Sunil (age 52), a businessman who runs a small shop, came to my clinic last Thursday. He has been suffering from Type 2 Diabetes for 5 years.
"Dr. Priya, I take my diabetes pills as prescribed. But my sugar levels fluctuate constantly. The latest HbA1c report is 8.2%. Everyone tells me to exercise, but I weigh 92 kilos and have osteoarthritis . I have difficulty walking because my legs hurt. How can I exercise?" Sunil explained his helplessness.
I explained to Sunil: "Sunil, exercising for someone with diabetes is just as important as taking pills. When we exercise, our body's insulin sensitivity increases. This means that even with low levels of the hormone insulin, the body's cells can easily absorb the sugar in the blood. As a solution to your knee pain, you can do simple exercises that do not put pressure on the joints (low-impact exercises). Today, let's talk about how diabetics like you who have joint problems or are overweight can choose exercise safely."
๐จ Red Flags that should stop exercising immediately
Although exercise is very beneficial for diabetics, exercise should be stopped immediately if the following dangerous symptoms occur during exercise:
- Severe tightness, squeezing, or pain in the center of the chest (this may be a sign of a heart attack).
- Severe difficulty breathing or uncontrollable shaking.
- Dizziness, fainting, confusion, or blurred vision.
- Symptoms of hypoglycemia (excessive sweating, shakiness, hunger, or slurred speech) caused by a rapid drop in blood sugar levels.
๐ก Steps to take:
If any of the above symptoms occur, sit down and rest immediately. If your blood sugar level is below 70 mg/dL, immediately drink a spoonful of sugar or fruit juice. If chest pain persists for more than 5 minutes, go to the nearest hospital immediately.
The main benefits of exercise for people with diabetes
- Blood sugar control: Exercise activates muscles, which directly burn blood sugar for energy.
- Increased insulin action: Helps control drug doses by increasing insulin sensitivity in cells.
- Reducing the risk of complications: The risk of heart attack and stroke is significantly reduced.
- Diabetes Remission: Research has shown that regular exercise and diet in the early stages of the disease can help to completely control or put diabetes into remission.
Comparison of simple exercises suitable for diabetics
| Exercise type | Impact on joints | Main health benefit | Recommended frequency |
|---|---|---|---|
| Brisk Walking | Moderate | Strengthening the cardiovascular system, reducing HbA1c values. | 5 days a week, 30 minutes a day. |
| Stationary Cycling | Very low (Low impact) | Strengthening the thigh muscles without putting pressure on the joints. | 3-4 days a week, 20-30 minutes each time. |
| Swimming | Very low (Low impact) | Increasing muscle function and flexibility throughout the body. | 2-3 days a week, 30 minutes each time. |
| Weightlifting / Resistance Bands | Less | Increase muscle mass and accelerate sugar burning. | 2 days a week (one day off). |
| Yoga | Very low | Stress management, increasing flexibility and balance. | 15-20 minutes daily. |
Do's & Don'ts
| โ๏ธ Things to do (Do) | โ Don'ts |
|---|---|
| Meet the American Diabetes Association (ADA) guidelines for at least 150 minutes of moderate exercise per week. | Never exercise barefoot or in ill-fitting shoes if you have foot injuries or diabetic neuropathy. |
| Avoid the risk of hypoglycemia by measuring your blood sugar levels before and after starting exercise. | Don't start intense exercise all at once. Always start with a 5-minute light warm-up. |
| Drink small amounts of water frequently to prevent dehydration while exercising. | Do not start exercising if your blood sugar level is below 70 mg/dL or above 250 mg/dL. |
โ Some other questions you may have (FAQ)
How to prevent dangerously low blood sugar levels (Hypoglycemia) during exercise? โผ
If you take insulin or blood sugar-lowering medications, check your blood sugar before exercising. If it is below 100 mg/dL, eat a small snack containing carbohydrates (a banana or 2 biscuits) before starting exercise. Always carry glucose tablets or something sweet with you.
Why should people with diabetic neuropathy be careful when exercising? โผ
Diabetic neuropathy can cause pain in the feet due to wounds or blisters. This can lead to infection and serious complications, so wear soft shoes and thick socks when exercising, and check your feet every day after exercise.
Can more exercise completely cure diabetes? โผ
Type 2 diabetes can be diagnosed early and managed with regular exercise and weight control to bring blood sugar levels back to normal without medication (Diabetes Remission). However, since it is not a completely curable disease, blood sugar levels can rise again if you return to a sedentary lifestyle.
How can busy people find time to exercise daily? โผ
If you don't have time to exercise for 30 minutes at a time, you can break it up into 3 10-minute sessions a day. Research has shown that short bursts of exercise provide the same level of benefits.
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