Presented by: Baldeep Singh, MD
Clinical Assistant Professor, Medicine
Kathleen Wasowski, DPT
Senior Physical Therapist, Orthopedics and Sports Medicine
November 13, 2014
Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose). Patients with type 2 diabetes do produce insulin—just not enough to keep their glucose levels normal. Maintaining proper sugar levels not only prevents serious complications to the body’s organs and tissues but also improves resistance to infection, increases, energy, and sustain overall health, said Baldeep Singh, MD, a clinical assistant professor of medicine, at a presentation sponsored by the Stanford Health Library. The evening was part of a three-part series on the major concerns related to type 2 diabetes.
Dr. Singh suggests patients take a simple, “ABC” approach to controlling their blood sugar that focuses on attitude, blood sugar, control, diet, exercise, and fortitude. Exercise, in particular, is one of the most important ways to control diabetes 2 and has been shown in multiple studies to control insulin and reduce the onset of the disease.
“It’s all plus and no minus,” he said. “Tackling pre-diabetes (when blood sugar levels are above normal) early can prevent it from becoming full-blown disease.”
Exercise helps the body run more efficiently and improves circulation, energy levels, sleep quality, muscle strength, cognition, and recovery from injury, said Kathleen Wasowski, DPT, a senior physical therapist. It also burns excess body fat, helping to decrease and control weight.
People who are physically active for about seven hours a week have a 40 percent lower risk of dying early than those who are active for less than 30 minutes a week. The Centers for Disease Control and Prevention (CDC) recommends at least 30 minutes of moderate-intensity physical activity five or more days of the week or at least 20 minutes of vigorous-intensity physical activity three or more days a week. Moderate-intensity exercise can include day-to-day activities like gardening or walking, while vigorous-level activities include swimming, biking, or running.
Research has found that 10 minutes of activity three times a day has the same benefit as 30 consecutive minutes, making it easy to get started or work with a busy schedule and still get good results. Older adults or those with chronic conditions should be as physically active as their abilities allow.
“For all individuals, some activity is better than none,” she said. “Physical activity is safe for almost everyone, and the health benefits far outweigh any risks.”
Set a Goal
Using the rate of perceived exertion (RPE), you should feel effort, not exhaustion.
Maximum heart rate can be obtained by subtracting your age from 220. Target heart rate for moderate activities should be 50 to 70 percent of maximum; vigorous intensity physical activity would require 70 to 85 percent intensity of maximum heart rate.
There are four main types of exercise:
- Aerobic exercise raises your heart rate and keeps it up for an extended period of time. It is the most important exercise for diabetics and for general health benefits.
- Strength/Resistance training builds muscle mass and is recommended twice a week after an aerobic workout. It includes lifting weights, elastic bands, and exercises that use your body weight such as squats, lunges, and push-ups. Strength training makes your body more sensitive to insulin and can lower blood glucose.
- Flexibility/Stretching keep your joints flexible and prevent stiffness. Yoga, tai chi, and pilates can help develop the routine of exercising also help to strengthen the core.
- Balance is critical for improved safety, especially for people with joint probems or neuropathy. Keep safety in mind by standing near a wall or stable surface if you are unsure about your balance.
There are many chances to be active throughout the day; the more you move, the more calories you burn. Incorporate activity into your daily life by taking the stairs, parking far from your destination, garden, or do housecleaning at a more energetic level.
Moderate exercise can increase glucose usage by up to 20 times the normal rate, helping to lowers blood sugar levels.
But intense exercise can have the opposite effect and temporarily increase blood glucose levels right after you stop because the body perceives intense exercise as a stress. Diabetics may need to check sugar levels after exercise. To reduce the risk of hypoglycemia if you have diabetes, follow a regular routine of exercising, eating your meals, and taking your medicines at the same time each day. If your blood sugar is very high, you may need to hold off on intense exercise.
Create a Habit
To start incorporating exercise, be realistic about your current levels of activity and start slowly, she advised. Find something you like to do and set realistic, measurable goals. Increase intensity only about 10 percent every few workouts so you don’t “crash and burn.”
“Doing something is better than nothing,” Ms. Wasowski said. “Five minutes of exercise done daily is far better than 30 minutes done occasionally. It also is a great way to start a habit of moving regularly that you can gradually build up.”
About the Program
In type 2 diabetes, your body does not use insulin properly, a condition called insulin resistance. The pancreas makes extra insulin at first, but over time it is not able to produce enough insulin to keep blood glucose levels normal. When glucose builds up in the blood, instead of being used by cells for energy it can starve cells and lead to organ and nerve damage. Type 2 diabetes usually gets worse over time if steps are not taken to curb its progression. This series addresses some of the biggest concerns related to type 2 diabetes: prevention, exercise, and nutrition.
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