Review article
PHYSICAL ACTIVITY AND DIABETES MELLITUS
MAJA BARETIĆ
orcid.org/0000-0002-7242-8407
; Zagreb University Hospital Centre, Clinical Department of Internal Medicine, Department of Endocrinology, Zagreb, Croatia
Abstract
The increasing incidence of diabetes is associated with constant lifestyle changes including non-traditional dietary patterns and lack of physical activity, i.e. sedentary lifestyle. Basic treatment of diabetes involves healthy eating (modification of type and frequency of meals), regular exercise and, in some cases, diabetes medication or insulin therapy. Physical activity is always part of the basic treatment of diabetes. It is also important as a specific aspect of health promotion and disease
prevention. There are many proven benefits of exercise in diabetes, e.g., reduction of insulin resistance, improvement of glycemic control and lipid profile. Exercise also reduces body weight and increases cardiorespiratory capacity. The benefi ts of physical activity improve most of the metabolic abnormalities in type 2 diabetes. Exercise can even reduce the demand for drugs and slow development of some diabetic complications. One of the easiest and most appropriate types
of physical activity is walking. It is recommended that individuals perform moderate physical activity for 30 minutes daily, i.e. moderate-to-vigorous intensity aerobic exercise at least 5 days a week, or a total of 150 minutes per week. Even small increases in physical activity show benefit. Prior to starting an exercise program, diabetic patients should be screened for the presence of macro- and microvascular complications. Some chronic complications may worsen with exercise and these patients have some limitations regarding duration and type of physical activity. There is specific activity limitation in diabetic retinopathy, ischemic heart disease and for diabetic patients with loss of protective sensation. Patients should be instructed to wear proper footwear and examine their feet daily for lesions. During and after intense exercise, plasma glucose falls due to the increased glucose utilization and increased insulin sensitivity. Hypoglycemia can occur during, immediately after, or hours after exercise. With proper instructions, hypoglycemia can be avoided. Patients treated with insulin or insulin secretagogues have a risk of hypoglycemia. Such patients should be instructed to modify the amount of calories according to the type of activity and body weight. It is necessary to give instructions about customization of therapy before and/or after exercise. For people with type 1 diabetes willing to exercise (especially those planning
professional sports or extreme exercise), it is important to balance insulin doses with food and activity. Blood glucose must be self-monitored and response to physical activity evaluated; if blood glucose is initially too low or too high, exercise must be delayed. For such patents, insulin pump therapy is a good solution; a number of professional athletes are treated with insulin pumps. The majority of people with diabetes can exercise safely as long as certain precautions are taken. Patients with diabetes should be able to enjoy sports and many benefits of physical activities. Finally, diabetes is not an obstacle to participation in sports, although it requires commitment and knowledge of both the medical team and the patient. When choosing the type of physical activity, personal preference must be also taken in consideration.
Keywords
diabetes; physical activity; sports
Hrčak ID:
184907
URI
Publication date:
19.7.2017.
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