Nutrition Meets Food Science

Managing Diabetes with Physical Activity

Physical activity or exercise is being recognised by more people as an essential part of our lifestyle. Earlier we used to travel less by vehicles or escalators and used to have walks not only to reach our destinations but as a pleasant pastime. Now we hardly walk and our pastime is with electronic gadgets. So people have become lethargic and sedentary. This is one of the prominent risk factors for type 2 diabetes. This along with other factors such as obesity and high blood sugar etc. causes insulin resistance. To prevent onset of diabetes it is always better to start the physical activity and do it on a regular basis. It has been noticed that even after a person has been diagnosed as diabetic, he or she can keep the sugar under control with the help of physical activity and in many cases improve the insulin sensitivity. 

Research has shown that physical activity not only helps people reduce the risk of diabetes but also helps people with diabetes. American Diabetes Association (ADA), American College of Sports Medicine, and Academy of Nutrition & Dietetics among others are recommending physical activity for diabetics which not only helps manage sugar levels but there are other benefits. 

Benefits of Physical Activity

Physical activity or exercise is beneficial for those who have diabetes. For diabetics this also helps control weight, lower blood pressure & harmful LDL cholesterol, raise healthy HDL cholesterol, strengthen muscles & bones and reduce anxiety. Specifically exercise controls blood glucose levels and improves sensitivity to insulin. 

Exercise lowers blood sugar in two ways, firstly by decreasing insulin resistance. Thus cells can use available insulin more effectively to absorb sugar from blood for energy. Exercise also stimulates a mechanism enabling muscles to absorb and utilise sugar for energy even without insulin. So when muscles contract during physical activity, cells are able to take up glucose and use it for energy purpose whether insulin is available or not. Not only does exercise control sugar in the short term but long run exercising contribute to lower the glycosylated haemoglobin values in diabetics.

Sedentary lifestyle is a major risk factor for developing type 2 diabetes. High incidence of obesity and overweight in diabetics is highly correlated with inactivity. Starting a workout can lower BMI and decrease the insulin resistance of type 2 diabetics. Along with medical and nutrition therapy, exercise has been recognised as one of the first lines of defence in type 2 diabetes control.

Blood Sugar Response & Exercise

The effect of physical activity on sugar level in blood will depend on time of activity and some other factors. It can lower blood sugar up to 24 hours or more after the workout by making body sensitive to insulin. Keeping a tab on sugar level under doctor’s care would help understand how body reacts to different activities. This will help exercise caution to prevent blood sugar going too high or too low. This is especially necessary for those who are on insulin medication. 

Talking to diabetes care persons such as doctor, nurse, dietitian etc. regarding how to manage proper insulin dose, carbohydrate intake and exercise is extremely essential to avoid hypoglycaemia and for care if one experiences hypoglycaemia during or after exercise. 

Physical Activity Needed

American Diabetic Association (ADA) recommends 

  • At least 2.5 hr. moderate to vigorous physical activity such as brisk walking, swimming etc. per week 
  • 2 or 3 sessions of resistance exercise such as lifting 2 kg weight or push ups per week to strengthen muscles
  • Avoid sitting longer than 30 min continuously 
  • Add flexibility exercises such as stretching and yoga
  • Avoid break from physical activity more than 2 days

Medical Advice

Before starting an exercise program diabetics should consult a physician. This is more important for those with certain diabetic complications and those taking insulin medications to prevent hypoglycaemia where blood sugar may go too low due to exercise. 

In general, it is advisable to exercise 1 to 3 hours after eating, when blood sugar level is likely to be higher. In insulin users, checking blood sugar level before exercising is important. If the glucose level is below 100 mg/dL, eating a piece of fruit or a small snack will boost it and avoid hypoglycaemia. Also for insulin users, there is a risk of developing hypoglycaemia 6 to 12 hours after exercising. Thus medical advice before starting exercise program is very essential for diabetics especially those using insulin.

Staying Safe While Exercising

It is always better to keep a log of activities and sugar levels before and after exercise. Meticulous record helps plan and alter the exercise as well as diet before and after the exercise. 

Staying hydrated is also important and more so for diabetics as dehydration is associated with blood sugar levels. ADA also recommends warm up and cool down before and after the exercise. 

When one is starting the exercise after a long inactive life it is better to start slow and gradually build up the stamina and to manage the sugar levels over time as there are lesser dangers. Another precaution should be exercised by diabetics is to carry cell phone and have access to medical services. 

No matter you are a diabetic or not, indulging in physical activity not only keeps you fit and fine but also prevents onset of various diseases. Also, your entire body helps you in doing so many day to day activities without a complaint, so don’t you think you owe it some appreciation in some way.  So, what are you waiting for? Put your shoes on and take a step forward towards your body fitness.

References

https://www.health.harvard.edu/staying-healthy/the-importance-of-exercise-when-you-have-diabetes

https://dlife.com/exercise-diabetes-control/

https://care.diabetesjournals.org/content/39/11/2065

https://www.eatright.org/health/diseases-and-conditions/diabetes/physical-activity-and-diabetes

Authors

Ms. Swechha Soni

Manager – Food & Nutrition

PFNDAI

 

Jagadish PaiDr. Jagadish Pai

Executive Director

PFNDAI

Swechha_Soni

Manager - Food & Nutrition, PFNDAI

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