Tuesday, September 1, 2015

How to exercise with diabetes

Diabetes affects almost 26 million children and adults in the United States. It afflicts people of all ages, races and genders. Complications from diabetes, including problems with insulin and sugar regulation, can affect any system in the body.

How to exercise with diabetes

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Diabetes affects almost 26 million children and adults in the United States. It afflicts people of all ages, races and genders. Complications from diabetes, including problems with insulin and sugar regulation, can affect any system in the body.

The cost of diabetes is staggering: $245 billion dollars each year for both direct medical costs and lost productivity due to the disease. So why bring it up here in a sports medicine blog?  Because exercise can be very beneficial to patients with diabetes and can help to improve health and decrease costs.

Exercise can help to maintain good blood sugar control. Good blood sugar control helps the body to use proteins effectively to build muscle mass and enhances the appropriate storage of sugar and water in the muscles. Poor blood sugar control causes the breakdown of proteins and muscle mass and decreases the body’s ability to use sugar for energy, which can cause a build-up of acid in the blood and can result in a situation called diabetic ketoacidosis, which can be life-threatening.

People with diabetes who want to exercise and those who are athletes tend to be more invested in controlling their disease. People who are more invested will have a better understanding of the disease as well. When beginning an exercise program, diabetics will need to check their blood sugar more frequently to understand the effect that different forms of exercise will have on them.

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Changing the intensity, duration, or type of exercise will alter the change in blood sugar. Maintaining proper nutrition for improved exercise or performance will also enhance blood sugar control. Exercise itself increases muscle sensitivity to insulin by up to 40 percent for up to 24-48 hours after the bout of exercise. This allows the muscles to restore the lost sugar and helps to improve blood sugar regulation. Diabetics also need to be careful about checking their sugar before they start each exercise session. If the blood sugar is around 250 or higher, it will actually increase during exercise, not decrease. This will also lead down the path towards ketoacidosis.

Diabetics who exercise will definitely see the benefits. Consistent control of blood sugar can decrease complications by 30-70 percent. Exercising on a routine basis can lead to weight loss for Type 2 diabetics and potentially allow patients to decrease the amount of medication they take. For our elite diabetic athletes, you will see improved maximal oxygen consumption and improved trainability and performance.And for the almost 80 million people who are pre-diabetic, exercising on a regular basis decreases your chance of progressing to diabetes.

Many benefits exist for diabetic patients who exercise, but you do have to be cautious. If you are diabetic and want to start a new exercise program you should have a full evaluation first to assess your risk factors and exercise tolerance and set up an exercise plan. Understanding the signs and symptoms of hypoglycemia (low blood sugar) and hyperglycemia (high) are crucial, and you should exercise with a friend who knows what to look for and how to treat you if you have blood sugar issues during exercise. If you are on insulin you need to understand how exercise affects insulin requirements and absorption.

Diabetics can enjoy the benefits of exercise the same as anyone else. A full pre-exercise evaluation will help to make sure you are exercising safely for any complications you have. Following with a physician who understands exercise and diabetes and can help track and regulate your progress is the best path to better health.


Read more Sports Doc for Sports Medicine and Fitness.

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J. Ryan Bair, PT, DPT, SCS Founder and Owner of FLASH Sports Physical Therapy, Board Certified in Sports Physical Therapy
Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Justin D'Ancona Philly.com
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Brian Maher, BS, CSCS Owner, Philly Personal Training
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
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Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Kelly O'Shea Senior Producer, Philly.com
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David Rubenstein, M.D. Sports Medicine Surgeon, Rothman Institute
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Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Associate Chief of the Division of Sports Medicine at Drexel University
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