Scientific literature has widely demonstrated that exercising has huge health benefits: body weight management, prevention of cardiovascular diseases, tumors and chronic conditions, improvement of lifestyle. Everyone can benefit from physical activity, especially those who suffer, or have suffered, from certain conditions.
In today's article I will tell you about what diabetes mellitus is, the benefits of physical activity in diabetics and how I work with a diabetic client.
Diabetes mellitus
Diabetes mellitus is a chronic disease widespread throughout the world. It affects more than 300 million people, over 55 million just in Europe, and according to the latest estimates the number of diabetics will increase. For this reason it is important to promote prevention and assist people who suffer from this condition so that its spread will slow down, and possibly stop.
Diabetes mellitus is a form of diabetes consisting of a group of metabolic disorders in which the level of sugar in the blood is constantly unstable: it moves from conditions of hypoglycemia (low blood sugar levels) to conditions of hyperglycemia (high blood sugar levels). There are two main types of diabetes mellitus: Type 1 and Type 2. Other types are gestational diabetes, which can occur in pregnant women, and secondary diabetes, which develops following other conditiond and the pharmacological treatments used to cure them. Let's see the two main types in detail now.
Type 1 diabetes mellitus
Type 1 diabetes is an autoimmune disease in which the beta cells of the pancreas are destroyed causing a subsequent insulin deficiency. It occurs during childhood and adolescence, but can develop at any age. The clinical manifestation of the disease occurs when 80% of the beta cells of the pancreas have been destroyed.
The person with Type 1 diabetes must follow insulin therapy. For these people the greatest risk they may incur is hypoglycemia during, or in the period immediately following, physical activity.
Type 2 diabetes mellitus
Type 2 diabetes occurs because of the concomitance of multiple factors, both genetic and environmental, which lead to alterations in insulin secretion and fat metabolism, and to insulin resistance.
In Type 2 diabetic subjects, the training program must be planned based on the therapeutic regime to which they are subjected. Since subjects receiving insulin or sulfonylurea therapy (organic compounds used to produce medicines for Type 2 diabetics) are at risk of hypoglycemia like Type 1 diabetics, they should be managed in the same way.
The dosage of the drug will need to be adjusted based on the volume of physical activity performed as well as nutrition, both in terms of caloric intake and the distribution of macronutrients.
Physical exercise in diabetic subjects
As mentioned above, physical activity has numerous benefits, especially for Type 2 diabetics. It improves insulin sensitivity by reducing glucose intolerance and cardiovascular risk factors in both sexes of any age.
Approximately 30 minutes of training a day, 5 days a week, produce positive effects both in terms of prevention and delaying the effects of the disease. International organisations recommend 3-4 weekly aerobic activity sessions of 30-45 minutes and two weight training sessions (if there are no specific contraindications).
Among the recommended activities, especially in the initial stages of a training program, there are low-impact activities such as swimming or cycling, while running is not recommended.
Training a diabetic client
When a diabetic client contact me to start a journey to improve their health conditions, before thinking about building a tailor-made training plan I carry out a free initial consultation to get to know the person better, their needs and understand their clinical situation. The consultation also give them the opportunity to ask me all the questions they need to get a complete picture of what to expect from the work we will do together.
Planning a workout for a diabetic client is not like planning for a healthy person. Most Type 2 diabetics are obese and therefore require some extra precautions, especially with regards to heart rate, blood pressure and glycemic levels monitoring, and the intensity needed to reach VO2Max (maximum consumption of oxygen).
Furthermore, before starting a training plan the doctor will have to evaluate the possible presence of visual problems (retinopathy), renal problems (nephropathy), cardiac problems (especially the silent forms of coronary artery disease and macroangiopathy), neurological problems (somatic and autonomic neuropathy) and give the green light for physical exercise.
Then later I carry out an initial physical assessment taking into account elements such as:
nutritional plan
functional and anthropometric evaluation
body composition analysis
Only after all these evaluations I focus on choosing the type of activity that best suited my client's needs and I establish the intensity, duration and frequency of the training sessions, planning them according to the meal times. I also constantly monitor my client's blood sugar levels before and after training, and I always have something sweet with me in case of need (candy, sugar sachets).
Training a diabetic client, especially if obese, requires continuous monitoring of the individual and a great teamwork with professionals such as: doctor, nutritionist and psychologist.
Physical activity and nutrition are the basis from which to start for all those who suffer from diabetes and want to change their lives for the better. It is not an easy path to undertake, but thanks to the help of a professional it is certainly feasible.