Hey doc, I heard exercise can reverse diabetes. Is that true?
egular exercise is probably one of the most commonly prescribed treatments by doctors these days. When it comes to managing diabetes, exercise has remained the main treatment in addition to diet and medication. There is a robust evidence base supporting the role of exercise in controlling diabetes is effectively.
If you suffer from type II diabetes, then this article is for you.
Let’s take a look at how exercise can help reverse diabetes.
Normal physical activity
If you are someone who does not have diabetes, then you may be quite amazed by the way the body handles blood glucose levels during physical activity.
In order to meet the energy than the body needs in during activity, different components such as triglycerides, glycogen and free fatty acids breakdown and produce glucose.
This glucose provides energy on the muscles and tissues to function during excess activity. It is very uncommon for blood glucose levels to drop markedly in people who do not have diabetes.
However, in those who suffer from diabetes, these regulatory mechanisms are faulty and sugar levels can drop. This is particularly seen in those who are on medication especially insulin.
If you are looking to take up an exercise program, it is important for you to undergo certain medical tests to ensure that it is safe to do so.
Your doctor will organize a specific number of investigations after going through your history and performing a physical examination.
Your physical examination will include examination of the heart, kidneys, blood vessels, eyes, nervous system and the feet.
To ensure you do not have heart disease, you may be asked to undergo an exercise treadmill test.
The current recommendation is that all individuals who have diabetes and are aged over 35 years must have an exercise test.
If you are above 25 years of age and have had Type 2 diabetes for more than 10 years, then the treadmill test is certainly in order.
The presence of specific risk factors that can increase your chances of developing heart disease also requires a treadmill test.
However, if you are only planning a simple exercise routine such as gentle walking, a treadmill test may not be necessary.
The actual role of a stress test before starting an exercise program remains controversial. Furthermore, there is no clear guideline whether a treadmill test is required if you plan to undertake weight training and resistance training.
Simple solution? Follow your doctor’s advice.
The Blood Vessels
Diabetes can affect the blood vessels that supply oxygen rich blood to the legs. This is known as peripheral arterial disease.
A simple clinical examination can help determine if the circulation of the leg is intact. However, in order to confirm can intact circulation, an ultrasound doppler scan may be performed.
The current American Diabetes Association guidelines are clear when it comes to eye care.
If you have just been diagnosed with type 2 diabetes, then make sure you visit your eye doctor as soon as possible. Diabetes can affect the eyes in a number of ways and it is essential that you follow the advice of your eye doctor carefully.
For those in whom proliferative diabetic retinopathy (new blood vessels at the back of the eye) is present, strenuous activity such as weightlifting and similar straining should be avoided.
There are no clear-cut guidelines when it comes to what activities individuals should and should not do when they have kidney disease. Your doctor will guide you with regards to this bearing in mind your underlying blood pressure.
If you do have kidney disease and a high creatinine, then you will be advised not to have protein supplements or a high protein diet.
If your diabetes is affecting the function of your nerve fibers, then it is important to limit any ‘weight-bearing’ exercises.
For example, running long distance without wearing well fitted protective footwear can lead to the formation of ulcers and injuries to the feet.
Make sure you have a good pair of shoes before you begin running.
The nerve involvement does not only involves those nerves that supply the feet. Autonomic neuropathy is a recognised complication of diabetes that can cause the heart rate can increase and the blood pressure to fall with change in posture.
If you are suffering from autonomic neuropathy due to diabetes, then vigorous physical activity is not recommended as your blood pressure can change and fluctuate markedly. Furthermore, performing physical activity in extreme temperatures can make things worse.
Be careful if you plan on stepping up your exercise routine in the future.
Exercise is a lot of fun. Make sure you are prepared to enjoy it once you get started.
You may have heard of the words ‘warm-up’ and ‘cool down’. It is important to have a good warm-up session and cool down session before and after each exercise routine.
A strategic warm-up session can help improve the blood flow to the muscles and can prepare the heart and lungs for the exercise. After you have warmed up a little, gently stretching the muscles for about 5 to 10 minutes is recommended. You could either warm-up the muscles that you are about to use for your exercise routine or you could perform a gentle overall muscle warm-up.
After your exercise routine has concluded, a cool down must be done. This is very similar to how a warm-up has done and should last about 10 to 15 minutes in total. The aim of the cool down is to help the muscles relax after the exercise and to reduce the heart rate back to normal.
