Types And Classifications Of Diabetes And Prediabetes
Physical activity recommendations and precautions may vary by diabetes type. The primary types of diabetes are type 1 and type 2. Type 1 diabetes results from cellular-mediated autoimmune destruction of the pancreatic -cells, producing insulin deficiency . Although it can occur at any age, -cell destruction rates vary, typically occurring more rapidly in youth than in adults. Type 2 diabetes results from a progressive loss of insulin secretion, usually also with insulin resistance. Gestational diabetes mellitus occurs during pregnancy, with screening typically occurring at 2428 weeks of gestation in pregnant women not previously known to have diabetes. Prediabetes is diagnosed when blood glucose levels are above the normal range but not high enough to be classified as diabetes affected individuals have a heightened risk of developing type 2 diabetes but may prevent/delay its onset with physical activity and other lifestyle changes .
Common Exercise Mistakes In Diabetes Management
Six Key Tips For Physical Activity In Adults With Type 2 Diabetes
The consensus statement gives six key tips for physical activity in adults with type 2 diabetes, as follows.
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Regular aerobic exercise improves glycemic management meta-analyses have reported fewer daily hyperglycemic episodes and reductions in A1c of 0.5%0.7%.
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High-intensity resistance exercise, when performed safely, is better than low-to-moderate intensity resistance exercise for glucose management and attenuation of insulin levels. Resistance exercise typically results in improvements of 10% to 15% in strength, bone mineral density, blood pressure, lipid profile, skeletal muscle mass, and insulin sensitivity.
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Exercise after meals, such as taking a walk after dinner at one’s own pace, takes advantage of the blood glucose-stabilizing effects of exercise.
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Reduce sedentary time by taking regular breaks for small “doses” of physical activity, which can modestly attenuate postprandial glucose and insulin levels, particularly in individuals with insulin resistance and a higher body mass index.
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To prevent hypoglycemia during or after exercise, people taking insulin or insulin secretagogues should increase carbohydrate intake, or if possible, reduce insulin.
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People who are taking beta blockers should not rely on a heart monitor to measure workout intensity. They could ask a certified exercise professional about using ratings of perceived exertion to track how a workout feels.
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Keeping Active On The Move
Its surprising how a slight change of routine can increase your physical activity levels and help you feel better when youre living with diabetes. This could include:
- getting off the bus or tube one stop earlier, or parking further away from your destination
- taking the stairs instead of the lift or escalator
- using your food shopping as weights
- cycling
- walking.
The Benefits Of Any Kind Of Exercise
Sure, there are more things to think about and prepare for when exercising with type 1 diabetes. But there are also extra benefits! In addition to getting stronger, improving heart health, decreasing stress, aiding weight management and loss and improving general mental health, those with type 1 diabetes can see these benefits:
- Muscles are better at absorbing glucose when they are contracted. This increased glucose uptake by your muscles increases insulin sensitivity the opposite of insulin resistance, a problem when the body requires more insulin to process glucose.
- Exercise slows carbohydrate absorption, better using the glucose it has and reducing the insulin you need. This counteracts after-meal hyperglycemia.
Type 1 diabetes should never hold you back from your fitness goals. There are no exercises specifically for people with diabetes, any workout you want to do is possible. There will be highs and lows as you figure out what works for you, but dont let them get you down! Youve got this!
T1D athlete Maddie Maloney uses a combination of yoga and meditation to get in the right headspace for exercise. Watch her explain how she does it.
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Exercise Makes It Easier To Control Your Diabetes
When you have type 2 diabetes, physical activity is an important component of your treatment plan. Its also important to have a healthy meal plan and maintain your blood glucose level through medications or insulin, if necessary.
If you stay fit and active throughout your life, youll be able to better control your diabetes and keep your blood glucose level in the correct range. Controlling your blood glucose level is essential to preventing long-term complications, such as nerve pain and kidney disease.
Staying physically active helps boost your overall wellness, especially if you have type 2 diabetes. Photo: 123rf
The Time Of Day You Exercise May Also Affect Your Insulin Needs
For example, in the morning, glucose levels tend to decrease less with exercise because hormones produced in the morning help raise glucose levels. On the other hand, in the afternoon, levels of the same hormone fall, so you may need to temporarily reduce your insulin dose to prevent hypoglycemia.
Its important to always consult with your healthcare provider before you make any adjustments to your medications to find what works best for you and your level of physical activity.
