Physical exercise and Type 2 diabetes

Type 2 diabetes mellitus is the most prevalent form of diabetes and is associated with modern lifestyle: poor diet and sedentary lifestyle. Many people are unaware that they suffer from this disease as there are no symptoms. A diagnosis may be reached only after seven years.

Type 2 diabetes is more prevalent in individuals over the age of 60, as ageing is associated with reduced levels of physical activity and metabolic alterations. Type 2 diabetes is closely related to being overweight and obesity, and consequently also to musculoskeletal and cardiovascular complications.

Type 2 diabetes is the consequence of the body’s difficulty in responding to the production of insulin, resulting in increased levels of glucose in the bloodstream. For this reason, it is important to choose healthy eating habits while avoiding a sedentary lifestyle. Therefore, physical exercise is one of the most effective ways of controlling blood glucose levels and, consequently, diabetes.

According to a survey carried out by the American College of Sports Medicine in 2010, most of the benefits of physical activity in the treatment of Type 2 diabetes are related to acute and chronic responses to insulin in both aerobic and resistance exercises (muscle strengthening or bodybuilding).

Although physical activity is the key element in the prevention and treatment of Type 2 diabetes, many people with this chronic disease are not active or do not engage in regular physical activity.

The definition of physical exercise is repetitive physical activity, which is programmed and structured with the aim of improving or maintaining one or more components of physical fitness. That is, all physical exercise is physical activity, but not all physical activity is exercise.

The actual exercise which is indicated for the diabetic patient should include recommendations on the type, mode, duration, intensity, frequency and progression of the exercise, which the physiotherapist should be familiar with.

On the other hand, the physiotherapist should also guide the diabetic patient on specific situations, such as the prevention and control of hypoglycemia or on how to adapt various exercises to associated co-morbidities, such as is the case with diabetic foot.

In addition to the benefit obtained as far as glucose metabolism is concerned, physical exercise contributes to weight loss and to abdominal fat reduction, improving cholesterol levels and helping to lower blood pressure, factors widely known to be at risk for heart and vascular disease. In fact, there is a strong and positive correlation between diabetes and these diseases.

If you are diabetic and sedentary, and if you want to start practising physical activity, there are four basic recommendations:

■ Pay your doctor a visit.
■ Look for a physiotherapist with experience in exercise for diabetic patients.
■ Consult a nutritionist for an adapted eating plan.
■ Drink at least 2 litres of water per day.

By André Sousa
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André Sousa is a physiotherapist at Hospital Particular do Algarve in Gambelas.