will be diabetics as well. Moreover modern life conditions (stress, obesity, overeating, inactivity and lack of exercise) affects its growth and the refinement of diagnostic tools allows the recognition of this illness in an increasing number of patients.
Until a few years ago doctors suggested to people with diabetes to avoid any sport, especially competitive sports with high cardiovascular and metabolic commitment.
In the last twenty years the attitude of doctors towards diabetes and exercise has changed radically: physical activity and sport is universally regarded as useful to prevent and limit the onset and progression of the disease and to encourage better control of the metabolic state. Now the combination of diabetes and exercise are considered positively.
However it is important to remember the severity of the disease and the doctor and the patient should take all necessary precautions to make the activity useful and risk-free.
Exercise for Diabetics can be useful for both.
Type 1 Diabetes and Exercise
The type one, insulin dependent, diabetes mellitus is a metabolic disorder. It begins in adolescence and is probably due to pancreatic damage in genetically susceptible individuals.
The type one diabetic is unable to produce insulin and the only possible remedy is its ingestion from the outside, in order to avoid acute hyperglycemia, osmotic diuresis and keto acidosis.
When the patient undergoes an acute exercise, he runs the risk of getting: hypoglycemia during exercise, hypoglycemia after exercise or hyperglycemia due to the effort.
In subjects with type one diabetes the level of circulating insulin depends only on the quantity and quality injected and the time elapsed since the last administration. It is important that the patient knows how to adjust the dose so as to undermine what is physiologically happening.
It is necessary to learn and experiment through daily life and use self-control in order to know the right amount of insulin and carbohydrate. The sport especially aerobics produces an increased insulin sensitivity and a reduction of the daily requirement. Exercise increases the maximum capacity for oxygen consumption and trains the heart, which together with improvements in the lipid profile is particularly beneficial to subjects exposed to cardiovascular complications.
A physical activity on a regular basis has very favorable metabolic effects, increases the effectiveness of exogenous insulin and reduces the dosages and has a preventive effect against vascular complications. It also has an educational value because the diabetic learns the factors that influence the disease and how to cope better. It has also a beneficial effect on reducing the psychological level of anxiety and psychological stress and on increasing self-esteem and willingness to participate in society.
Type 2 Diabetes and Exercise
The type two diabetes is non-insulin-dependent and is characterized at least initially by an increased peripheral resistance to insulin especially in the peripheral tissues of the liver muscle and adipose tissue. The lower response of the cells results in a reduced utilization of glucose in relation to the achieved insulin levels and to an increased hepatic production of glucose, phenomena that lead to hyperglycemia.In reality, the muscles burn more glucose than a normal subject but it is a pathological phenomenon.
During exercise, the peripheral utilization of glucose increases but does not reduce the insulin as it should and this causes a glycemic reduction. An exception occurs in patients taking oral hypoglycemic agents in which case the effort might even lead to high insulin hypoglycemia stress.
A single session of physical activity causes an increase in peripheral insulin sensitivity, or rather a decrease in insulin that lasts several hours after exercise and has important effects in all patients. The beneficial effect is greater and lasts longer if the patient is trained on a regular basis: the glucose utilization can increase by 30-35% compared with the usual levels and the increase is proportional to the improvement of aerobic power.
In patients with type two diabetes who are physically active, the most common complication is hypoglycemia both during and after exercise. This happens both to those treated with replacement therapy and to those who are treated with oral hypoglycemic agents that stimulate hormone secretion by the pancreas.
Different Types of Exercise
The blood glucose response and the use of metabolic substrates depend on whether a physical activity is of very short duration but high intensity (anaerobic alactacid), of medium intensity and medium-short duration (anaerobic lactic acid) or low intensity with long duration (aerobic alactacid).
The recommended activity is the last one because prolonged exercise, carried out below the individual anaerobic threshold, practiced in predetermined conditions of metabolic control, seems to be the one that best suits the diabetics.
Paradoxically the aerobic alactacid long-term activities expose at less risk of hypoglycemia for a variety of reasons such as the requirement of being regularly trained and therefore capable of engaging in long duration activities which, after about one hour use free fatty acids and triglycerides adipose tissue. This leads to a saving of glucose and then in spite of the duration to a lower risk of hypoglycemia.
Different sports impact differently on metabolism, In the aerobic exercise, the glucose will be burned completely to provide energy. In the anaerobic exercise the glucose is burned only partially and produces little energy and some lactic acid which poisons your muscles.
Of course the sport most suitable for diabetics will consists especially of aerobic medium intensity exercise to train but not strain your heart.
Before starting an exercise program the patient should undergo a medical evaluation and appropriate diagnostic tests, which should evaluate the presence of micro and macro vascular complications, which could be adversely affected by the exercise program.
A careful medical evaluation and physical should focus on all the symptoms and signs of diseases affecting the heart, blood vessels, eyes, kidneys and nervous system. A regular sport can be done even in the presence of some medical complications and the goal should be to help maintain an acceptable quality of life without overloading or damaging the organs.
Exercise and Fitness
Man is made to move, but the exercise should be planned wisely to be useful. This is valid for a healthy person and is even more valid for a diabetic individual. The term planned means a physical activity that is done every day, at the most appropriate time in relation to meals or when it is appropriate to reduce blood glucose levels. In this way the exercise will constitute an important part of diabetes treatment, and will have a positive effect on the general welfare of the individual.,It will also give you an extra edge, to prevent cardiovascular disease and the risk of atherosclerosis.
The exercise may be done the in the gym or by walking, running, swimming, biking and practicing some sport. Training is important because it produces a gradual adaptation to stress of the cardiovascular system, general metabolic system and muscles in order to achieve better muscle performance with less fatigue.
The exercise has also a preventive effect in the healthy population on the future development of type two diabetes, especially if a person is overweight, it is of considerable importance given the increasing prevalence of childhood obesity.
Technorati tags: Diabetes, Type 1, Type 2, Treatment, Exercises, Physical Activity.
Blogalaxia tags: Diabetes, Type 1, Type 2, Treatment, Exercises, Physical Activity.