Exercise guidelines for diabetics

Couple on bikes outdoors smilingElliott Joslin, the father of modern diabetes, mentioned dietary management along with exercise and insulin injections as the cornerstones of diabetes therapy in the 1920s.

A Regular exercise programme, undertaken after due fitness evaluation, is an essential part of modern diabetes management. Regular exercise not only improves blood sugar control, but also has several other benefits.

Inactive adults have approximately twice the risk of premature death and serious medical illness as compared to active individuals. The benefits of regular exercise can be any or all of the following:

• Lowering of blood glucose levels
• Improved insulin sensitivity — Insulin sensitivity can increase by as much as 40% in a person who exercises regularly, even if there is no weight loss
• Reduced blood pressure
• Lowering of glycosylated haemoglobin levels
• Decreased triglyceride levels
• Increased HDL (good) cholesterol
• Conditioning of the heart
• Increased strength and flexibility
• Reducing the fat in the body and increasing the muscle mass
• I mprovement in sense of well-being and quality of life.

During exercise, the body uses two sources of fuel, sugar and
free fatty acids (fat) to generate energy. The sugar comes from the blood, the liver and the muscles. The sugar is stored in the liver and muscle in a form called glycogen.

During the first 15 minutes of exercise, most of the sugar comes from either the blood stream or the muscle glycogen that is converted back to sugar. After 15 minutes of exercise, however, the fuel starts to come more from the glycogen stored in the liver. After 30 minutes of exercise, the body begins to get more of its energy from the free fatty acids. As a result, exercise can deplete sugar levels and glycogen stores.

The body will replace these glycogen stores but this process may take 4 to 6 hours, even 12 to 24 hours with intense activity. Exercise also increases the basal metabolic rate, which remains high for next three to four hours after exercise. This means the body continues to utilise and burn more calories
even after the exercise is over. Therefore, moderate to intense exercise can cause the blood sugar to drop for the next 24 hours following exercise.

Mild exercise also induces release of certain chemicals known as opioids from the brain. These opioids have appetite reduction property. Therefore, mild exercise in combination with proper diet is effective in blood sugar control. On the contrary, severe exercise induces fatigue and stimulates appetite.

If properly followed, a regular exercise schedule has beneficial results for the diabetics. However, if done carelessly, it can be deleterious for the diabetics. Therefore, one should know:

1. Exercise guidelines: how long, how hard, how often and when to exercise?
2. How to prevent high and low blood sugars during and after exercise?

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