Type 2 Diabetes Exercise

Type 2 diabetes doing exercise of any form and amount will get amazing improvement in their blood-glucose level, physical and mental well being.

Additionally, lower your blood pressure and cholesterol levels.

Type 2 diabetes exercise

Physical activity is defining as any bodily movements produced by skeletal muscles resulting in energy expenditure. It comprises four dimensions: 

1. Mode or type of physical exercises such as aerobic versus anaerobic activity, resistance or strength training, balance and stability training,
2. Frequency of practice that is the number of sessions per day or week,
3. Duration of exercise in minutes or hours per day or week,
4. The intensity of exercise is indicating in the rate of energy expenditure measured as oxygen consumption, heart rate, and respiratory exchange ratio. 

Also, there are four domains of physical activities; they are occupational, domestic, transportation, and leisure time. 

Aerobic exercise is an endurance activity or cardio activity in which the larger muscles move rhythmically for a sustained period. It causes your heart to beat faster than usual, increases cardiorespiratory fitness.  Some moderate-intensity aerobics’ are walking briskly (3 miles/hour or faster, but not race-walking), water-aerobics, bicycling slower than 10 miles per hour, tennis (doubles), ballroom dancing, and general gardening. Some vigorous-intensity cardio activities are race-walking, jogging, or running, swimming laps, tennis (singles), aerobic dancing, bicycling 10 miles/ hour or faster, jumping rope, gardening (continuous digging or hoeing, with heart rate increases), and hiking uphill or with a backpack. 

Muscle-strengthening exercise causes the muscles to work/hold against a force or weight. It is essential to put all the major body muscle groups to work, such as the legs, hips, back, abdomen, chest, shoulders, and arms.  Muscle Strengthening activities include exercise bands, weight machines, weight lifting, and calisthenic exercises (such as climbing a tree or doing push-ups) — also, gardening (digging & lifting), yoga, and tai chi exercises.

Bone-strengthening exercises put force on the bones promoting bone strength such as weight-bearing or weight-loading activity. This force is generally producing by influencing the ground, such as jumping jacks, running, brisk walking, and weight-lifting exercises. These activities can also be aerobic and muscle strengthening. 

What will happen when you are doing exercise?

When you are exercising, your body uses two sources of fuel, glucose, and free fatty acids (from fat) to generate energy.  Moderate exercise requires up to 20 times more energy than usual.

1. During the first 15 minutes of exercise, most of the glucose for energy comes from either the bloodstream or the muscle glycogen.
2. After 15 minutes of exercise, the fuel starts to come from the liver’s glycogen storage.
3. After 30 minutes of exercise, the body begins to get more of its energy from the free fatty acids.

As a result, exercise can deplete sugar levels and glycogen stores. The body will replace these glycogen stores; it takes 4-24 hours with more intense activity. During the rebuilding of glycogen stores, your blood-glucose level is maintaining low in some; it may cause hypoglycemia. 

Two distinct pathways stimulate glucose uptake by muscle; they are:

1. At rest and postprandial, its absorption by the flesh is insulin-dependent and serves primarily to replenish muscle glycogen stores.
2. During exercise, muscle-contractions increase BG uptake even when insulin-mediated absorption impaired in type2 diabetes.

Muscles BG uptake remains elevated post-exercise by both contraction-mediated pathway and insulin-mediated uptake. Exercise-induced muscular-contraction stimulates BG uptake even if you have insulin resistance, which helps lower glucose level. A combination of aerobic and resistance training may be more useful for BG management than either type of exercise alone. The BG lowering effect persists for at least 24-48 hours after exercising.

What can you do to be physically active?

Physical activity is something simple everyone can do. It does not mean to run a marathon or spend the whole day at a gym. Look for simple ways to include physical exercise into your daily activity.

Ten simple tips to help you to be active:

1. Start your physical activity slowly and gradually increase your endurance. Make your exercise plan a lifetime commitment and continue doing.
2. Choose an activity you love, such as swimming or cycling. It increases your chances to continue doing.
3. Convert your exercise therapy into social time, look for a community group, or get your family or friends to join the exercise activity. It will be more joyful and healthy.
4. Try walking, whenever and wherever possible.
5. Take the stairs instead of the elevator.
6. Play with your kids will be relaxing and healthy for both.
7. Plan a jolly trip by walk or cycle.
8. Doing regular gardening work increases your activity.
9. Take your pet for waling.
10. Wash your car, clean your house; this can save money, and help maintain cleanliness. 

"Doing something is better than nothing," Thus start with thirty minutes of physical activity on most days throughout the week.

