Exercise in Diabetes Management
Give me the breakdown on diabetes!
Diabetes is a chronic disease categorised by high levels of glucose (sugar) in the blood. Our bodies function by converting glucose from food into energy, this process is controlled by a hormone called insulin which is produced in the pancreas. Diabetes occurs when the body becomes resistant to insulin or the pancreases is unable to produce sufficient amounts of insulin (or both).
Diabetes is a complex and serious condition that affects the entire body. Without appropriate management, complications can develop and significantly impact quality of life and reduce life expectancy. Diabetes is serious and must be treated as such;
- Diabetes is the leading cause of blindness in working age adults,
- It is the leading cause of kidney failure,
- It increases the risk of heart attack and stroke of up to four times,
- It is a major cause of limb amputations,
- Diabetes affects mental health – depression, anxiety and distress occur in more than 30% of all people with diabetes.
What are the different types of diabetes?
TYPE 1 DIABETES
Type 1 diabetes is often referred to as insulin dependant diabetes as it is an auto-immune disease where the body’s immune system attacks the insulin producing cells of the pancreas. People with type 1 diabetes require life long insulin injections for survival.
TYPE 2 DIABETES
Type 2 diabetes is associated with lifestyle risk factors (i.e. poor diet, physical inactivity, overweight/obesity) and hereditary factors. Type 2 diabetes is becoming increasingly prevalent among the Australian population and blood sugar levels are often managed with medication and insulin injections. People with type 2 diabetes CAN manage, treat and in some cases cure their disease with lifestyle changes including diet and exercise intervention.
Gestational diabetes occurs during pregnancy when the mother’s body cannot meet the demands for increased insulin producing resulting in high blood sugar. Gestational diabetes can be effectively managed by adopting a healthy eating plan and performing regular physical activity. Effective management of gestational diabetes is important to reduce the risk of complications during pregnancy and the birth of the baby.
Okay, I have been diagnosed with diabetes. What now?
If you’ve been diagnosed with diabetes – it can be overwhelming. First step – take action! It is highly recommended to engage with a doctor you feel comfortable with to help support and educate you for best self-care. Your doctor will advise on appropriate medication and insulin injections should you require it. Next step – engage a health care team to assist you best in the management of your condition (exercise physiologist, diabetes educator and dietician). All types of diabetes are best managed with lifestyle modification including exercise intervention, a healthy diet and monitoring blood sugar levels. By keeping your blood sugar levels within range, you can significantly reduce the risk of developing the various short-term and long-term complications associated with diabetes.
Why is it so important to manage blood sugar levels?
Elevated levels of sugar in the blood is referred to as hyperglycaemia and can cause damage to your nerves, blood vessels and organs. This causes the diabetes related complications such as kidney failure, neuropathy (nerve damage), blindness, increased risk of heart attack and stroke, etc.
Simply put, imagine your blood is the major water supply to various towns. If the water supply is contaminated and dirty, the pipes connecting the water supply will deteriorate, the people in the towns will eventually get ill, reduce their capacity to function and the town will eventually shut down. Your blood is the major nutrients and oxygen supplier to your organs, nerves and limbs. Hyperglycaemia (elevated levels of sugar in the blood) ‘contaminates’ the nutrients and oxygen supply, causes damage to the blood vessels and impacts the nerves and organs no longer receiving adequate supply.
How does what I eat effect my blood sugar levels?
Your body absorbs all food and liquid consumed as either carbohydrates, proteins, fats and vitamins and minerals. The carbohydrates you consume turn into blood sugar – simply, the more carbohydrates you consume, the higher levels of sugar will be released in your blood as you digest. Fibre is a component of carbohydrates that is not converted into sugar as it cannot be digested. Therefore; proteins, fats, water, vitamins and minerals and high fibre-low carbohydrates foods will not have as significant effect on blood sugar levels as high-carbohydrate foods/liquids.
Common high-carbohydrate foods/liquids that generate the greatest spike in your blood sugar include; white grain products (rice, pasta, etc.), white bread, processed cereals, sugary drinks (soft drinks, fruit juices, alcoholic beverages, etc.), potato chips and sweets.
