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The American Diabetes Association has three elements of treatment for diabetes - they include: nutrition, insulin, and exercise. The use of physical conditioning usually doesn't get as much fanfare as new insulin discoveries, but it is nonetheless just as important.
Diabetes comes in many forms, but the two that most people are familiar with are type 1 diabetes - which is an inability of the pancreas to secrete insulin. Persons with this type of diabetes must take daily insulin injections. The majority of diabetes sufferers have type 2 - or adult onset. This form of diabetes is very closely associated with obesity, and over 90% of all diabetes cases fall into this category. What many don't realize is that one of three persons who has diabetes had not yet been diagnosed. Because the symptoms of diabetes complications (blindness, kidney failure, heart disease, neuropathy) take years to develop, many people will visit the physician only after they begin to have one of these complications. However, with early diagnosis, a proper nutrition program, and regular moderate activity, they can be avoided.
What constitutes good blood sugars? Diabetes professionals look at two types - long term and short term. An A1c (a-one-see) test measures long term sugar control. A measurement of 7% or under is considered good. Short term monitoring involves sticking the fingers multiple times per day and dropping a small quantity of blood on a home glucose meter. These meters accurately tell diabetics their sugar response to meals, exercise, and stress. Levels of around 70-90 milligrams per deciliter of blood (mg/dl) are good for morning fasting, and levels of 140-200 are responses to a meal. Blood levels that hover over 300 mg/dl all day indicate a problem with diabetes control, and a visit to your diabetes health care team is in order.
It has been difficult to recommend exercise to many persons with diabetes. Many are overweight and exercise has not been a part of their lifestyle for years (if ever). Another reason is that they relate exercise with physical education classes such as kickball and calisthenics. Many have never seen the inside of a health club, or many new products that have been developed for home-based exercise.
The key to a sound program is maintaining a good blood sugar level. Exercise has the ability to enhance blood sugar usage, and keeps levels close to normal. It is when blood levels remain chronically high that we begin to see the complications mentioned above. Exercise may be beneficial to prevent complications, and persons with long standing diabetes may effectively perform regular exercise, as a recent report from Royal Victoria Hospital in Ireland. Their subjects with long standing diabetes performed as well on exercise tests than did controls. Other research points to the fact that regular exercise may be beneficial for persons with diabetes - whether they have been diagnosed from 2 years to 20 year prior.
How can exercise help? Conditioning has the ability to drive blood sugars into muscle cells for energy. This lowers blood sugar levels both short term, and long term. The key is to be regular in exercise, and monitor blood sugars after your program.
What is a good program? Start by daily walking. Unless you have problems with your feet, walking can play an important part in controlling blood sugars, and getting you into the groove of regular exercise. treadmills , aerobic products , heart rate monitors
Another important aspect of exercise is resistive training. Once shunned by doctors as too aggressive for diabetes, it is now considered as good as aerobic training in lowering blood sugars and improving muscle function. However, strength training programs require some up front instruction to assist in creating an optimal program. Instructors can also recommend specific types of equipment - such as proper shoes for walking, and home exercise products that will be beneficial in helping maintain an optimal program for months to come.
strength products ,
exercise balls ,
resistance bands , wearable weights
A sample home exercise program is highlighted below:
PHASE I - INTRODUCTION PHASE
Walking
4-6 days
per week Moderate pace - break a
sweat during the exercise
monitor heart rate during
exercise and blood sugars
afterwards. Stretches after
each
exercise session
PHASE II - COMBINATION PROGRAM
Walking or home exercise
machine 3
days per
wee
k
Moderate
intensity
-50-60
percent maximal
effort
Strength
training 2
days
per week.
Use
major muscle groups on
exercise
days to train using 2-3
sets
Ball squats 2
sets 10 reps
Dumb
bell flies 2 sets
10 reps
Ankle weight leg curls 2 sets 10 reps
Calf raises on stairs 2 sets 15 reps
Resistance band rows 2 sets 10 reps
Ball crunches
2 sets
10-15 reps
Resistance band biceps 2
sets 10 reps
Resistance
band triceps 2 sets
10 reps
Each session ends with five minutes of stretches. Then - monitoring of blood sugars. This is important because as you get in better shape, you will use more blood sugar as fuel - hence you levels will drop during exercise. You want to avoid hypoglycemia, or low blood sugars after your workout. Testing is the only way you will know when your levels are low enough that you should consume some carbohydrate.
Other exercise tips. Train at about the same time each day. This will also have a beneficial effect on your blood sugars, insulin injections, and general mood. Watch for the signs of hypoglycemia, such as jitters, queasiness, dizziness, nausea, or blurred vision that is unlike a normal response to exercise. Remember that even regular moderate exercise has tremendous benefits on improving diabetes health. With initial education and instruction, and the selection of proper equipment, you can make great strides to better health with one of the three elements of diabetes care - exercise.
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