Exercise and Diabetes

exerciseanddiabetesDavid B. Gealt, DO
Director, Sports Concussion Program
Assistant Director of Sports Medicine
Cooper Bone and Joint Institute

Diabetes is a disease that affects 20.8 million people or 7 percent of the population. Unfortunately, it is the sixth leading cause of death in the United States; and the amount of people affected with the disease is rising due to the increase in obesity within our population. The disease is characterized by an increase in blood sugar due to the inability of the body to produce insulin or the body’s resistance to the action of insulin. Insulin is an important hormone made by the pancreas that allows glucose, or sugar, to enter cells.

There are many forms of diabetes. The most common types are type I and type II. Type I diabetes is usually diagnosed in childhood or adolescence and occurs because the body cannot produce and secrete insulin properly. Of Americans, 5-10 percent have this type of diabetes. Many people who need to inject insulin have this form of diabetes. Type II is usually known as adult onset diabetes and usually affects overweight or sedentary individuals. It is due to the body’s resistance to insulin and is associated with insulin insufficiency. Of Americans, 90 percent have this type of diabetes. People with this form of diabetes usually take oral medications but may require insulin.

There are two other main forms. Pre-diabetes affects people who have high blood sugar levels but these levels are not high enough to classify them as type II diabetics. Gestational diabetes is diabetes that occurs during pregnancy.

Benefits of Exercise for Diabetes Patients

The United States is facing an epidemic of obesity and an increase in the number of diabetic patients. Exercise with a diagnosis of diabetes helps to keep weight under control. It helps to decrease one of the complications of diabetes which is cardiovascular disease. Exercise can also increase the body’s sensitivity to insulin and it can improve regulation of blood glucose.

Complications

Certain diabetic complications will stop someone from being able to exercise. Luckily, these complications do not often show themselves early in the course of childhood diabetes. Adults with diabetes may have certain restrictions; and they may need an EKG to check for cardiovascular complications if they have had the disease for a long time.

Adults with peripheral neuropathy (a complication that leads to numbness in the feet) or microangiopathy (where small vessels become thicker, weak, and may leak) should avoid pounding types of exercise. Patients with proliferative retinopathy (a condition where small vessels begin to grow in the retina) should avoid strenuous, pounding exercise, or exercise that excessively elevates blood pressure, exercise done underwater or while inverted.

If you have any of the above complications due to diabetes, consult with your physician. Attempts should be made to monitor your glucose level before and after exercise as well as during exercise to gauge fluctuations in blood sugar while active. Ideal control is definitely under 7 percent. You should also attempt to get your Hemoglobin A1C, which is a marker in your blood that tells how well your glucose is controlled over the life of a red blood cell (about 60-90 days), ideally between 6-7 percent. Control of your cholesterol, triglycerides, and blood pressure are also essential before you start an exercise program.

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