RECOMMENDATION: Mindfully consuming meals with more protein, fats and fibre will assist in slowing the digestion of carbohydrates and decrease overall consumption of sugar. Avoiding sweets, sugary drinks, processed foods and keep an eye on sugar content added to ready-made meals, dips, sauces and dressings will reduce blood sugar spikes.
Your health status, age, activity level and health goals dictate your personal dietary guidelines. Seek a professional that can advise you and set you on the right path.
How does exercise effect my blood sugar levels and why is to so important?
Physical activity is a key management tool for any type of diabetes and may reduce the risk of diabetes associated complications and insulin resistance. Regular exercise by people with diabetes results in improved glucose tolerance, increased insulin sensitivity (or lowers requirement for exogenous insulin in T1) and decreased HbA1C (glycated haemoglobin: identifies average blood glucose concentration over 3-months).
Regular exercise also attracts significant improvements on cardiovascular disease risk factors and overall well-being. 150 minutes of moderate intensity exercise per week is associated with reduced morbidity and mortality, while prolonged sedentary time (no movement) has been associated with deleterious health outcomes. The good news: The poor health outcomes associated with prolonged sedentary time can be decreased by initiating exercise intervention. Therefore, all individuals with diabetes should be encouraged to be regularly physically active! For optimal blood glucose control a combination of aerobic and strength training is recommended.
Aerobic exercise (i.e. walking, cycling, swimming, jogging, etc.) can improve heart health and lower your risk of heart attack and stroke.
When you perform strength training exercises that target large muscle groups, your body uses glucose to power them which can effectively clear out excess glucose in your system – signalling the glucose to enter the muscle cells. As you develop muscles, they will be able to store glucose more effectively and assist in the regulation of blood sugar at rest. Finally, the more muscles we have, the more calories we burn! Therefore, strength training promotes weight loss and helps build stronger bones.
Okay, I have heard enough – I want to manage my blood sugar! Where do I start?
Beginning exercise, analysing your diet and attempting to change lifestyle habits can be a daunting task on your own. Seek out someone that is qualified and able to assist you. Modifying lifestyle habits is no easy feat, however it is likely one of the most important things you will do to determine the health of your future. I am the Clinical Exercise Physiologist at POGO Physio and if you have been diagnosed with type 1 or 2 diabetes or gestational diabetes, I want to see you get moving towards a high quality, healthy and long future. POGO physio now provides diabetes exercise classes targeted at improving your blood sugar control, decreasing your risk of developing diabetes associated complications, weight loss and general health and wellness. Class sizes are small and fun to ensure quality and progress.
4-Week Programs have been purposefully constructed for diabetics beginning exercise intervention for the first time, or after a long period of not exercising. The program introduces the components of exercising safely in respect to movement, technique and form and management of chronic conditions. The aim is to build your confidence, exercise capacity, strength and cardiovascular fitness so that you are equipped to continue exercising independently, effectively and safely long into your healthy future. The 4-week program entails a comprehensive one-on-one initial consultation, dietary analysis, behavioural modification assessment, pre- and post- fitness measurements and 8 x 60-minute exercise sessions (2 sessions per week). Blood glucose monitoring before and after each exercise session will be conducted.
DIABETES GROUP EXERCISE AT POGO
Group exercise classes are located in Wollundry Park, Mermaid Waters adjacent POGO Physiotherapy clinic.
Tuesday 10.30am-11.30am and 4pm-5pm
Thursday 10.30am-11.30am and 4pm-5pm
Bookings are essential. Please phone the friendly admin team to organise your initial assessment or to book into an exercise class.
– 4 Week Program total cost is $275 or $71.50 with GP referral*
– Pay as you Go: Initial assessment (required before first exercise class) $85, exercise class = $35 per session or $60 for two sessions per week.
– Personalised Home/Gym Exercise Program (suitable following initial 4 week program) $85
If you are diagnosed with type 2 diabetes, your GP can refer you for Group Allied Health Services under Medicare. The total out of pocket cost for the 4-week program will therefore be $71.50. You are eligible for this Medicare claim once per calendar year.
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