Written by Dr Rajesh Kesari MD
Exercise in Type I DiabetesType I Diabetic patients who are regularly on insulin have to be very careful with exercise, which is neither harmful nor contraindicated for them but they have to take precautions since exercise may cause :Hypoglycemia during the time of exercise or many hours after stopping exercise And Hyperglycemia - after exercise Formation of Ketone bodies leading to Diabetic Ketoacidosis ( Click here to know about symptoms of Ketoacoacidosis an acute emergency situation)Exercise can be of 2 types- Aerobic and AnaerobicAerobic exerciseAnaerobic exerciseAerobic exercise involves contraction of a large numbers or different groups of muscles for short periods, Anaerobic exercises involve contraction of small number of muscle groups for a longer period of timeIn these exercises glucose and fats are utilized in presence of oxygen i.e aerobic oxidation takes place, this is more effective in burning calories.In these exercises lesser utilization of oxygen take place and are less effective in burning caloriesExamples Walking, running, Cycling, Swimming, Skipping Examples- weight lifting, stretching, muscle strengthening exercises Exercise or increased physical activity has manifold effects like
- Increased energy consumption ( Burning of calories).
- Increased utilization of glucose present in the blood, thus decreasing blood sugar levels.
- Increased Insulin sensitivity- i.e the same amount of insulin present in blood can help in transporting more glucose molecules from blood into the cells.
- Increased utilization of fat deposits to provide energy for working of muscles.
- Decreasing body weight- thus increasing insulin sensitivity and decreasing blood pressure.
- Decrease in blood pressure, good for heart.
- Increasing HDL ( High density Lipoproteins) the good cholesterol which prevents (atherosclerosis) formation of fat plaques inside the blood vessels heart attacks and angina.
- Relaxation of peripheral blood vessels- helpful in treatment of Diabetic neuropathy and peripheral vascular diseases.
- Mood enhancing effect- due to release of neurotransmitters.
Special PrecautionsIt is advised to exercise 30-45 mins at least for 5 days per week.If you havent been exercising earlier, slowly increase the exercise period. Start with 15 mins daily for the first week then move to 20-30 mins next week . One should be able to reach the target exercise levels within 2-3 month of beginning of regular exercise.One should take precautions so as not to exercise while the blood sugar is very high or low.Allow for a warm up period at the beginning of exercise ( approx. 10 mins) and cool down period at the end of the exercise session ( also approx. 10 mins).Important: Diabetics with Severe Diabetic Retinopathy ( Eye complications) or Nephropathy ( Kidney Complications- Kidney failure) are not advised to indulge in stressful exercises which may involve jerks etc, like jumping, horseriding, running, lifting heavy weights.Yoga in DiabetesYoga is good for all but is has a special role in people with Diabetes or Pre-diabetes.Diabetes is closely linked to stress- Cortisol the main stress hormone is also a Glucose counter regulatory hormone in simple terms excessive secretions of cortisol increase blood glucose levels. Yoga is known to decrease blood cortisol levels, thus decreasing stress levels and providing the many beneficial effects.Excess abdominal fat- the main culprit of insulin resistance and obesity in Indians leads to development of type 2 Diabetes and scores of other problems like High Blood cholesterol, Triglycerides etc. predisposing to Heart diseases like Heart attacks, Coronary Artery Disease, Stroke, High Blood pressure etc..Many poses in yoga target this excessive abdominal fat and thus decrease insulin resistance, decrease weight and very beneficially influence ( lower) the Blood sugar, Cholesterol, Triglyceride levels, thus decreasing Blood Sugar, Blood Pressure and likelihood of drastic complications.Most of these poses cause increase in pressure of abdomen and result in massage of internal organs as a result of different movements.For best results yoga should be done along with aerobic exercises, this would induce a greater weight loss and would help in better Blood Sugar control.Most effective poses for Diabetics would be:DhanurasanArdhyamatsyendra asanPaschimottan aasanVajra asanHala asanBreathing exercises or Pranayam is also helpful in decreasing Blood Glucose and regulating High Blood Pressure, the greatest action of Pranayam is on the HPA axis and thus reduces the stress levels and corresponding Cortisol levels in the body.But its important that these measures may not be enough at some point of time and medications or Insulin may be required in addition to these.