You may need to take certain precautions if you suffer from any of the complications of diabetes.
For example, if you have been prone to developing low blood sugars i.e. hypoglycemia, then make sure you carry with you some glucose tablets and where a diabetes identification bracelet. This is particularly important if you are taking insulin injections.
A simple way to prevent hypoglycemia during exercise is to check your blood sugars before and after a session of physical activity.
Make sure you are well hydrated before you begin your exercise routine.
It is recommended that half a liter of water be consumed about two hours before any physical activity.
If the activity is going to be a strenuous one, then make sure you take sips of water throughout the routine in order to replace the water that is lost through sweat.
If you have diabetic neuropathy, then comfortable shoes are a must and insoles can be worn to prevent blisters and ulcer formation.
‘Get Going’ And Reverse Diabetes
The American Diabetes Association recommends 150 minutes of ‘moderate intensity’ aerobic exercise every week.
This would average up to 30 minutes of exercise every day for five days a week. Ideally though, exercise must be performed regularly rather than just five days a week.
There is no clear guideline, but amongst us Indians, if you are looking to reverse diabetes, then try and do some form of cardiovascular exercise at least 60 minutes a day. You can split this into small sessions if you cannot do it all in one go.
So, how can exercise reverse Type 2 diabetes?
There are a number of different mechanisms.
Better Insulin Sensitivity
Individuals with diabetes are less sensitive to the insulin that is secreted by the pancreas. This phenomenon is called ‘insulin resistance’ and is the core reason for the development of diabetes.
Clinical studies have shown that even one week of aerobic exercise can improve insulin sensitivity in individuals with type 2 diabetes.
While moderate to vigorous exercise seems to have a better effect, even lesser intensity exercise can also help.
What does this mean?
In simple terms, it just means that exercise makes whatever insulin your body is producing more effective.
This is because the exercise can improve the ability of the muscles to respond to insulin. This in turn helps push glucose into the muscle to provide it with energy.
Clinical trial data has shown that a single bout of moderate intensity aerobic exercise can improve insulin sensitivity for 24 to 72 hours. This depends on how intense your exercise routine was.
It is recommended that there should not be more than two consecutive days without any aerobic physical activity.
Reduced Body Fat
When exercising regularly, the body fat utilization increases and the amount of body fat reduces over a period of time.
A lower body fat is directly linked to better blood sugar control.
As the body fat content falls, the body weight also falls. It is important however to combine your exercise routine with a low-fat diet.
Better Heart Health
It is a well-known fact that exercise improves the health of your heart.
It can lower cholesterol, reduce body weight, maintain healthy blood pressure and control insulin levels.
Exercise regularly and you can keep your heart strong.
Better Blood Glucose Control
Clinical studies have shown that those individuals who exercise regularly can reduce the HbA1c values by nearly 10 to 20%.
Interestingly, when exercising, it is very unlikely for the blood sugar levels to drop and cause hypoglycemia.
This is because the exercise can not only help improve glucose entering into the muscles; it also increases the amount of glucose that is generated in the liver.
In other words, a balance is maintained between the glucose produced in the glucose utilised in the body.
But be careful if you are on insulin.
So What Do I Do Now?
Now that you are armed with information on how exercise can help reverse diabetes, it’s time for you to get on your feet!
If you have never exercised before, then don’t hit the ground running.
Set realistic goals. Start with short walks regularly and increase your duration and intensity of exercise over a matter of weeks to months.
Try and incorporate your exercise routine in your daily activities. For example, walk to the bus stop in the morning or to your local shop when you need to buy your groceries.
Some examples of aerobic exercises include walking, jogging, swimming, basketball, tennis and cycling.
Find exercise boring? Then ask a friend or family member to join you to make it fun and enjoyable.
Wish to take up weight training? If your doctor says it is okay, then most certainly do so. The increased muscle mass that develops with regular weight training will improve the way glucose is used. This will in turn reduce blood sugar levels and keep them under control.
Got to choose between the elevator and stairs? Then take the stairs. You will burn calories with every step up or down.
Mix-and-match. Do cardio on one day and resistance training another day. You can do both the same day if you wish to!
Remember that exercise alone cannot completely reverse diabetes. It is important that you make the right lifestyle changes and dietary changes to make it work for you.
Just exercising when you feel like it will not be of any good. You have to commit to make a change in order to bring down your sugars and possibly reverse your diabetes completely. Exercise with a partner can motivate you to achieving your goals.
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