Exercise tips

1. Wear comfortable shoes and practice proper foot care.
2. Drink enough water before, during, and after exercise to prevent dehydration.
3. Avoid exercising when your diabetes medication is at its peak action.
4. Avoid consuming alcohol before or immediately after exercise.
5. Avoid hot tubs, saunas, and steam rooms immediately after exercise. 

Benefits of Physical Activity in diabetes management

Regular exercise and increased physical activity are the most important things you can do to improve health. Some of the benefits are:

1. Glycemic control - improves the glucose level by 10%, fasting BS by 7%, and A1C by 1.0–1.5%. Patient doing exercise can reduce their dose of diabetes medication up to 72%.
2. Insulin sensitivity - physical training mobilizes visceral-adipose tissue, which increases insulin sensitivity by about 46%, improves your body's ability to use insulin. A change in visceral abdominal fat was associated with the improvement in insulin sensitivity.
3. Hypertension - normalizes blood pressure in case of hyperinsulinemia also in others. Additionally, it improves blood circulation.
4. Prevent cardiovascular diseases - You can prevent it by reducing hyperglycemia, hyperinsulinemia, and hypertension.
5. Weight management - It promotes excess fat burning and helps control weight. It can decrease in body-fat results in improved insulin sensitivity.
6. Avoid diabetes complications - It can protect against the CHD, stroke, hypertension, obesity, non-insulin-dependent diabetes mellitus, osteoporosis, colon cancer, and depression.
7. Increase’s energy level, thus, balance fatigue caused by diabetes.

Physical exercise helps:

blood-glucose management,

reverse insulin resistance (improve insulin sensitivity),

stop diabetes progression (slows down pancreas beta-cell death), and prevent diabetes complications.

Thus, regular exercising (both aerobic and muscle-strengthening) is a necessary therapy for diabetes control.

Other benefits of physical activities

1. It reduces stress, promotes relaxation, and relieves tension and anxiety.
2. It improves quality of life,
3. Improved cardiorespiratory and muscular ¬fitness
4. Vital in determining energy expenditure; help energy balance and weight control.
5. Reduce blood-clotting tendency where arteries have narrowed.
6. It increases arterial elasticity.
7. Help improves mental health, mood, and cognitive function by changing brain chemistry.
8. Strengthen your bones and muscles; improve bone and functional health.
9. In older adults, helps maintain full functioning and independence among the elderly.
10. In disabled, it improves the ability to do daily activities and prevent falls.
11. Increase your chances of living longer.
12. It can improve sleep quality and quantity.

Be careful, when exercising

Physical exercise surely provides you with numerous health benefits; still, as a person with diabetes, you should be extra cautious for certain instances; they are:

1. Hypoglycemia: Low blood glucose is a blood-glucose level anything below 70 mg/dl. Low blood glucose due to exercise is rare if you are not on insulin or insulin secretagogues. Those who use insulin or insulin secretagogues require carbohydrate after exercise to prevent low blood sugar.
2. Hyperglycemia: Do not exercise if your blood sugar is over 250 mg/dl, and you have ketones.  If your blood sugar is over 400 even without ketones, type-2 should not do exercise. In the case of type1 diabetes with blood sugars of 300 or more, test within 5 to 10 minutes after start exercising. If your blood sugar is dropping, you may continue exercise, otherwise, stop doing exercise.
3. Medication dosage adjustments - To prevent exercise-induced hypoglycemia, you may require to adjust certain medications. Some of such mediations are insulin, insulin secretagogues, beta-blocker (hypertension medication), diuretics, and or statins (cholesterol medication). 

Physical activity for people with chronic medical conditions 

For most chronic diseases, physical exercise provides therapeutic benefi¬ts and is considering as a treatment. 

• Peripheral neuropathy without acute ulceration individuals can do moderate weight-bearing exercise. Moderate walking does not increase foot ulcers or re-ulceration. Physical activity can help stop the progression of peripheral neuropathy; in some cases, it even reversed it.
• Retinopathy - Workout may increase intraocular pressure. Thus, those with uncontrolled proliferated-retinopathy should avoid exercise.
• Nephropathy and microalbuminuria - Person with these conditions can do exercise to improve physical function. Quality of life improves in the case of individuals with kidney disease undergoing dialysis sessions.
• Vascular disease such as cardiovascular disease (CVD) is not an absolute contraindication to exercise. Those with angina classified as moderate or high risk should likely begin the exercise in a supervised cardiac rehabilitation program. Physical activity is advisable for anyone with peripheral artery disease (PAD).
• Osteoarthritis is common among older adults; strong scienti¬fic evidence shows both aerobic and muscle-strengthening exercise provides therapeutic bene¬fits. Study shows, safe exercising reduces pain, make physically functional, the better quality of life, and improve mental health in patients with osteoarthritis.