Exercise has long been recognized as an important factor for the treatment of diabetes mellitus. Before the discovery of insulin, patients with diabetes, particularly those with Type 1 diabetes, were very limited in their ability to exercise, because it was almost impossible for them to avoid dehydration and ketosis. After treatment with insulin was established as a mainstay of treatment, the exercise is no longer an elusive activities. With their ability to exercise, it became clear that hypoglycemia is often developed in the immediate post-exercise period and during the 24 hours after exercise. It was also acknowledged that ketosis could be induced by exercise in patients with poor glucose control and that even patients with excellent control sometimes develop hyperglycaemia after vigorous exercise. As our understanding of exercise in patients with type 1 diabetes has increased, the goal was to manage homeostasis glucose metabolism and fuel so that patients can participate fully in all forms of exercise.
Improvements in glucose-monitoring technology have further contributed to the feasibility of active physical exercise programs for people with diabetes. In particular, personal blood glucose monitors have allowed patients to follow their blood glucose levels closely and thus readily develop individualized exercise regimens. This has made it much easier for individuals with diabetes to participate in competitive sports or endurance activities such as marathon running. It is important to address strategies for avoiding hypoglycemia (both during and after exercise), as well as hyperglycemia and ketosis, with all patients before they embark on routine exercise.
Patients with type 2 diabetes clearly benefit from frequent exercise. Physical activity plays an important part in the treatment strategy in these patients, as it decreases obesity and lowers blood pressure while improving insulin sensitivity, long-term glycemic control, and blood lipid profiles. Because of the risk of exercise unmasking ischemia as well as causing soft tissue and joint injury or retinal hemorrhage, it is critical that all patients have a complete history and physical examination before they engage in moderate or vigorous activity.
For all patients with diabetes, physician-patient interaction is key to establishing a successful exercise program. A team approach that involves coordination among exercise physiologists, nutritionists, diabetes educators, the physician, and the patient is usually the most effective way to create an individualized exercise regimen that provides benefits to the patient while avoiding potential harm.
Improvements in glucose-monitoring technology have further contributed to the feasibility of active physical exercise programs for people with diabetes. In particular, personal blood glucose monitors have allowed patients to follow their blood glucose levels closely and thus readily develop individualized exercise regimens. This has made it much easier for individuals with diabetes to participate in competitive sports or endurance activities such as marathon running. It is important to address strategies for avoiding hypoglycemia (both during and after exercise), as well as hyperglycemia and ketosis, with all patients before they embark on routine exercise.
Patients with type 2 diabetes clearly benefit from frequent exercise. Physical activity plays an important part in the treatment strategy in these patients, as it decreases obesity and lowers blood pressure while improving insulin sensitivity, long-term glycemic control, and blood lipid profiles. Because of the risk of exercise unmasking ischemia as well as causing soft tissue and joint injury or retinal hemorrhage, it is critical that all patients have a complete history and physical examination before they engage in moderate or vigorous activity.
For all patients with diabetes, physician-patient interaction is key to establishing a successful exercise program. A team approach that involves coordination among exercise physiologists, nutritionists, diabetes educators, the physician, and the patient is usually the most effective way to create an individualized exercise regimen that provides benefits to the patient while avoiding potential harm.
