Diabetes and the Benefits of Exercise
Steven McCune, PT, PES
Procore Physical Therapy P.C.
For all of us, exercise is essential for good health. The benefits of exercise include weight management, cardiovascular improvements, and managing blood pressure, as well as the esthetic advantages.
For an individual with diabetes, exercise is even more important. The greatest benefit of exercise to a person with diabetes is that it is a natural and healthy way to manage sugar and keep sugar levels in an appropriate range.
In simplest form, diabetes is a situation when the body does not properly use or produce insulin. Insulin helps sugar get into body cells, which the cells use as fuel to drive many bodily functions. When there is an insulin shortage, the cells do not get the sugar fuel that is required to run the body. Instead, all this excess sugar builds up in the bloodstream because it cannot find a way into the cells.
The World Health Organization has called diabetes an epidemic with approximately 150 million people suffering from it worldwide. This number is expected to double in 20 years. Exercise is and will be important to so many of these people.
In all individuals, when the body is exercising a chemical is produced called nitric oxide which activates certain proteins that help the cells suck sugar into them without the need of insulin. For people with diabetes, the greatest benefit of exercise is that the sugar gets into the cells without or with less the need for insulin medication.
While this effect is important for a person with diabetes, it is not the only benefit of exercise. The systems of the body that benefit from exercise in anyone tend to be weaker in people with diabetes. Therefore, the same reasons every person should exercise are magnified in a person with diabetes.
However, an exercise program for a person with diabetes should be structured to avoid overly strenuous workouts because of potential side effects. It is very important that individuals with diabetes and their health care providers be educated and aware that the body's systems are more easily overloaded in a person with diabetes.
For example, early onset of fatigue and higher blood pressures are associated with circulation problems inherent to diabetes.
Because the eyes and the vestibular (balance) systems are affected, it is important to include safe elements of balance training and allow for slower reaction times.
Since sugar goes from the blood into the cells during exercise, the sugar levels in the blood drop significantly. This can be potentially dangerous. So you always want to make sure the sugar level in the blood is OK before the onset of exercise. For someone with diabetes, you want the sugar (glucose) level to start around 120-130.
If the glucose level is at 80 before they begin exercise, there is a significant risk of fainting due to hypoglycemia (low blood sugar level).
It is also recommended to test the sugar level 2 hours after exercise to avoid a hypoglycemic episode, and is also why we don't suggest exercise before going to bed.
Proper footwear for exercise is imperative because of the increased risk of developing blisters and sores as a result of decreased sensation and circulation in the feet. Appropriate footwear includes a good fit, with the least number of seams the better because seams can cause blisters. There are companies that make shoes and sneakers with these factors in mind. There are even specially designed socks that are thicker, stretch better and even ones that release oil when you step on them to keep the foot properly lubricated. Insoles are also available that help pull moisture away from the foot so you don't get overly sweaty feet.
Exercise has many important benefits for all of us. And for those of us with diabetes the importance and the benefits are magnified. Exercise, when done properly and with knowledge of the complexities of diabetes, can be one of the best means to a longer, healthier life. Good Luck and Have Fun.