Exercise and diabetes

To paraphrase Shakespeare
– “To exercise or not to exercise, that is the question”

To be perfectly honest, no-one questions the role of exercise these days. Even the most “sedentary” (or = lazy) individuals might not do much exercise, but as to the value, well, that is not really in question.

So my question is tongue-in-cheek for the most part. The benefits of exercise are even more far reaching for the diabetic person. So along with cardio-vascular effects, reduction of bad cholesterol, sometime weight control, reconnection with your dog, a nice burst of endorphins, and a chance to chill-out and de-stress, the diabetic gains even more benefits.

The basics of diabetes:
The amount of insulin present in the blood stream is the source of the problem for diabetics. Two types of the disease are found:

• Because the specialised insulin-producing pancreatic cells in Type 1 diabetics are dormant they need to supplement/supply their insulin levels with daily injections to keep healthy blood sugar levels.
• The mature/age onset Type 2 diabetics often require diet control and even sometimes medication to keep their sugar levels to low enough levels to maintain good health, without necessarily taking extra insulin.

So, what difference does exercise make…?
Insulin helps convert stored sugar into usable sugars for cells and muscles. The benefit of exercise relates to how muscles respond to exercise. Muscles are sensitive to insulin, and when a person exercises (especially regularly) the sensitivity actually increases so that the muscle actually needs LESS insulin to keep blood sugars correct as compared to muscle which hasn’t been exercised regularly. This is why exercise is both useful and indeed important for all diabetics – healthy exercised muscles are more sensitive to any insulin present.
Hence, the diabetic needs less additional insulin if they exercise themselves regularly. For example, a Type 1 diabetic might reduce the amount of insulin in their daily injections, or, in the case of a Type 2 diabetic, they might not even need medication to maintain healthy blood sugar levels. A fantastic outcome you would agree!

The other great benefit of exercise relates to circulatory problems that can occur in long-term diabetics. The smaller blood vessels and capillaries especially in the heart and lower leg and feet seem to suffer narrowing with uncontrolled high blood sugar levels. Exercise increases the number of blood vessels and improves general blood flow both in cardiac vessels and to the limbs, along with lowered lipid/bad cholesterol levels;  all very positive benefits of being active.

So fellow Shakespeareans (one and all), please ensure that you do 20-30 minutes of moderate aerobic exercise at least 5 times a week. Less than 3 times per week is insufficient to make the muscle changes discussed above.

We are talking about “lifestyle changes” here. Remember – it is not only good intentions needed (we all have those!) – but planning and committing to doing it. It can be brisk walking, bike riding, walking the dog, swimming, running or even regular sport if you want – it isn’t “what” you do but more importantly “if” you exercise, that matters.

Steve Rodda - Physiotherapist and Director, Back In Motion Woodville