Exercise: Type, Extent, Merits and Demerits

Exercise is a physical activity which helps an individual for maintaining is ideal weight and to remain in good health. Depending on age and overall physical condition, exercise plays a very important role in the management program of diabetes. There are several good reasons why regular physical activity may be helpful. They are as follows:



1. By increasing physical activities, one expends certain calories; this can help in achieving weight reduction. Thus continued regular exercise can help to keep the weight off.

2. With vigorous and regular exercise, the number of insulin receptor sites seems to increase, making the available insulin more efficient.

3. The physical activity may have a medication-like effect and assist in glucose utilization. With regular exercise, there is lowering in blood sugar level and so medication requirements may get reduced.

4. A regular exercise program increases cardio-respiratory reserve. This may slow development of cardiovascular (heart and blood vessel) complications. Exercise also lowers cholesterol and other blood fats.

5. Exercise brings about an overall sense of well-being. It helps to relieve tension, anxiety and depression. Physical fitness guarantees physical and emotional health.


Before starting an exercise program

If one has not been very active, discuss exercise with the physician before setting out on one’s own. Wrong exercise for the wrong person can be harmful. Types of exercise for and how much is best for one will depend on one’s physical and metabolic status.

Some precautions may be necessary. Certain activities may not be recommended if the sensation in one’s feet is reduced or if circulation is poor. One will need good running shoes, if jogging is one’s choice. Sturdy, comfortable shoes are also important for walking.

If one is on insulin, one may need to adjust food intake or insulin dosage before embarking on physical activity.


You can do it

If one is seriously overweight and not very active, one may resist the idea of exercising. Hauling around extra weight is hard enough. Also, high blood sugar may have one drained of energy, leaving him too tired to do much.

However, once one gets going, one will probably begin to feel better and smart. Together with a controlled diet, one will be rewarded by seeing the pounds disappear.

If one has been inactive and dislikes the idea of exercising, one may try some simple activities. For example, try waking up the stairs instead of going up on an elevator, or try walking instead of driving short distances, or do some simple exercises even while watching television, or do the usual chores at a little faster speed.

Exercise tends to lower the blood sugar in the diabetic in whose body there is an adequate supply of insulin, whether this be of endogenous or exogenous origin. This effect is so striking and so beneficial that exercise along with diet and insulin is now accorded a definite and prominent place in the everyday treatment of diabetes.” (E.P. Joslin).


Two kinds of exercise

Activity based on exercise is rhythmic and repetitive and uses one’s large muscles, such as those with in the back and legs. This type of exercise helps make the entire cardiovascular system work proficiently. Called isotonic or aerobic exercises, they include such activities as walking, jogging, cycling and swimming.

Isometric activities, i.e., contacting the muscles against an immovable object, build the muscle strength but do not improve cardiovascular fitness.

Whatever one wishes to do, we need to work into it gradually; we should not exercise to the point of exhaustion or soreness unless well trained. If one is too ambitious in early activities and gets tired or exercised limbs begin to hurt, this may discourage and make one quit the program.

And finally, one should note that while exercise may improve blood sugar, the benefits may last only as long as one continues to do it regularly.


Benefits

1. Can lower blood glucose levels during and after an exercise session.
2. Increases sensitivity of body cells to insulin.
3. Increases physical fitness.
4. Strengthens the heart and lungs.
5. Decreases total cholesterol and increases HDL cholesterol (the ‘good’ cholesterol).
6. Lowers blood pressure.
7. Has psychological benefits–—improves self-image, helps manage stress, improves mood and decrease anxiety.


Risks

1. Problems with eyes, kidneys and nerves may be worsened.
2. Blood pressure during exercise may rise higher in persons with diabetes than in persons who do not have diabetes.
3. Insulin deficiency with poor control of exercise can cause a further rise in blood glucose levels.
4. Blood glucose may drop too low during or after an exercise continued for long duration. This can happen even long after exercise, e.g., four to ten hours.

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