User:Madison.brockbank/Diabetes management

Exercise
Those who have type two diabetes are prone to having higher than normal blood glucose levels; one way to help manage these levels is through exercise. People diagnosed with type two diabetes can use exercise as a way to maintain their blood sugar and it has been shown to work just as well as medications. Any physical activity can improve type two diabetes, whether that is walking, swimming, or dancing, any type of movement that burns calories.

People living with type two diabetes go through many challenges, one of those challenges is keeping on top of blood glucose levels. Exercise will not only improve blood sugar levels, but can also allow the body to be more sensitive to insulin, reduce the risk of heart disease and stroke which are common illnesses associated with diabetes. By exercising, the body becomes more sensitive to insulin allowing for better absorption of glucose by the muscle cells, not only during but up to 24 hours later as well. Through many studies, it has been made clear that exercise helps with glycemic control and has shown to lower HbA1c levels by approximately 4.2 mmol/mol (0.6%). Studies show that exercise along with diet can slow the rate of impaired glucose tolerance in those with type two diabetes. With that, it is recommended people with type two diabetes take part in 150 minutes on average of exercise a week.

There have not been studies that show how exercise can help manage blood glucose levels in those with type one diabetes. Studies on youth and young adults with type one diabetes where the HBA1c was monitored in both a controlled group and intervention group over a 1-3 month and even up to 5 month program showed no consistent effect on glycemic control. Possible factors that may affect the impact of exercise on management of glucose levels in type one diabetes are that energy consumption increases near time of exercise to account for possible hypoglycaemic episodes; this may be the reason type one diabetics do not see the lowering of glucose levels during exercise. Those with type one diabetes are also prone to nocturnal hypoglycaemic episodes due to exercise as the translocation and expression of GLUT4, which is an insulin-regulated glucose transporter that is used to give glucose to muscle and fat cells, are increased by exercise.

The two most effective forms of exercise for people with type two diabetes are aerobic and resistance training. Aerobic exercise has been shown to largely improve HbA1c, and contributes to weight loss and the enhanced metabolic regulation of lipids and lipoproteins. This may be any form of continuous exercise that elevates breathing and heart rate. A few popular forms of aerobic exercises include walking, cycling, hiking, swimming, rowing, tennis, and cardio classes like Zumba.

During the last 2 decades, resistance training has gained considerable recognition as an optimal form of exercise for patients with type two diabetes. The goal is to build muscle strength by lifting weights, training in calisthenics, yoga, or using weight machines. This form of exercise was linked to a 10% to 15% increase in strength, blood pressure, BMD health, insulin sensitivity, and muscle mass. Current diabetes guidelines recommend strength training two to three times per week in addition to aerobic activities.

The combination of aerobic and resistance training, as recommended by current ADA guidelines, is the most effective when it comes to controlling glucose and lipids in type two diabetes. During a review on 915 adults with diabetes it was reported that combination training was the most effective in reducing HbA1c instead of a singular form of exercise on its own. The American Diabetes Association recommends 150 minutes of moderate to vigorous aerobic exercise a week spread over three to seven days with no more than 2 days between each session paired with 2 to 3 nonconsecutive sessions of strength training. To maximize insulin sensitivity it is recommended to exercise daily. The Association claims that 75 minutes a week is sufficient for most physically fit or younger patients.

Not only does exercising regularly help manage blood sugar levels and weight, it helps reduce the risk of heart attack and stroke, improves cholesterol, reduces risk of diabetes related complications, increases the effect of insulin, provides a boost in energy levels, helps reduce stress and contributes to positive self-esteem. Although incredibly beneficial, the results begin to fade within 48 to 96 hours.Therefore, an ongoing exercise program is required to maintain the health benefits associated with these forms of training.