Diabetes and exercise
As with obesity, the number of people being diagnosed with diabetes is growing at an alarming rate. In the United States alone, that figure has increased from 11 million adults in 1987 to more than 16 million in 2000.
Just 10 years ago, if you were a world-class athlete and were diagnosed with diabetes, doctors recommended that you ended your athletic career. Yet Olympians Gary Hall Jr (gold medallist in the 50-metre freestyle swimming event in 2000) and Sir Steven Redgrave (who won five consecutive gold medals in five consecutive Olympics for rowing) and Arthur Ashe (the US Open and Wimbledon champion) have all proven this advice wrong.
While most diabetic exercisers are not elite competitors, they still benefit from working out. Between 90 and 95 per cent of diabetics have Type II (formerly known as non-insulin dependent, or NIDDM). Someone who has Type I diabetes (formerly known as insulin-dependent) has lost the ability to produce their own insulin, a hormone that allows muscle and fat cells to take up blood glucose (sugar). Just to stay alive, they must have daily insulin injections. Individuals with Type II have difficulty with insulin secretion as well as insulin action, where the available insulin isn't effective in reducing blood sugar levels.
In the past two decades much has been learned about how to control diabetes. Today, many experts agree that one of the most effective methods, along with diet and medication, is through physical activity. By increasing overall muscle mass and lowering fat, insulin gets better at picking up glucose which itself gets better at being picked up, slowing down its release by the liver.
The intensity, duration, type and fitness level of the diabetic individual is critical. That's because exercise is blood glucose dependent. For a diabetic without any other complications, his or her ability to exercise depends on the sufferer's blood sugar levels.
The American College of Sports Medicine (ACSM) along with the American Diabetic Association (ADA) has set out three important guidelines for sufferers' exercise. The first is to avoid exercise if you are fasting (or haven't eaten for eight hours) or glucose levels are within a certain range (either too high or too low).
Second, sufferers must monitor blood glucose levels both before and after exercise and learn the appropriate response to different exercise states. Finally, they must be ready with foods that are high in carbohydrate, before and after exercise.
While it has been proven that exercise is an important part of managing diabetes, there also are risks involved. These include hyperglycemia, hypoglycemia, and a worsening of diabetic complications such as cardiovascular disease, high blood pressure, lack of feeling in the feet (peripheral neuropathy) and adult blindness (retinopathy).
In their guidelines, the ACSM recommends all types of exercise for diabetics with some modifications.
As with most people, diabetics are recommended to engage in at least 30 minutes of continuous aerobic exercise a day. They must build up more cautiously using a low to moderate intensity level.
Resistance training is also acceptable for both Type I and Type II diabetics who aren't suffering from any complications, with the modification of using more repetitions and lower weight. Flexibility is also believed to benefit diabetics because of the loss of suppleness and range of motion in certain joints from excessive blood sugar.
