34 VOLUME 20 NUMBER 2 • NOVEMBER 2023 DIABETES NEWS SA JOURNAL OF DIABETES & VASCULAR DISEASE The importance of exercise in people living with diabetes Diabetes mellitus has become a prevalent health concern worldwide and is one of the top 10 causes of death globally. It is estimated that 9.3% of the world’s population has diabetes. These numbers are rapidly increasing, and our sedentary lifestyles and the global obesity epidemic are exacerbating the problem. In the lead-up to the 2023 Diabetes Summit, scheduled to take place on 15 November at the University of Pretoria’s (UP) Future Africa Institute, experts at UP’s Sport, Exercise Medicine and Lifestyle Institute (SEMLI) are encouraging staff and students to lower their risk of developing diabetes by maintaining a healthy weight and engaging in regular physical activity with simple exercises that can be done in the comfort, and safety, of your home. Diabetes is a chronic metabolic disease characterised by elevated blood glucose levels. It is caused by either insufficient insulin production, due to the autoimmune destruction of beta-cells in the pancreas (type 1 diabetes), or the ineffective utilisation of insulin produced by the pancreas (type 2 diabetes). Type 1 diabetes is usually diagnosed in children and young adults, while the more common type 2 diabetes, which accounts for about 90% of diabetics, is usually diagnosed in middle-aged people. Symptoms of diabetes include feeling very thirsty, urinating more than usual, blurred vision and reduced energy levels. Common risk factors for developing type 2 diabetes include family history, age, ethnicity, being overweight, being physically inactive and leading a sedentary lifestyle. Why exercise matters While some risk factors such as family history, age and ethnicity cannot be avoided, others such as leading a healthy lifestyle, maintaining a healthy weight and taking part in regular physical activity may reduce the risk. Medication and dietary management play pivotal roles in controlling this chronic disease. However, the importance of exercise and its role cannot be stressed enough. Taking part in regular physical activity not only assists in the management of diabetes, but also contributes to overall health. Exercise is frequently recommended in the management of type 1 and 2 diabetes. The benefits of physical activity for diabetics include improved blood glucose control, as regular exercise can assist in reducing insulin resistance by allowing glucose to enter cells, and improving insulin sensitivity by making it easier for the body to use glucose as an energy source. Weight maintenance is also a benefit of regular physical activity, which is essential for patients living with diabetes. Excess weight can contribute to insulin resistance, so maintaining a healthy body weight is especially important for diabetics. Diabetes also raises the risk of cardiovascular disease so the cardiovascular health benefits of regular exercise will help to strengthen the heart, lower blood pressure and improve cholesterol levels, which will aid in reducing the risk of heart disease. Another benefit of regular exercise is reduced stress levels. Blood glucose levels may rise due to hormones being released in response to stress; therefore, reducing stress levels in diabetics is crucial in managing blood glucose levels. The typical patient with type 2 diabetes is sedentary, overweight and middle-aged or older. Exercise will be beneficial among people in this group, but exercise prescription needs to be carefully implemented. Joint guidelines from the American Diabetes Association and the American College of Sports Medicine suggest a gentle warm-up of five to 10 minutes, followed by a period of stretching, and then an active cooldown lasting five to 10 minutes to allow a gradual adjustment of heart rate and blood pressure. An adult should aim to achieve 30 minutes of continuous moderate activity, the equivalent of brisk walking on five or six days a week, with the flexibility of shorter bouts of higher intensity activity increasingly being considered important. Vigorous activity can be safely undertaken by diabetics provided that cardiovascular and hypertensive problems are taken into consideration. Home exercise programmes At-home exercise is a great tool for diabetes management. The exercise prescription should consider a person’s readiness to exercise, attitude towards exercise and accessibility to exercise. Home exercise programmes have a high adherence rate as the work-outs can be done when people have time; they can be performed without any equipment; and they don’t require a visit to the gym. Exercises that can be performed at home with just the use of a mat: • Glute bridges • Plank • Hip abduction and adduction while lying on your side • Bird-dogs • Shoulder taps • Bear crawl hold • Dead bugs • Toe taps • Flutter kicks • Sit-ups • Side plank • Push-ups Exercises that can be performed with just the use of a chair: • Marching • Punching • Arm cycling • Arm circles • Leg circles • Flutter kicks • Ankle taps • Sit-to-stands Exercises that can be performed with just the use of your own body weight: • Lunges • Squats Diabetes News
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