Bismillahirahmanirahim
What we need to know
q
It is now generally considered that
physical activity should play a key role
in the management of individuals with
diabetes 1,2.
q
However
there are a
number of factors that people with type
II diabetes should be aware of prior to
beginning an exercise program or
increasing activity levels.
Contraindications
You should not begin an exercise program and you
should seek medical advice if you have
v
Unstable angina
v
BP >200/100
v
Significant drop in BP during activity
v
Febrile illness
v
Uncontrolled glycaemia
v
Recommendation
One
A medical history and physical
examination should be performed
by your GP prior to commencement.
¨
Reasons: Different stages of Type II
¨
diabetes
can present unique problems that may need to be highlighted prior to an
exercise routine so that appropriate modifications can be made. For example
peripheral and autonomic neuropathy.
Physical
activity programs
For
those with type II diabetes without significant complications or limitations
should include arrange of endurance and resistance exercises.The following
recommendations will help you to decide
¨
how much exercise you need,
¨
how hard it should be,
¨
how often you should do it and
¨
what to expect as you become more physically
active.
Frequency
(How much is enough?)
¨
Research suggests at least three
Non consecutive days and up to five physical
activity sessions each week to improve
cardiovascular endurance
Intensity
(How hard?)
¨
Research suggests low-to-moderate
intensity physical activity (RPE 10-12)
¨
Due to potential autonomic changes or
medications is may not be appropriate to use
heart rate as a guide of intensity therefore the
BORG rate of perceived exertion scale is
suggested as an easy means of self
assessment.
BORG
Scale RPE
Example
of exercise
Time
(How long?)
¨
New to exercise or long lay off ?– start with
10-15mins. Gradually increase this over the
coming session until you can manage 30
minutes.
¨
If weight loss is a goal then gradually increase
the sessions to 60 mins of low-moderate
Exercise.
Type
(what sort of exercise ?)
Should be enjoyable but allow for good control
over intensity.
¨
Combining with personal
hobbies/interests is better. E.g. bird watching –
may involve long varied walks at the weekend.
¨
Walking is the most popular activity but such
conditions as peripheral neuropathy or
degenerative arthritis may require alternatives.
¨
That are non-weight bearing such as swimming
and cycling Resistance training to improve muscle
mass,
muscle strength and endurance also has been
shown to decrease risk factors for
cardiovascular disease
Guideline for exercise
¨
Guidelines suggest 2 days a week of 8-10
exercises involving major muscle groups.
one set of 10-15 repetitions to near fatigue is
suggested as a good place to begin.
¨
However as poor technique or unfamiliarity with
machines is common then appropriate screening
and supervision is recommended prior to
commencing. Particular caution should be taken
with retinal and cardiovascular complications
Recommendation
Before and After Exercise
¨
Ensure you have proper fitting footwear that is
suitable for the activity you are doing.
¨
Monitor your feet before and after exercise for
signs of blisters or damage
¨
Get your feet checked regularly.
Awareness..
¨
If taking insulin you need to be aware of
hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar), both of
which have implications for exercise
¨
Factors affecting low blood sugar levels are the
intensity and duration of the exercise, dose and timing of insulin , time of
day and environment
¨
Make sure you monitor glucose levels before and
after exercise and during exercise of greater than 60 mins. 1 You may need to
alter insulin levels or increase carbohydrate.
¨
For high blood sugar (blood glucose levels above
15mmol/l) prior to activity it is suggested physical activity should be
postponed until normal levels return.
¨
Don’t forget to adequately hydrate prior to,
during and after exercise. D R I N K.
Wallahuaklam...
0 Comments:
Post a Comment