Diabetes is a main killer in present society which causes serious deadly complications. Heart disease is one of them that can ultimately end up in bed bound or death. These complications are directly targeted on groups that has poor physical activities. It’s true that we all are going through very tough life style, you may even have a very little time spend with your loved ones. But it is better you think about yourself also. It is very sad that only 38% of people who have diabetes engaged in routine physical activities.
Why heart diseases are common in Diabetes ?
Diabetes is a multi systemic disease which affects whole body. It can directly affects cardiovascular system which ultimately cause heart failure. This is caused by vessel wall damage to cause thrombosis, clotting of blood within blood vessels. And diabetes facilitates atherosclerosis which cause accumulation of atheromatic plaques. This happens with derangement of lipid metabolism.
Heart diseases can also occur due to direct damage to cardiac muscles. Cardiac muscle contraction and electrical activity of the heart can be deranged with high blood sugar levels.
How exercise can reduce heart diseases ?
Exercise or physical activities can improve the blood supply to cardiac muscles and skeletal muscles of the body. It causes effective clearance of reactive oxygen compounds which can damage the blood vessels and reduce formation of atherosclerotic plaques. It’s recommended that moderate intensity exercises like walking 30 minutes per day for 5 days a week.
Choosing a good exercise programme need much attention. It’s better to get advices from a specialist for selecting what are the exercises suits you. Because the level of damage caused by diabetes is differ from patient to patient. Therefore you need to follow an individualized exercise programme.
Let’s talk about how to choose a good exercise programme and what are the considerations you need think before start exercise programme.
It’s better you take advises from a specialist before planning a exercise programme.
They will evaluate you about,
- Cardiovascular risks you have like high cholesterol levels in blood, smoking, past history of chest pain or strokes. If you are in a high risk status it is better you start with short period of low intensity exercises and increase the intensity and duration slowly.
- You may be having conditions that can injured you during exercises such as hypertension, postural dizziness which is unsteadiness comes with standing from sitting position, lower limb numbness and instability, foot ulcers, poor vision.
- You may be having low blood sugar episodes frequently and especially exercise related ones. Exercise related hypoglycemia can cause blackouts and injuries.
- Your age and level of previous physical activities is also important. If you a person who had a very active life style you can easily go for high intensity exercises compared with others. Because your body can easily adapt to that situation.
- Your current blood sugar control is also a important factor which is accurately measured by HbA1C test. HbA1C test gives an idea about your blood sugar control within past 3 months. So recent high or low blood sugar episodes don’t affect the result.
- Your current treatment plan and the type of medications are considered before plan your exercise schedule. Because certain drugs can cause ,ow blood sugar rapidly. Therefore patients who are taking such medications should not attend to high intensity exercises.
Let’s have a look exercise types that is useful to you.
Brisk walking is a moderate intensity exercise that suitable for most of you. 3 to 5 days of aerobic exercise per week is recommended with no more than 2 consecutive days of rest. Recommended duration is 150 minutes per week or 30 minutes each day for 5 days. This is a easy exercise programme which you can practice even when you a going to your work place, grocery, or even with friends having a 30 minutes of active period or time is much better than sitting and taking.
This also advocated alongside aerobic exercise. Resistance training should be performed at least 2 days a week on 2 non consecutive days. Each training session should include 5 to 10 exercises involving the major muscle groups. Each set should include 10 to 15 repetitions to near fatigue.
Exercising without good sugar control
If you are having difficulty in controlling blood sugar levels with drugs but values less than 300mg/dl you can safely engage in exercises, provided there is no tendency to develop harmful ketone body formation. Ketone bodies are acidic compounds. Those are produced as a result of energy pathways which are not usually active. These pathways get activated because of the low insulin levels in the body, so that blood glucose can’t be used in regular energy pathway. Ketone bodies can damage the cells and even can cause death. Most of the type 1 diabetes patients experience diabetic ketoacidosis which can be precipitated in stress situations like strenuous exercise.
Low sugar levels can be developed during the exercise but it is very rare. If you are having good blood sugar control with life style modifications its unlikely to develop very low blood sugar levels. If you are on Insulin or any oral sugar lowering drugs it’s better to check your pre exercise blood sugar levels and if its below 100mg/dl you may need pre exercise snack to prevent from developing low blood sugar during exercise.
Exercising with Neuropathy
If you are having any features of neuropathy like numbness, burning sensation, walking on a pillow type sensation you should use proper foot wear and closely inspect the feet for lacerations on a daily basis. Repetitive, weight bearing exercises like jogging, brisk walking does not increase the incidence of foot ulcers. But if you are having foot ulcers it’s better you to not to engage in weight bearing exercises and swimming or cycling will be good alterations for you.
Weight bearing exercises can form calluses. Because of the impaired sensation of the feet, patients don’t detect this calluses early. These calluses can be fatal also or most of the time foot ulcers that ultimately end up with amputations.
Exercising with autonomic neuropathy
Autonomic neuropathy patients are experiencing dizzying when getting stand out, night sweats, constipation like symptoms. If you are having these kind of symptoms it’s better you to be screened by an expert and possibly undergo a stress ECG before starting an exercising programme.
Exercising with Retinopathy
Blurring of vision, double vision, sudden loss of vision or any other visual abnormality can present as Diabetes Retinopathy. So these kind of patients should avoid exercises that increase eye ball pressure such as intense aerobic exercises, resistance training, head down activities. It can cause bleeding in to the eye ball. It’s better you to seek expert advice if you have features of retinopathy.
Blurred vision or poor vision is not a very good situation for engage in high intensity exercises. It can cause serious injuries to the patients. Therefore it’s better to treat the retinopathy before participate these activities.
Seven golden tips for a good exercise programme
- Wear correctly fitting well contained walking shoes with good arch support.
- Start gradually and work up to the maximum target over a 2 weeks period.
- Check capillary blood sugar levels before and after exercise.
- Exercise is advocated 1 to 3 hours following a meal or snack.
- Stop exercising if low blood sugar levels develop during exercise.
- Always have a snack ready during exercise.
- Whenever possible you should exercise with a family member or friend.
Physical activities or any exercises are necessary for a healthy lifestyle. There is no doubt about that. Diabetic patients are facing special challenges in this situation. But there are methods that even they also can engage with exercises. It’s very important for controlling the disease as well.