Exercise is healthy, especially for diabetics. However, in order to be able to look after affected members properly, trainers should know what is important when diabetics pack their sports bag.
The figures from the International Diabetes Federation (IDF) are worrying: 415 million adults worldwide have diabetes (2015) - this figure is set to rise to 642 million by 2040. According to the IDF, there are 6.5 million diabetics in Germany, including many gym members. This is a good thing, because people with diabetes particularly benefit from regular training sessions. Regardless of whether they have type 1 or type 2 diabetes.
The background: a lack of exercise and being overweight are key causes of the common type 2 diabetes, alongside a genetic predisposition, so regular exercise is an important part of the treatment. You can therefore sell exercise to those affected as a "carrot" with a clear conscience. This is because fit diabetics can improve their blood sugar and blood pressure levels and even manage to take less medication.
Those who exercise regularly can also declare war on excess kilos - another good way for diabetics to lead a healthy life. More muscle means a higher energy turnover - another plus point that type 2 diabetics who exercise benefit from even after the training session. And regular exercise also prevents secondary damage such as cardiovascular disease. This also applies to type 1 diabetics who, unlike type 2 diabetics, will not be able to change their insulin dependency. The practical recommendation "Diabetes, sport and exercise" from the German Diabetes Association (DDG) points out that a combination of regular endurance- and strength training has the greatest effect on improving blood sugar levels in type 2 diabetics. For lasting positive therapeutic effects, muscular exercise is recommended at least three times a week with moderate endurance training (50 to 60 percent of the maximum heart rate in the aerobic training range). An alternation of different intensities between 60 and 80 percent of the maximum heart rate (alternation of aerobic and anaerobic intensity) in the sense of interval training can therefore achieve greater effects.
"Start low, go slow"
Trainers who coach diabetics should clarify at the outset whether those affected have consulted a doctor before starting training. Among other things, this is important in order to identify any secondary illnesses that may restrict training or certain physical exertion. In the case of retinal disease (retinopathy), for example, an increase in blood pressure above 180 to 200/100 mmHg should be avoided according to the practice recommendation, and suitable footwear is also important for certain nerve diseases (neuropathy) in order to prevent diabetic foot syndrome.
When you finally start training, you should make sure that, in addition to individual adaptation to previous illnesses and risks, type 2 diabetics in particular take a moderate approach. This is because type 2 diabetics are often over 60 years old, may not have done any sport for a long time, may have limited mobility or may be unmotivated - especially if sport has been "prescribed" by the doctor as therapy.
The DDG practice recommendation therefore initially talks about less than 10 minutes of exercise per session, but exercise should take place on as many days of the week as possible and preferably several times a day - true to the motto "Start low, go slow". The duration and intensity of exercise should therefore be slowly increased over a period of weeks. In order to achieve the desired long-term effects, experts consider 20 minutes of exercise to be sensible - six to seven times a week.
Watch out for hypoglycemia!
In addition to medical supervision, individual adaptation of training and the right pace, diabetics differ from other athletes in terms of the risk of hypoglycaemia. This is because exercise reduces the need for insulin. Insulin-dependent type 1s must therefore adjust their insulin requirements and their glucose intake from food to exercise accordingly in order to avoid hypoglycaemia on the crosstrainer or in the middle of an aerobics class.
The blood sugar of type 2 patients, who are rarely at risk of hypoglycaemia when taking oral medication, can also plummet, especially when taking insulin, sulphonylureas or glinides. In the event of hypoglycaemia, fast-acting carbohydrates such as sugar, cola or apple juice can help (not chocolate, which causes the blood sugar to rise slowly due to its high fat content). Diabetics should therefore always have an appropriate SOS emergency kit to hand when exercising.
Trust is good, control is better: Diabetics on insulin therapy should always check their blood sugar before and during exercise. The following also applies to type 1 diabetics in particular: if your blood sugar is above 250 mg/dl and you have acetone in your urine, you have a severe insulin deficiency that needs to be corrected before you start exercising. But you should also "crack the whip gently" after training by encouraging the diabetics you are looking after to measure their blood glucose levels. This is because, depending on the duration and intensity of the muscle work, glucose stores can be depleted for up to 48 hours after the end of muscle work - which means a correspondingly long, increased risk of hypoglycaemia for diabetics.
What types of exercise are recommended for diabetics?
Jogging/walking
Joints and feet should be healthy for jogging. If you are very overweight or have joint or foot problems, walking or Nordic walking are more suitable. The indoor version in the studio is particularly suitable for disciplined lone walkers. If you don't like walking on your own, you are in good hands in a running or Nordic walking group. They train endurance, leg, core and gluteal muscles. When Nordic walking or cross-training, the poles take the strain off the knee and hip joints and train the upper body muscles.
Cycling
Because most of the weight is on the saddle when cycling, it is also suitable for overweight people and those with joint problems. It mainly trains endurance and the leg muscles. leg muscles. Caution: Spinning-classes are not suitable for people with cardiovascular problems. Otherwise, beginners should make sure that they choose the right course and do not overexert themselves, especially at the beginning. It is recommended that newbies visit the classroom fifteen minutes early before attending their first class so that an instructor can explain the spinning bike to them in peace and quiet.
Strength training
Strength training complements endurance sports. Gentle strength training should be possible at any age and in any "weight class". Special exercises can also help with joint or back problems. There are a few restrictions to bear in mind when putting together a training plan: People with diabetes should, before starting dumbbells and machines - this is the only way to avoid excessive strain, for example in the form of short-term spikes in blood pressure, which can damage the blood vessels; this is problematic, for example, if there is retinal damage in the eyes as a result of diabetes.
Swimming
If your gym has a pool: Swimming is of course also suitable for diabetes-related conditions such as obesity and joint problems. Backstroke is the ideal technique if you have problems with your spine. It trains endurance and muscles throughout the body, especially arm- and shoulder muscles. The spine and joints are relieved. When swimming breaststroke, make sure that your head does not stick out of the water. This puts strain on the cervical vertebrae.
Source: shape UP
Published on: 16 May 2017