Curing Diabetes

Along with a diet plan and a medication regimen, a patient with diabetes needs an exercise program. Exercise can help her control her blood glucose levels, improve her body’s use of insulin and glucose, and control her weight. Your patient with diabetes has much to gain from regular exercise, but inform her of the risks as well. Giving her proper instruction and follow-up can help make exercise more effective and enjoyable.

Exercise increases the insulin sensitivity of patients with diabetes, reducing their insulin needs. Exercise also improves glucose tolerance. After exercise, blood glucose levels drop. An overall improvement in glucose metabolism may continue for days after an exercise session.

Many of the long-term benefits of exercise for patients with diabetes are the same as for anyone else. These benefits include improved fitness and sense of well-being, better body composition and weight control, and improved physical strength.

Exercise also helps reduce the risk of developing atherosclerosis. In patients with Type 2 diabetes, a regular exercise program lowers the levels of triglycerides and VLDLs. However, HDL levels don’t change, possibly because the level of exercise required to raise HDL cholesterol levels is greater than is recommended for patients with diabetes. A combination of exercise and nutritional therapy may reduce blood pressure in people who have Type 2 diabetes with hypertension. This combination may even prevent or delay the development of Type 2 diabetes in those at risk for the disease.

Blood glucose levels

Instruct your patient with diabetes to monitor her blood glucose levels before and after exercise. When she exercises for more than an hour, she should stop after 1 hour to check her blood glucose levels again before resuming exercise.

Your patient should continue to monitor her blood glucose levels throughout the day because hypoglycemia can occur many hours after exercise. In patients who are controlling Type 2 diabetes with diet alone, however, low to moderate exercise is unlikely to provoke hypoglycemia.

Point out that blood glucose response differs throughout the day. Suggest that your patient keep a log to help integrate meals, insulin therapy, and exercise times into the best daily pattern.

Risks

Before beginning an exercise program, your patient should undergo a thorough physical examination that includes an exercise stress test and a review of her blood glucose control.

Teach your patient how to ensure safe exercise. First, she must bring her blood glucose levels under control. Before each exercise session, she should eat a snack if her blood glucose levels are less than 100 mg/dl. She shouldn’t exercise if her fasting blood glucose levels are greater than 250 mg/dl and ketones are present in her urine or if blood glucose levels are greater than 300 mg/dl, whether ketones are present or not.

Filed under: Diabetes Treatment