An estimated 30 million Americans now have diabetes, and public health experts predict that one in three Americans will have diabetes by 2050 (CDC, 2014). Common symptoms of diabetes include frequent urination, increased thirst and hunger (even with regular eating and drinking), tiredness, blurred vision, cuts and bruising that heal slowly, unexplained weight loss and tingling, pain or numbness in the hands or feet ( ADA) 2018).
Diabetes is diagnosed by a doctor using one of the following blood tests (American Diabetes Association, 2016):
- Fasting Plasma Glucose Assay (FPG) – This test requires fasting for 8-10 hours before the test. A small blood sample is collected and measured for glucose concentration. A reading of 1
- Oral Glucose Tolerance Test (OGTT) – An OGTT requires that the patient ingests a concentrated glucose blend. Two hours later, blood is drawn and blood glucose levels are measured. A content of 140 mg / dl or more means prediabetes and 200 mg / dL or more diabetes.
- A1C or Glycosylated hemoglobin test (HbA1C) – HbA1C gives the average of a person's blood sugar levels over a for two to three months. Hemoglobin is the part of a red blood cell that carries oxygen and sometimes combines with glucose in the bloodstream. Diabetes is diagnosed at an A1C greater than or equal to 6.5%. An A1C score of 5.7% to 6.4% may mean that a person is elevated due to diabetes and is often classified as prediabetes.
Early detection and treatment can reduce the risk of diabetes-related complications, such as organ damage or heart disease, and diabetic eye disease. Exercise is central to both the prevention and treatment of diabetes. Here are four important considerations for developing safe and effective exercise programs for patients with diabetes.
1. Daily movement is ideal.
People who suffer from diabetes are encouraged to follow the applicable physical activity guidelines for Americans, including:
- At least 150 minutes of moderate intensity aerobic exercise per week or 75 minutes of intense aerobic activity Intensity physical activity or a combination of moderate and vigorous physical activity
- Muscle strengthening activities that involve all major muscle groups at least two or more days per week (S. Department of Health and Human Services Office for Disease Prevention and Health) Promotion, 2018 )
All adults are advised to be physically active most days of the week, but daily physical activity is especially beneficial for people with diabetes. The American College of Sports Medicine (ACSM) recommends no more than two consecutive days of inactivity for diabetics, as regular physical activity may help to stabilize muscle and liver insulin action (ACSM, 2018). While all activities are beneficial, programs that combine both resistance and aerobic exercise improve blood glucose control better than any type of training done alone (Colberg et al., 2016).
2. Longer sitting behavior should be avoided.
In addition to regular physical activity, it is important to avoid prolonged periods of sedentary behavior. Americans have become so sedentary both at work and at leisure that longer sedentary behavior is now recognized as an independent risk factor for cardiovascular disease and premature death (Owen et al., 2010). Even regular practitioners are not exempt. We all need to reduce sitting time and other sedentary behaviors to reduce the risk of chronic illness. In people with type 2 diabetes and people who are at risk for the disease, excessive session time is associated with decreased blood sugar control. However, it has been shown that intermittent seizures of light activity – even just 5 minutes – are performed every 20 to 30 minutes to improve glycemic control (Colberg et al., 2016).
3. Physical activity poses a particular health risk for people with diabetes, but complications can be lessened by proper planning.
People with diabetes are at greater risk for acute stress complications such as heart disease, hypoglycaemia (low blood sugar) and hyperglycemia (high blood sugar) (National Institutes of Health and the National Institute for Diabetes and Digestive and Kidney Diseases) 2018). Asymptomatic individuals with diabetes under control are unlikely to require special pre-workout testing. Persons who are symptomatic and who are considered to be at higher risk should, however, be referred to their health care providers before starting a new exercise program and before participating in high-intensity exercise activities.
4. Special care should be taken to avoid foot problems.
People who suffer from diabetes are more susceptible to foot problems due to nerve damage and poor blood flow due to high blood glucose levels. Encourage these customers to wear comfortable and supportive shoes. In addition, the feet should be examined for wounds and blisters before, during and after physical activity, so that these types of skin fractures can be immediately recognized and treated.
To successfully treat diabetes, multimodal approaches are needed. Diet, exercise and many medications are all important parts of the puzzle. As a health and sports expert, you can help patients with diabetes achieve better health and disease control. The doctor's instructions should always be followed, and some patients may need additional support from other health professionals, such as a nutritionist or a certified diabetes consultant. For more information on diabetes prevention and management, visit www.diabetes.org. References
American College of Sports Medicine (2018). The ACSM guidelines for exercise testing and prescribing, 10 th edition. Philadelphia: Wolters Kluwer.
American Diabetes Association (2018). Diabetes Symptoms
American Diabetes Association (2016). Diagnosing diabetes and learning about prediabetes.
Centers for Disease Control and Prevention (2014). National Diabetes Statistics Report.
Colberg, S.R. et al. (2016). Physical Activity / Exercise and Diabetes: A Statement from the American Diabetes Association. Diabetes Care . 39, 2065-2079.
National Institutes of Health and National Institute of Diabetes and Digestive and Kidney Diseases (2018). Diabetes diet, diet and physical activity.
Owen, N. et al. (2010). Sitting Behavior: New evidence of a new health risk. Mayo Clinic Proceedings 85, 12, 1138-1141.
US. Department of Health and Human Services for Prevention and Health Promotion (2018). Scientific report of the Advisory Committee on Physical Activity.