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Sweat it out and control blood sugar

How exercise helps you manage your diabetes.

By Christian Obmerga

NOVEMBER 2013

We all know that physical activity is an indispensable tool in keeping the body fit and lowering the risks for numerous ailments. But does it offer any benefit for the sick, say diabetics? The U.S. National Diabetes Information Clearinghouse suggests it does, listing the following research-based benefits of physical activity for patients with diabetes:

• lowers blood glucose and blood pressure

• lowers bad cholesterol and raises good cholesterol

• improves body's ability to use insulin

• keeps the heart and bones strong

• keeps joints flexible

• lowers risk of falling

• helps lose weight

• reduces body fat

• gives more energy

• reduces stress levels


Hannah Urbanozo, M.D., chief fellow with the UP-Philippine General Hospital, Section of Endocrinology, Diabetes and Metabolism, concurs, “Even those who are just at risk of developing diabetes—the ones who have pre-diabetes—are benefited by regular physical activity. ” Citing the article on nejm.org published by The Diabetes Prevention Program Research Group in 2002, Dr. Urbanozo says that “…people with pre-diabetes who did moderate intensity activities such as brisk-walking for a half-hour, at least five times a week and lost five to seven percent of their total weight cut their risk of developing full-fledged diabetes by about 58 percent.”

For patients who already have the condition, regardless of type, Dr. Urbanozo recommends having “at least 150 min per week of moderate-intensity aerobic physical activity, spread over at least three days per week with no more than two consecutive days without exercise.” Experts recommend activities like walking, swimming, dancing or gardening. Resistance exercise or those exercises that involves weights in particular has also been shown to decrease insulin resistance, Dr. Urbanozo adds.


Keep in mind

Before you start any physical activity, consulting your doctor is the first step to optimizing the activity’s benefits and to prevent any untoward incident. Dr. Urbanozo says, “[T]he patient has to be assessed for the presence of cardiovascular risk factors so as to tailor their exercise program properly.”

She also advises the following:

• High-risk patients should be started on low-intensity, short duration exercises. There are also contraindications to vigorous exercise such as uncontrolled hypertension, severe neuropathy and the like.

• Include a proper warm-up and cool-down period. Five to 10 minutes of low-intensity aerobic activity, such as walking or cycling, prepares the skeletal muscles, heart and lungs for a progressive increase in exercise intensity. Then, gently stretch the muscles for another five to 10 minutes. After the activity, a cool-down structured similarly to the warm-up, about five to 10 minutes should be done to gradually bring the heart rate down to its pre-exercise level.

• Hydrate. Proper hydration is essential, as dehydration can affect blood glucose levels and heart function adversely. During exercise, fluid should be taken early and frequently in an amount sufficient to compensate for losses in sweat reflected in body weight loss, or the maximal amount of fluid tolerated.

• Measure blood glucose before and after the activity. Certain conditions of type 1 diabetic patients require them to stop physical activity (see sidebar).

• Keep readily available carbohydrates handy, such as candy and juice, in case of hypoglycemia. In individuals taking insulin or oral medications that stimulate insulin secretion called insulin secretagogues—physical activity can cause hypoglycemia if medication dose or carbohydrate consumption is not altered. Thus, added carbohydrate should be ingested if pre-exercise glucose levels are <100 mg/dL (5.6 mmol/L).

• Have a glucometer at hand to check for immediate changes in blood sugar before and after exercise. This is especially important for insulin-dependent diabetics, who are more prone to hypoglycemia (blood sugar <70 mg/dl) and severe hyperglycemia (blood sugars beyond 250 mg/dl) if insulin administration is erroneous. “Both conditions may be worsened by exercise, but they are preventable,” says the endocrinologist.


Get more facts about diabetes and how to handle it in the November issue of HealthToday.










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