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    Exercising

    Non-insulin dependent diabetes (type 2) (80 to 90% of diabetics) generally appears after 40 years old, almost always associated to obesity. It’s not the lack of insulin, at least in the beginning, but it is due to the resistance of the tissues to the action of insulin (muscles, liver, fatty tissues). Bringing on the increase of insulin sensibility and loss of weight, physical exercise is a real treatment for non insulin dependent diabetes. No one can contest this fact, but the difficulty is to get started.

    What is less known, is the physical exercise preventive effect on diabetes.

    This prevention has 2 levels:

    - Either by preventing the outbreak of diabetes

    - Either by improving its evolution and restraining its complications

    When diabetes is present, physical exercise is able to help lower blood glucose, especially with the help of a well balanced diet.

    Exercising is important for everybody, but even more important for a diabetic person. Exercise lowers your blood glucose (sugar level in your blood).

    - It helps lose or maintain weight that also helps control your blood glucose.

    - It helps your organism react better to insulin and helps your blood circulation.

    - It reduces your blood pressure.

    - It reduces your risk of a heart attack.

    Physical exercise should always be part of your health plan in treating diabetes. Aim at reaching a goal exercising at least 3 times a week for 20 to 30 minutes each time.


    Precautions for type 1 diabetics

    All forms of physical activities can bring on changes in your blood glucose control.Generally, exercise lowers the level of blood glucose. Exercise effects depend on certain factors:

    • The quantity of insulin in your body
    • The time of the last meal and the type of food you have eaten
    • The physical shape you are in
    • The type of intensity and duration of your physical activity

    The most common and important risk is hypoglycemia (low blood glucose). It may be necessary to adjust your insulin and/or your food intake to prevent this situation, especially if you exercise for more than one hour.

    Post-exercise hypoglycemia can occur up to 24 hours after an intense physical activity. It is very important to respect meal times and snacks and to check your blood glucose. Always be prepared to take care of a low blood glucose level.

    Do not exercise if your blood glucose is over 14mmol/l and if your urine or blood test shows ketones present in it. This indicates that you are in need of insulin. In this case, exercising could further increase your blood glucose level and deteriorate your condition.


    Precautions for type 2 diabetics

    A person that has wounds on their feet must be careful and choose physical activities that are better suited. For example, jogging or exercise that requires jumping may cause further damage.

    Before starting any physical activity, have a good warm-up. Wear comfortable and fitted shoes made for the chosen physical activity. Check your feet before and after exercising. Look for developing blisters, redness, cuts and scratches. Drink enough water during your physical activity to prevent dehydration, since this could make it harder to control your blood glucose. Stop all physical activity if you feel weakness or pain.

    Talk to your doctor about your exercise program. You may have other health issues that could limit your physical activity choices.

    Even more: If you suffer from retinopathy (eye damage), any exercise that elevates your blood pressure, like weight lifting, may damage even more your retina.

    If you suffer from a neuropathy (nerve damage), a “silent heart attack” could occur. Running and jogging should be limited since they can cause wounds to your feet. Start your program gradually. Check your feet regularly.

    How to prevent hypoglycemia while exercising

    Check your blood glucose before, during and after an intense physical activity and especially during a new activity.

    Be informed and ready to treat a hypoglycemia during or after exercise. It can happen during intense and lengthy physical effort as in a marathon run, hockey, etc.

    Hypoglycemia can occur up to 24 hours after exercising.Depending on your blood glucose, the duration (more than half an hour) and intensity of your physical activity, it may be required to have a snack before, during and after your exercise.

    If you are exercising to lose weight and that you have more hypoglycemia reactions, you might probably have to reduce your medication. It is a better solution to treat a low blood sugar that way, than having more snacks. Talk with your doctor about this.

    The time of day for exercising is important. Exercising when your insulin action is at its peak can cause your blood glucose to go down faster.

    You should know when the peak action of your insulin is to avoid this problem. Always carry fast acting sugar, such as glucose tablets, in case of hypoglycemia.

    Never inject insulin in a muscle, used for physical activity. Since physical activity increases blood circulation, insulin would be absorbed faster you could have a hypoglycemia.