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Yoga Reduces Stress For Blood Sugar Control
Say om: Like tai chi, research shows that if you have diabetes, yoga can help reduce stress and manage the condition, according to a review published in September 2018 in Endocrinology and Metabolism. When stress levels go higher, so do your blood sugar levels, says Colberg.
One of the advantages of yoga as an exercise is that you can do it as often as you like. The more the better, she says. A study published in March 2017 in the Journal of Physical Activity & Health concluded that exercise helps lessen depressive symptoms in adults with type 2 diabetes.
Exercises For People With Diabetes
Try to make a habit of doing the following exercises on a regular basis, Cotey says. Theyll give you the maximum benefits to help you manage your diabetes, and are relatively easy to fit in each day.
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Orthopedic And Overuse Injuries
Active individuals with type 1 diabetes are not at increased risk of tendon injury , but this may not apply to sedentary or older individuals with diabetes. Given that diabetes may lead to exercise-related overuse injuries due to changes in joint structures related to glycemic excursions , exercise training for anyone with diabetes should progress appropriately to avoid excessive aggravation to joint surfaces and structures, particularly when taking statin medications for lipid control .
How Much Exercise To Aim For
The amount of exercise you’ll want to plan for will depend on your personal fitness goals. If you’re just starting out, aim for just one or two 10-minute exercise sessions per week, then build up to five or more 30-minute sessions weekly. Because people with diabetes often have complicated health concerns, its important to talk with a medical professional or healthcare provider before beginning a cardio training regimen. If you’re over 35, you may need a stress test.
The American Heart Association recommends adults get at least 150 minutes of moderate-intensity exercise each week, which works out to five 30-minute cardio sessions per week.
Achieving and maintaining a higher-than-normal heart rate is the basic goal of a cardiovascular workout, and can be a good metric to reference for intensity level. Different people have different target heart rates and will want to maintain those rates for different lengths of time. Heart-rate monitors can help determine these metrics. A practitioner or healthcare provider also can help with these determinations.
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Diabetes Exercise And Foot Care
People who have had diabetes for a long time or those who have consistently high BGLs are at higher risk of developing foot problems. If you have nerve damage to your feet this makes you more prone to injury and to problems such as foot ulcers.
The health of your feet should be checked regularly by a podiatrist to make sure you are safe to do the exercise you are planning.
You can prevent foot injuries and infections by:
- wearing well-fitting socks and shoes check that shoes are long enough, wide enough and deep enough
- wearing the right shoe for the activity you are doing
- inspecting your feet daily
- having annual foot checks by a podiatrist
- reporting to your doctor any changes to your feet, such as redness, swelling or cuts or wounds, as soon as you detect them.
Why You Should Stay Fit And What Exercises To Do
Exercise is an absolutely vital part of type 1 diabetes treatment. Staying fit and active throughout your life has many benefits, but the biggest one for people with diabetes is this: it helps you control diabetes and prevent long-term complications.
Exercise makes it easier to control your blood glucose level. Exercise benefits people with type 1 because it increases your insulin sensitivity. In other words, after exercise, your body doesn’t need as much insulin to process carbohydrates.
If your child has type 1 diabetes, making sure he or she gets enough exercise is not only a great way to help manage his or her diabetes but also instill healthy habits from an early age. To learn more about how to safely incorporate exercise into your child’s routine, read our article about .
Exercise can also help people with type 1 diabetes avoid long-term complications, especially heart problems. As you can read about this in our article on , people with diabetes are susceptible to developing blocked arteries , which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesteroland that helps you avoid arteriosclerosis.
Additionally, there are all the traditional benefits of exercise:
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Lower blood pressure
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Stronger bones
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More energy
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What Is Medical Nutrition Therapy
Medical nutrition therapy is a service provided by an RD to create personal eating plans based on your needs and likes. For people with diabetes, medical nutrition therapy has been shown to improve diabetes management. Medicare pays for medical nutrition therapy for people with diabetes If you have insurance other than Medicare, ask if it covers medical nutrition therapy for diabetes.
Keeping Active At Home
If you’re spending time at home, there are lots of ways to get active and keep moving that much more. How about doing:
- on-the-spot walking during TV ad breaks
- stretches for your arms and legs whilst sat in a chair
- hoovering your home or washing your car
- using cans of food as weights
- gardening – if you have a garden. If you dont, do you have any house plants you can water, prune and re-pot while standing up?
