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Exclusive: Exercise and Diabetes- Ask Dr. V Mohan

M3 India Newsdesk Jan 06, 2020

This time in his exclusive 12-article Diabetes series, Dr. V Mohan discusses the key benefits of exercise in diabetes, the types of activities that can be suggested, and useful exercise tips that can be advised to diabetes patients.


In ancient times, man had plenty of physical activity because he had to move about from place to place, in search of food as he was basically a hunter gatherer. Over the millennia, several changes took place reducing the physical activity of man, but these were particularly accentuated in the last few decades, thanks to the industrial revolution and to mechanisation.

Indeed, in the last decade or so, we have become an extremely sedentary society. With the advent of motorised transport, elevators, escalators and thanks to television viewing (to which people are addicted and spend several hours sitting in front of the “idiot box”), people have, in general, become extremely sedentary.

Today, it is said that ‘sitting is the new smoking’ and all the bad side effects that one used to get due to smoking, one will get by sitting most of the time.

Given this background, what are the tips that I can give for regular exercise especially for people with diabetes?


First of all, let us define what is ‘Physical activity’ and what is ‘Exercise’

Physical activity:  Any body movement produced by skeletal muscles that results in energy expenditure beyond the resting expenditure.

Exercise: A type of ‘physical activity’ that is planned, structured, repetitive, and purposeful, usually aimed at improving or maintaining physical fitness.


Benefits of exercise in diabetes and pre-diabetes

  • Prevention of type 2 diabetes
  • Maintenance of glycaemic control
  • Prevention of diabetes complications
  • Additional benefits

Additional benefits of exercise for everyone

Regular exercise also helps the heart, reduces cholesterol (especially the bad cholesterol), increases the good cholesterol (HDL cholesterol), and decreases the blood pressure. It also helps to reduce weight.


Types of physical activity

There are 3 types of physical activity that can be done:

  1. Aerobic exercise includes walking, jogging, swimming, cycling, dancing, and various other games that involve the utilisation of oxygen by the tissues and also increase the heart rate.
  2. Resistance training: An example of this is lifting small weights. These can be done as 10 to 15 repetitions and this helps to build muscle and improve strength.
  3. Flexibility leads to better balance. Older people tend to fall easily and thus are prone to fractures. This can be avoided if flexibility is improved.

Essential tips for exercising

Warm up and cool down: When doing exercise, a ‘warm up’ and ‘cool down’ for about 5 minutes each, are very important. Warm up helps to prepare the body for the physical activity and prevent soreness of muscles. Cooling down helps to bring the body back to the normal position.

Individualised exercise: Exercise regimens have to be highly individualised. A step-by-step build-up will not only increase fitness and stamina, but also help control diabetes and other non-communicable diseases as well.

Following the FITT principle:

  • Frequency- At least 5 days/week
  • Intensity- Moderate
  • Type- Aerobic + resistance + flexibility
  • Time- For at least 30 to 45 minutes at a stretch

How much should one exercise?: The recommendation is to have at least 30 minutes of exercise, e.g. a brisk walk, at least 5 times a week amounting to a minimum 150 minutes/week.

Practical ways to increase exercise: There are several ways of increasing exercise in day-to-day life, such as taking the stairs instead of the elevator whenever possible, taking pets for walks, playing outdoor games with children or grandchildren.

How to know if one is doing the right amount of exercise? One should still be able to talk or sing while doing exercise. This means one is not overdoing it.

Steps counting: Today thanks to our mobile phones, especially on smartphones we have so many (mostly free) apps to help and motivate people to exercise. One of these is the step counter. By just keeping the phone in the pocket, the number of ‘steps’ taken will be counted by the phone. The goal is to reach 10,000 steps a day. This cannot normally be achieved unless one goes for a walk of at least 45 minutes (which will add up to about 5,000 steps). For older people, even 6,000 – 7,000 steps will be sufficient. On a totally sedentary day, one may not even cross 1,500 – 2,000 steps. Many studies have shown that the ‘10,000 steps/day rule’ is a simple way to motivate people to increase their physical activity to stay fit and to avoid or control diabetes and obesity.


In summary, regular physical activity is a must for a long and healthy life and to maintain ideal body weight, control diabetes, and prevent complications of diabetes.


To read articles published in the series, click,

Treatment algorithm; factors to consider while prescribing medication: Dr. V Mohan

Diabetes Q&A with Dr. V Mohan: Treatment algorithm for DM

Managing hypertension in diabetic patients: Dr. V Mohan

Diabetes Q&A with Dr. V Mohan: Managing hypertension in diabetic patients

Diet and Diabetes: Dr. V Mohan

Being a part of this exclusive series allows you to post a question for Dr. V Mohan. Answers will be published in the next article in this monthly series.


 

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author, Dr. V Mohan is the Chairman & Chief of Diabetology at Dr. Mohan’s Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, India.

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