The role of exercise in the management of diabetes

The role of exercise in the management of diabetes

Diabetes is one of the most common chronic diseases in the United States and many parts of the world. Currently it is CDC reports that over 1 in 10 adults in the US have diabetes and 1 in 3 have prediabetes or early signs of developing diabetes.

As a health coach, you may have a client with diabetes who has sought your services to help them adopt a lifestyle to manage their diabetes. They may have questions about whether exercise and physical activity are safe for them, or they may be looking for your support to exercise safely while living with diabetes.

In this article, we describe the benefits of exercise for people with diabetes and provide tips for helping a patient with diabetes make physical activity part of their life.

Types of diabetes

Diabetes is a chronic metabolic disease characterized by the body's inability to effectively process and use blood sugar. As a result, diabetes patients tend to have higher than average blood sugar levels.

There are three main forms of diabetes: Type 1, Type 2 and pregnancy.

Type 1 diabetes is an autoimmune disease in which the immune system attacks the insulin-producing islet cells in the pancreas. Because insulin is the hormone responsible for the effective uptake of glucose into cells, cells cannot access the energy provided by glucose. These patients tend to be dependent on exogenous insulin. Type 2 diabetes is characterized by insulin resistance and/or a relative insulin deficiency. In this type of diabetes, the body's cells do not respond to insulin and glucose builds up in the bloodstream. Gestational diabetes is a type of diabetes that only occurs during pregnancy. Women with gestational diabetes develop reduced insulin secretion and are at high risk of high blood sugar. Unmanaged gestational diabetes can increase the risk of death to the woman and the fetus. With effective treatment, most women return to normal glucose metabolism after childbirth. Prediabetes, sometimes called Borderline diabetes is a condition in which a person's body shows early signs of insulin resistance, which can lead to diabetes. Typically, people with prediabetes have no symptoms, but this can be determined with the fasting plasma glucose (FPG) test, a glucose tolerance test, or an A1C test. The prediabetes diagnosis was developed to identify people who are at risk of developing diabetes. If a person is diagnosed with prediabetes, makes lifestyle changes or takes medications, the development of type 2 diabetes can be prevented or delayed.

Both genetic and environmental factors influence the development of different types of diabetes.

The American Diabetes Association Statement on Exercise and Physical Activity

The American Diabetes Association (ADA) is one of the leading research and human advocacy organizations live with diabetes. They are often considered the primary authority on guidelines for the treatment, management, and diagnosis of diabetes.

In 2016, the ADA released a Position information Summary of the latest evidence on the relationship between exercise, physical activity and diabetes management.

Exercise is planned and structured physical activity, and physical activity is any movement that increases energy expenditure.

The ADA states that:

Exercise improves blood sugar control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss and improves well-being. Regular exercise can prevent or delay the development of type 2 diabetes. Regular exercise has significant health benefits for people with type 1 diabetes, including improved cardiovascular fitness, muscle strength and insulin sensitivity. The challenges associated with blood glucose management vary depending on the type of diabetes, type of activity, and presence of diabetes-related complications. Recommendations for physical activity and exercise should therefore be tailored to the specific needs of each individual.

In general, exercise is beneficial for people with all types of diabetes. Nevertheless, it is important to tailor physical activity plans and approaches to each individual's medical and personal needs and capabilities.

Supporting patients with diabetes to remain physically active

Although researchers have demonstrated the multiple benefits of exercise for people with different types of diabetes, people with diabetes may face significant challenges when exercising regularly.

Some these challenges include:

Pain from nerve damage Diabetes can cause pain and inflammation in the joints. Physical discomfort experienced during exercise. Low energy due to poor energy metabolism. such as depression and anxiety Fear of hypoglycemia (low blood sugar) Lack of child care Social responsibilities and family issues Lack of motivation Lack of medical advice regarding exercise Misinformation from family members Other health conditions No easily accessible place to exercise (no sidewalks, street lights, safety) Cultural taboos that limit the ability to participate in exercise

Many of the obstacles mentioned above are partially or completely beyond a person's control. It's important for health coaches to create a safe space and uncover the reasons why your clients living with diabetes aren't exercising.

Some of the ways you can help clients integrate exercise and physical activity into their lives in ways that make sense for them include:

Let them tell you whatthey want to achieveand build your coaching style and plan around it. Ask about their daily activities and suggest ways to increase physical activity rather than planned, regulated exercise. Remind them that all types of physical activity are beneficial. Ask them to bring a family member or friend to help them perform physical activities. This may include exercising with them or taking responsibility for other activities such as housework or childcare while your client exercises. If you don't want to exercise outdoors or go to a gym, ask if home, app, or web-based exercise programs seem appropriate. Ask them to tell you how they feel after training. This may indicate their blood sugar levels and you may need to adjust physical activity plans accordingly. Remind them to contact their primary care team immediately if they feel excessively tired or suddenly sleepy, as this may be a sign of hyperglycemia or hypoglycemia. If they don't have an easily accessible primary care team, you may be able to help them navigate the healthcare system and identify a healthcare team that meets their needs.

Additionally, you may want to work on creating oneTrauma informedEnvironment to understand how diabetes and other medical conditions can be directly related to past trauma and to work directly with your clients to achieve goals that are sensitive to their experiences, limitations and needs.

... more about that in the next part.
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