Ms. Thomas, 42, was juggling a busy life, work, children, family, elderly parents; trying to find a balance was difficult and to top it all she was dealing with type 2 diabetes herself and would have to take insulin injections four times a day.
A casual conversation with her colleague changed her outlook, who mentioned that she was seeing a physiotherapist and had started following a healthy, active lifestyle. Ms. Thomas decided to consult a physio herself.
The following is a gist of the discussion that ensued between Ms. Thomas and the physiotherapist.
Ms. Thomas: What is Diabetes?
Therapist: Diabetes is a chronic disease which either compromises the body’s normal capability of producing insulin or the use of insulin, which is a hormone which controls the amount of sugar in blood.
Ms. Thomas: Is it harmful to have high blood sugar?
Therapist: The answer is yes and no. Let me explain you with one simple example, you eat a donut which has total 20gm of sugar. Now, you go for walk which requires energy so insulin will be produced by your pancreas which is sitting behind stomach. Insulin will breakdown the donut into energy to help you walk. You used 10gm of sugar to walk, so insulin will help you produce energy from 10 gm of sugar and other 10 gm will stored as fat in your body. Let me ask you, what will happen if there is no enough insulin to break sugar?
Ms. Thomas: Oh! so, no insulin means no breakdown.
Therapist: Yes, now back to your question. Yes, high sugar can cause damage to your eyes, kidneys, nerves and also increases the risk of osteoporosis.
Ms. Thomas: I am assuming there are different types of diabetes.
Therapist: Yes, there are two types: Type 1 is juvenile onset and insulin dependent, where usually pancreas are not able to produce enough insulin. The causes can either be autoimmune, genetic or environmental. Type 2 is inadequate utilization of insulin and can be caused by obesity or due to family history of diabetes.
Ms. Thomas: Is type 2 reversible?
Therapist: I would not say reversible but according to new researches, exercises are proven to be helpful in controlling diabetes, reduce dependence on external insulin sources and thereby reduce complications.
Ms. Thomas: What type of exercises can I do?
Therapist: Let me explain in detail.
Type of exercise: You can choose from aerobic exercises, strength training and flexibility exercises or a combination of them.
Frequency and intensity: You can start off with 150 min/week with 30 min sessions/day for 5 days/week. If you have never maintained an active lifestyle before then you can begin with 3 sessions/day of 10 min duration. Once you are comfortable with 150 min/week, you can go up to 300 min/week or more.
To decide the intensity, rate yourself on an scale of 0-10 on the amount of exertion per activity, 0 being no exertion and 10 being maximum exertion. You can start with an average of 5, which is moderate intensity and progress as required.
Precautions: I would advice you to look for the signs and symptoms of hypoglycemia (low blood sugar) which is very common with DM patients who exercise; shakiness, weakness, abnormal sweating, nervousness, anxiety, dizziness, headache, tingling of mouth and fingers, hunger, visual disturbance, confusion, amnesia, seizures and coma. It is advisable to start exercises under supervision to begin with and also adjust carbohydrate intake or medication before and after exercise based on blood glucose level; your family physician and dietician will help you with the same.
Here are some links for detailed reading which are also the reference sources for this article.
ACSM’s Guidelines for exercise testing and prescription, 9th edition.
Disclaimer: All characters are fictional and given examples are for educational purpose only. Please consult your health practitioner for case specific details and before you start any exercises.