Diabetes is one of the most widespread health challenges worldwide, with 1 in 10 of us living with that condition. The focus of this year’s World Diabetes Day is to educate people about diabetes so that we all can know more about what this disease is about, how it can be prevented and how it can be managed at best. When thinking about diabetes most of us probably think about sugar and regulation of our diet, while the role of movement is often disregarded, both for diabetes prevention and management.
What diabetes is about?
Diabetes is a metabolic chronic disease related to a dysfunction in our pancreas in producing insulin, the hormone responsible for regulating sugar levels in our blood (what is known as glycemic level). There are two types of diabetes: type-1 and type-2 diabetes.
Type-1, also known as juvenile diabetes, usually (but not always) emerges early during childhood or young age and it has mostly a genetic cause. The pancreatic dysfunction it involves causes dependence on insulin injections for the entire life for people affected.
Type-2 diabetes, on the contrary, is mostly diagnosed in older people, even if the prevalence among younger people is increasing and it is mostly caused by lifestyle factors, such as eating habits, sedentary life, smoking, abdominal fat and being overweight. The insulin dysfunction in type-2 diabetes is less severe than in type-1, so that blood sugar can often be managed with changes in lifestyle, without depending on insulin injections daily. Since depending mostly on lifestyle habits, type-2 diabetes can be largely prevented.
Moving well to prevent type-2 diabetes
Movement is one of the best preventative medicines against diabetes. As well as maintaining our whole body in good function and promoting our cardiovascular health, it helps us control our weight and reduce abdominal fat, which are two key risk factors for developing diabetes during life. This does not mean we all need to be skinny for preventing diabetes - curves and soft edges are still fine, as a body mass index (the relationship between our weight and height squared) lower than 25 kg/m2 is considered a no risk factor for diabetes and significant risk is above 30 kg/m2.
It does not even mean we all need to be sporty people in order to prevent diabetes: avoiding sedentary life with about half an hour of movement everyday could be enough. And if we think about it, we may realise that most of us are already doing that level of movement everyday as a part of our activities: a morning commute, household chores, going out for shopping or just for a relaxing walk. That’s already an excellent start, and if we are happy to insert a bit more intense aerobic and resistance training a couple of days a week, we’ll be watertight.
Movement as a medicine
If we’re already living with type-2 diabetes, physical activity can be one of the best medicines. To keep glycemic levels under control without recurring to extra insulin, controlling our daily intake of carbs is essential. But renouncing pasta, pizza, biscuits and desserts in our diet is not the only way: exercise also plays a fundamental role in regulating sugar levels in the blood. Exercise boosts the action of insulin thanks to the chemicals released in our body when our muscles are contracted and it helps to reduce our glycemic levels.
If we cannot really renounce a cookie with our afternoon tea (especially if it makes us feel more content), we could still have it and combine it with the habit of a walk afterwards. This is just a rough indication, as glycemic regulation changes individually and it depends on our different metabolism, on the quantity of carbs contained in the cookie and the intensity and duration of our walk. But you get the point: movement can be an ally when setting up new habits that allow us to manage our diabetes effectively.
What if exercising becomes a challenge?
Not surprisingly, because of the effects it has in changing our glycemic levels, exercise can also be a challenge for people living with diabetes. Especially if we live with type-1 diabetes, we might be able to see more troubles than advantages in engaging in some forms of exercise. Our blood sugar might go down faster than we expected, or we might not feel like moving because glycemic levels are already too high, thus causing stress in engaging in some form of regular exercise.
Here are some tips to overcome this stress and still get the best from moving:
Move little and gradually: starting with low-intensity activities can help gather an understanding of how our body reacts to exercise and maintain our control on glycemic curves as we increase the intensity of exercise with little steps.
Make movement become a habit: if we embrace an active lifestyle, choosing to walk instead of driving when we can, standing up to stretch while working and doing household work regularly, our body will be used to some level of movement and will be less of a big change when you decide to insert more exercise to your routines.
Have a check: it would be wise to check your blood sugar before starting a physical activity. If it is too low (ie under 100 mg/dL) evaluate to have some sugary food before starting to exercise, while if it is too high (ie above 250 mg/dL), better to wait to avoid risk of ketoacidosis, as exercise would increase ketone levels in your blood and increase the need for insulin. If your glycemic level is in normal range, there’s no reason you should worry about exercising. Check your blood sugar again when you finish the activity.
Stay hydrated: make sure you drink enough water while exercising to avoid dehydration.
Take care of your feet: foot ulcers are common among people with diabetes. If you suffer from this, make sure you wear comfortable socks and shoes and check for any sores, blisters, irritation or other injuries when you finish your activity.
Ask the expert: if you are still unsure about what level of exercise you could embrace in your daily habits or if you’re struggling in managing your glycemia during exercise, talk with your GP or a specialist to get advice tailored to you.
Final thought: as well as preventing diabetes and helping us manage it through the regulation of blood sugar, movement is well known to be correlated with improved mood, improved thinking abilities and better sleep. Since diabetes is known for impacting the quality of sleep and mental wellbeing of many people living with it, adding movement in those lives can really make a difference.