It might help to pop some music on while youre doing this, especially if youre not in the mood to move. It can stop you concentrating on the time and help you feel motivated. For more inspiration, watch Zahoor explain how he manages to move more around his home in this We Are Undefeatable video.
If you need to start off at an easier pace, try standing during a TV advert. If you can manage it, work towards standing for the whole advert break, then to walking on the spot during adverts. You can mix this up by doing stretches instead, or jogging on the spot while the ads are on. This will help you get your steps up.
Everyones different, and some people find video workouts helpful to keep them motivated and follow a routine. There are lots to choose from, but the NHS fitness studio might be a good place to start. Whether youre into aerobics, Pilates, even belly dancing – there are plenty of options for beginners and experts. But remember to warm your body up first. We recommend this warm-up video from the NHS.
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Diabetes Exercise And Ketoacidosis
People with type 1 diabetes are at risk of developing a build-up of ketones if they are unwell or have forgotten to take their insulin.
If you have type 1 diabetes and you are unwell, avoid exercise until you feel better. If your BGL is above 15 mmol/L and you have positive blood or urine ketones, you need to clear the ketones from your blood before beginning exercise. Extra insulin is needed to clear ketones. Ask your diabetes health professional for an individual management plan.
People with type 2 diabetes are generally not at risk of developing dangerous levels of ketones and therefore do not need to check for them.
Different Types Of Exercise And How They Affect Type 1 Diabetes
Lifting weights at the gym. Running on a treadmill. Joining a soccer team. All three provide great exercise, all with a different effect on glucose control. From the professional athlete to the occasional power walker, people with type 1 diabetes can reap the benefits of exercise with the right management. Heres a rundown for you before you run.
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Will It Hurt Your Joints
Long-term diabetes can affect them. Over time, blood sugar starts to build up in them, a process called âglycation.â Good control over your disease can help delay it, but the longer you have the diabetes, the more likely it will happen.
Glycation can make your joints stiff and brittle. Pounding away with HIIT or making a lot of fast moves might be risky — one wrong move could lead to an injury. Routines that have you do the same moves over and over can cause problems. Stiff joints can also take a toll on your balance, setting you up for a fall.
Many people with type 2 diabetes take cholesterol medications called statins. They can cause muscle or joint pain, making it tough for you to do high-impact moves correctly or quickly. These drugs also make muscle or joint injuries more likely.
On the other hand, workouts like yoga, Pilates, and tai chi are good choices. Theyâll help you build your strength, balance, and flexibility.
Why Do Aerobic Exercise And Anaerobic Exercise Affect Your Glucose Levels Differently
Oxygen isnt the only difference between aerobic and anaerobic exercise. Your body also powers them differently. When youre working aerobically , fat and glucose provide energy.
Move anaerobically as you would during a sprint and the body pulls glycogen from the muscles to be used for fuel. The depleted glycogen stores and buildup of lactic acid during high-intensity anaerobic exercise are part of why the activity can make your muscles so tired.
Like aerobic exercise, anaerobic exercise burns calories and improves your cardiovascular health, insulin sensitivity and blood glucose management. Theres a big difference for your muscles, though: anaerobic exercise also improves power and builds muscle strength and mass.
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Being Physically Active Helps Your Mind And Body In Many Ways
Exercise has so many benefits, but the most critical one is that it makes it easier to control your blood glucose level. People with type 2 diabetes have too much glucose in their blood, either because their body doesnt produce enough insulin to process it, or because their body doesnt use insulin properly .
In either case, exercise can reduce the glucose in your blood. Muscles can use glucose without insulin when youre exercising. In other words, it doesnt matter if youre insulin resistant or if you dont have enough insulin: when you exercise, your muscles get the glucose they need, and in turn, your blood glucose level goes down.
If youre insulin resistant, exercise actually makes your insulin more effective. That isyour insulin resistance goes down when you exercise, and your cells can use the glucose more effectively.
Exercise can also help people with type 2 diabetes avoid long-term complications, especially heart problems. People with diabetes are are likely to develop blocked arteries , which can lead to a heart attack or stroke. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesteroland that helps you avoid high cholesterol and the build up of plaque that may block the blood from passing easily through your arteries.
- Lower blood pressure
- Increased level of good cholesterol
- Leaner, stronger muscles
- Stress management
But Before You Begin ExercisingYou should talk to your doctor