Introduction:
Chronic diseases are one of the main concerns for healthcare professionals worldwide. In the modern world, the number of people suffering from chronic disorders such as hypertension (high blood pressure) and diabetes (high blood sugar) is increasing daily. Around 400 million people around the world are suffering from diabetes, and according to the World Health Organization, the number will increase significantly. That is why non-pharmacological measures like exercise play a crucial role in preventing diabetes.
What Is Diabetes?
Diabetes mellitus is a chronic condition characterized by elevated levels of glucose in the blood. There are primarily two forms of diabetes. Type 1 diabetes is an autoimmune disease that results in the destruction of beta cells in the pancreas. These cells are responsible for producing insulin. A hormone associated with glucose metabolism. The destruction of beta cells, which secrete insulin, leads to a decrease in insulin levels. This, in turn, causes an increase in blood sugar levels. Five to 10 percent of cases of diabetes are type 1 diabetes. Factors such as viral infections, toxins, and dietary habits cause this type of disorder. It is commonly seen in children or adolescents. On the other hand, type 2 diabetes is caused by insulin resistance and is also known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Almost 90 percent of cases of diabetes are type 2 diabetes. This metabolic disorder occurs when there is a defect in insulin secretion and an inadequate response from insulin-sensitive tissues like the muscle, liver, and adipose tissue. In such cases, impaired glucose transport and increased breakdown of fat may also occur. Also, other factors like excess fatty acids and excess pro-inflammatory mediators are associated with this due to their association with dysfunctional glucose transport and increased fat breakdown.
Common clinical features of diabetes include excessive thirst, excessive hunger, frequent urination, nocturnal urination, and sudden weight loss. Additionally, individuals with diabetes are prone to developing other health complications such as cardiovascular disorders, hypertension, retinal problems, skin issues, and neural complications associated with the disease.
What Is the Role of Exercise in Diabetes?
The role of exercise in diabetes can be summarized in terms of short and long-term effects. These effects are:
Short-term Effects of Exercise:
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In type-2 diabetes cases, exercise increases insulin sensitivity. As a result, a rapid decrease in the blood sugar level after exercise is observed.
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Exercises increase body temperature and the rate of blood flow. This causes higher serum insulin levels. In type-1 diabetic patients, such activities lead to a drop in the blood sugar level.
Long-Term Effects of Exercises:
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Aerobic physical activities are known to increase capillary density, the use of muscle glycogen, muscle fibers, and the number of insulin-dependent glucose transporters. Such factors increase insulin sensitivity of the skeletal muscles and are beneficial in type-1 diabetes cases. Also, the long-term effects of exercise increase insulin-independent glucose uptake by the skeletal muscles. This is beneficial in type-2 diabetes cases in reducing blood glucose levels.
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Obesity is one of the main causative factors for type-2 diabetes. Exercises not only reduce body weight but are also responsible for increasing the metabolic activity of the body. Also, excessive fatty tissue in the body is associated with increased circulation of fatty acids and lipotoxicity, which is another factor in insulin resistance. As a result, a reduction in fatty tissue due to exercise is beneficial for type-2 diabetes cases. Associated systemic problems related to diabetes, such as hypertension and cardiac problems, are often linked to increased production of pro-inflammatory cytokines, as well as adipokine secretion. Exercise can reduce the synthesis of the cytokines.
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Glycated hemoglobin or HbA1c is an important indicator of glycemic control in type-2 diabetes patients. Also, it is linked to the production of free radicals and systemic inflammation. Regular exercise not only reduces the amount of glycated hemoglobin in the blood but also reduces the amount of free radical formation in the blood. This reduces the risk of cardiovascular diseases and other diseases linked to diabetes-related organ damage.
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Exercises have a positive impact on beta-cells of the pancreas. Regular exercise increases both the number and the functionality of the beta-cells of the pancreas which increase the production of insulin in the body. That is why, regular exercise is indicated for type-1 diabetic patients.
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An increased amount of triglycerides and cholesterol in the blood is one of the major concerns for diabetic patients. Regular exercise reduces the amount of bad cholesterol and triglycerides in the blood and increases high-density lipoprotein (HDL; good cholesterol) in the blood.
What Are the Different Types of Exercises Recommended for Diabetes?
The different types of exercises indicated for patients suffering from diabetes are:
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Aerobic Exercises: Aerobic exercises include various physical activities that engage numerous muscle groups of the body. These exercises stimulate multiple muscles and muscle groups through consistent and rhythmic movements. Walking, walking up stairs, running, and jogging are considered to be highly efficient aerobic exercises. These exercises can be carried out either indoors or outdoors using cardio equipment such as a rowing machine or treadmill. Swimming is a popular low-impact aerobic exercise. Additionally, cycling is another highly favored form of aerobic exercise. As per the direction the American College of Sports Medicine put forward, 15 to 60 minutes of aerobic exercises five times per week can be effective in diabetic patients. A minimum of 150 minutes of moderate to vigorous-intensity aerobic exercise is indicated. For young individuals or physically fit persons, a shorter duration of vigorous exercise, which is 75 minutes per week, is sufficient.
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Resistance Training: Resistance or strength training is performed with the help of resistance bands, weight machines, and free weights. These exercises are known to increase muscle endurance and muscle mass. Also, the metabolic rate of the body and muscles are both affected by this kind of exercise. According to researchers, combining both resistance training and aerobic exercises is useful in such cases.
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High-intensity Interval Training: This type of exercise includes repeated bouts of high-intensity effort followed by varying recovery times. The repeated short bouts of high-intensity exercises are responsible for the increased cardio-pulmonary activity. This increases the metabolic activity of the body and leads to a shift in the body’s activity. As a result, the anaerobic pathways of the metabolism are activated. The HIIT procedure involves doing four to six quick bursts of all-out effort lasting 30 seconds each, followed by short breaks (30 to 60 seconds) for rest or light activity. This type of exercise is usually done on a stationary bike, and each session only takes around 10 minutes. These exercises are known for increasing glycemic control, oxidative capacity of the muscles, and insulin sensitivity in adults with type 2 diabetes.
Conclusion:
Diabetes is one of the most common chronic diseases in the world. Regular exercises such as aerobic exercises, resistance training, and high-intensity interval training are beneficial for diabetic patients. These exercises not only reduce the amount of sugar in the blood but also increase metabolism and muscle functioning. Also, several diseases, such as cardiovascular disorders and kidney disorders related to diabetes, can be averted by regular exercise.
