Why people with diabetes need exercises

Exercises are extremely important in the management of diabetes because of its effects on lowering blood glucose and reducing cardiovascular risk factors.  Exercise lowers blood glucose by increasing the uptake of glucose by body muscles and improving insulin utilisation.

Exercise also improves circulation and muscles tone. These effects are useful in diabetes in relation to losing weight, easing stress and maintaining a feeling of well being.

However, patients with blood glucose levels of over 14mmos/L or 250mgld should not exercise.  Exercising with elevated blood glucose levels will cause increased secretion of glucagon and the liver will then release more glucose, resulting in an increase in blood glucose.

Patients who take insulin have a potential problem of hypoglycaemia i.e low blood sugar that may occur during moderate or strenuous exercise or after the exercise.  To prevent post-exercise hypoglycemia, one should eat a snack at the beginning and at the end of exercise.

Patients participating in extended periods of exercise should test blood glucose before, during and after the exercise.  Observers should be aware that the person exercising has diabetes and should know what kind of assistance to give in case severe hypoglycaemia occurs.

Exercise should be done at the same time of the day.  Exercise should start slowly and increase gradually in length.  For many patients, walking is a safe and beneficial form of exercise that requires no special equipment (except for proper shoes) and can be performed anywhere. Regular daily exercise rather than sporadic exercise should be encouraged.

The exercises

Walk up the stairs instead of taking a lift.

Park your car a distance from destination and walk.

Use next bus stop and walk.

Walk about while you are waiting for someone instead of sitting down.

Play actively with your child and grandchildren.

Do some gardening in our flower or vegetable garden.

Take a brisk daily walk for 30 to 45 minutes.

Sit down on a chair and raise yourself up 10 times while keeping your arms folded.

Get up on your toes and then down onto your heel for about 20 times.

Choose something you enjoy.

Drink plenty of water.

Carry some glucose sweets at all times to be used in case of hypoglacaemia.

Avoid making excuses when it comes to exercise.—Diabetes Association of Malawi