Review regular moderate physical activity is associated with lower mortality in people with diabetes

Review regular moderate physical activity is associated with lower mortality in people with diabetes

Physical activity — or exercise) is any movement, such as walking, dancing, and the like. You don’t have to go to the gym every day or work out with special equipment to get the benefits of physical activity.

Physical activity is as much a full-fledged component of the treatment of type 2 diabetes as nutrition, regular self-monitoring and taking hypoglycemic medications. Without regular physical activity, it is impossible to achieve success in managing diabetes.
9 benefits that physical activity will give you

Improved glycemic control. During physical activity, there is an increase in the sensitivity of tissues to insulin and an active expenditure of glucose in the muscles. This leads to a decrease in blood glucose levels.
Improvement of blood pressure indicators.
Improving the lipid spectrum: reducing the level of” bad ” low-density lipoproteins and triglycerides. Such changes reduce the risk of myocardial infarction, stroke, and leg amputation.
Weight loss, because physical activity requires energy consumption (“burns” calories), and also prevents weight gain.
Physical activity can prevent the development of certain diseases, in particular, cardiovascular diseases (myocardial infarction and stroke).
Improved sleep quality: you will feel refreshed with less sleep duration.
Increased stress tolerance.
Bones and muscles will become stronger, even if you just walk or train with a light weight.
You will feel flexibility and lightness in your body with any movement.

How long should I move?

In the largest study in patients with prediabetes, the “diabetes prevention program”, which lasted 4 years, it was shown that physical activity lasting 150 minutes a week (30 minutes 5 times a week) was able to prevent or delay the development of type 2 diabetes. During the study, patients lost between 4.5 and 9 kg.

Therefore, the standard recommendations for adults (healthy, with prediabetes or type 2 diabetes) — at least 30 minutes of physical activity per day for at least 5 days a week.

This can be any physical activity: walking, swimming, cleaning the house, working in the garden. You can start with 5-10 minutes several times a week and gradually move on to longer sessions.
Daily exercises

1. let’s start with stretching!

Any set of exercises should start with a 5-10-minute stretch-this will allow you to tune in, warm up your muscles and prepare for the exercises.

2. Aerobic exercise

Aerobic exercise increases your heart rate and respiration and makes your muscles work. For most people, the goal is at least 30 minutes 5 days a week. If you want to reduce body weight, the duration of exercise should be increased.

A fairly simple and attractive form of physical activity is daily walking (on the street or using a treadmill). You can start with a 10-minute walk 3 days a week, gradually increasing the intensity and duration of the walk to 30-45 minutes more than three times a week, and then to a daily walk. This mode will allow you to spend an additional 100-200 calories per day.

Examples of other aerobic exercises include dancing, Aqua aerobics, swimming, tennis, Cycling, or an exercise bike.

3. Strength training

Strength training several times a week will allow you to increase your bone and muscle mass, as well as help you better cope with daily tasks (for example, walking home with bags of groceries from the store).

You can start attending special strength classes in groups or work out at home on your own. In the latter case, light dumbbells are quite suitable.
How to start physical activity

Step one

Getting a doctor’s approval. On the one hand, complications of diabetes or problems with the cardiovascular system may be a contraindication to certain types of physical activity, so you need to consult with your doctor.

Also, before starting a new regime of physical activity, the doctor should decide whether to conduct an examination of the cardiovascular and respiratory systems.

Remember that physical activity can cause hypoglycemia, and if the blood glucose level is higher than 13-14 mmol / l, it is simply contraindicated.

Step two

Choosing the most appropriate type of physical activity. Choose what you are interested in, what you dreamed of doing (dancing, maybe?), what you really will do.

Step three

Set yourself an achievable goal. For example, start with walking or exercising for 10 minutes 3 times a week and, once the goal is reached, increase their duration and then the number per week.

Step four

You may have an indomitable will and will be able to do it yourself, but if it is difficult for you, find a company: it will be more fun to do it, and you will not be able to”slack off”.

Step five

Take the time. If you can’t do 30 minutes at a time, divide that time into three ten-minute sessions — it’s the same thing!

Step six

Stay active throughout the day. This will allow you to “burn” more calories and reduce glucose levels. As a result, you can reduce weight and improve glycemic control.

Here are just a few of the possible ways:

get off public transport one stop before the usual one;
Park further away from work or the Mall than you normally would;
use stairs instead of escalators to climb;
try new forms of physical activity. For example, gardening, daily dog walking, or a new sport.


When exercising, precautions must be taken:

Caution is necessary in the presence of concomitant diseases (coronary heart disease, arterial hypertension) or late complications of diabetes (eye, kidney, leg damage). Incorrectly selected physical activities can worsen the condition, so you need to consult a doctor, and possibly undergo additional examination, seek help in developing a set of classes from a specialist in physical therapy.
If during physical activity there are unpleasant sensations — shortness of breath, increased blood pressure, heart failure, dizziness, then they should not be overcome. We need to stop classes and consult a doctor.
Physical activity reduces the level of glucose in the blood, but if the blood glucose level is higher than 13-14 mmol / l and/or in the presence of ketone bodies in the urine, they are simply contraindicated. We need to think of other ways to deal with high blood glucose levels.
Physical activity can cause hypoglycemia. Before physical activity, it is necessary to measure the level of glucose in the blood and be sure to have fast-digesting carbohydrates with you to stop hypoglycemia.
During physical activity, the load on the legs increases, and the formation of scuffs and calluses is possible. It is necessary to choose the right shoes: soft, comfortable, if necessary — individual orthopedic. Feet should be examined before and after physical activity. If the legs cannot be actively used, then there are still options such as sitting exercises, swimming.

Correction of the dose of insulin and carbohydrates

Keep in mind that physical activity requires additional carbohydrate intake, and you may also need to change the dose of insulin and/or hypoglycemic medications.

1. Unplanned short-term physical activity (running behind the bus, climbing stairs, etc.)

It is necessary to additionally take easily digestible carbohydrates in the amount of 1-2 XE. This can be 100-200 ml of fruit juice or a sugar-containing carbonated drink, 1-2 medium apples, 2-5 pieces of refined sugar,which you should always carry with you.

2. Planned short-term (up to 2 hours) physical activity (tennis, swimming, running, rearranging furniture in the office, cleaning the apartment, etc.)

The amount of carbohydrates depends on the blood sugar level before exercise:

above 11 mmol / l-there is no need to take carbohydrates;
5,6-11 mmol / l-it is advisable to take 1-2 slow-digested HE (bread, crackers, granola bars) per hour;
below 5.5 mmol / l-slow-digesting 2-3 XE per hour;
if you can’t measure your blood glucose, take 1-2 XU per hour;
if physical activity is planned immediately after a meal, it is possible to reduce the dose of short-acting insulin by 30-50%.

3. Planned long-term (more than 2-3 hours) physical activity (walking, Hiking, Cycling, General cleaning, etc.)

If you are on insulin therapy in the mode of multiple injections, it is advisable to reduce the dose of both insulins by 20-50%.

Similar recommendations can be given by your doctor if you are on combined insulin therapy (basal insulin in combination with hypoglycemic drugs) or receive only PSP. It is necessary to take slow-digesting carbohydrates in the amount of 1-2 X every 2-3 hours.

Douglas Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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