- Intro

Being physically active is good for diabetes. This includes traditional

exercise like going swimming or playing football. But also small things like
moving more when you’re travelling to work or using the stairs instead of
the lift. It all makes a difference.

We know that the way your diabetes affects you is unpredictable. You
don’t always know how you'll feel or what you can and can’t do. Which
makes the small victories important, even when it comes to being active.
Because it doesn’t matter whether it’s something small and new, or just
that little bit more of something you already do.

Here we’ll take you through the benefits of being active for diabetes and
show you what type of activities are good to try. We’ll help you start small
and build up, in a way that suits you. As of February 2020, numbers from
the previous year are given below. Prevalence refers to the number of
people currently diagnosed with diabetes. There are 3.9 million people
who have been diagnosed with diabetes in the UK. [ CITATION Spo \l 1033 ]

Figure - 1: Diabetes Prevalence 2019

Source: DIABETES.ORG.UK

Some people worry that being physically active will be too tiring or
make their diabetes harder to manage.

And if you’re someone who gets hypos, you’re probably worried about
getting more. But activity doesn’t always make your blood sugar levels go
down – it can make them go up too. We’ve made a guide to blood sugar
levels and exercise to help you.

That’s a lot of worries and they’re all understandable. But we’re here to
bust these myths and make sure you know all the important benefits of
exercising when you have diabetes.

Benefits of being active with diabetes include:

helps the body use insulin better

helps you look after your blood pressure, because high blood pressure
means you’re more at risk of diabetes complications

helps to improve cholesterol (blood fats) to help protect against problems

like heart disease

helps you lose weight if you need to, and keep the weight off after you’ve
lost it – there are so many more benefits to losing extra weight

gives you energy and helps you sleep

helps your joints and flexibility

benefits your mind as well as your body – exercise releases endorphins,

which you could think of as happy hormones. Being active is proven to
reduce stress levels and improve low mood.[ CITATION Dia1 \l 1033 ]

- Fitness & exercise in the special population

There isn’t one type of activity that’s best for everyone with diabetes. It’s
about finding what works for you and depends on lots of things, like what
you enjoy, where you are and how much time you have. Think about how
activity can fit in with your life, not the other way around. And work
towards adding in some more traditional exercise too.

It’s best to do a mixture of different types of activity, because different

types have different benefits. And doing the same thing can get boring
after a while.
For example, swimming can make you breathe harder and raise your
heart rate. This is good for your heart health because your heart has to
work harder to pump blood around the body. And with diabetes, keeping
your heart healthy and fit is even more important because you’re more at
risk of heart disease and other complications.

Whereas doing something like digging in the garden helps with strength
and can help the body use insulin better.[ CITATION Spo \l 1033 ]

- Practical Application

When you have diabetes, there are loads of things you can do at
home to get active.

Gardening

Housework

Carrying shopping bags

Stand during a TV ad break

Get active when travelling

When you’re out and about, it’s surprising how a slight change of routine
will increase how active you are and help you feel better when you’re
living with diabetes.

Getting off the bus one stop earlier

Cycling

Walking

Get active at work

Keeping active at work when you have diabetes is important, especially if

you have to sit down in front of a computer for a long time.
Walking up stairs

Walking meetings

Standing when you’re on the phone

Chair-exercises like sitting and lifting your arms up

Get active as a hobby

Start up an active hobby – it’ll help you manage your diabetes and feel
good.

Swimming or dance class

Throwing or kicking a ball around in the park

Walking catch-ups with friends[ CITATION Spo \l 1033 ]

- Exercise guidelines:

If you have diabetes complications, like problems with your eyes and feet,
you’ll need to think a bit more about the activity you choose. For example,
if you have foot ulcers you might need to avoid certain types of weight-
bearing activity like jogging. Chair-based exercises might be better for
you, like raising your legs one after the other or lifting baked bean cans
while you’re sitting down.

Remember that a little bit of activity has so many benefits, so do as much

as you can and reward yourself for any small changes you make.

It’s really important you take care of your body, as well as be active. So
speak to your healthcare team for more advice on what’s best for you
before starting anything new. They can help you decide what’s safe for
you and consider any complications you have.[ CITATION Spo \l 1033 ]

- Role of the GSR:

This will be a great learning opportunity for me to learn from senior
doctors and help out as much as possible to ease the pressure on health
industry. I am more than happy to be involved in giving exercise tips and
training to the patients. As there are different age group of patients, so i
have prepared Physical/Training exercises suitable to them.

Being physically active can affect blood sugar levels in different ways,
depending on the type of activity you’re doing.

We know a lot of people don’t want to exercise because it can lower their
blood sugars. You might be constantly worried about hypos, and that’s
understandable. But did you know that not all types of exercise make your
blood sugars go down? Some make them go up too.

Understanding more about what happens before, during and after you’re
active could help ease some of this worry and also manage how your
levels fluctuate. If you check your blood sugars yourself, whether that’s
using some diabetes technology or test strips, try doing this more often
around the time you’re getting active. Trial and error can really help you
spot patterns, but remember to stay safe – check out our tips on
managing blood sugars.[ CITATION Dia1 \l 1033 ]

- Conclusion

The challenges of exercising and managing diabetes:

The risk of hypoglycaemia is high

When someone doesn't have Type 1 diabetes, their body reduces the
amount of insulin they produce when they exercise. If you have Type 1
diabetes, you don't produce your own insulin, so if you don't adjust the
amount you take, your body will have the same amount of insulin in it
when your exercise. This means that your muscles use more glucose
which can cause a hypo.

Competitive sports can cause your blood sugar levels to increase.

Your blood sugar, or blood glucose levels, are affected by different
hormones. When you compete in exercises, like a football match, this can
cause you to become nervous and stressed. Stress releases a hormone
that affects your blood sugar levels making them harder to control.

Different types of exercise have different effects on your blood sugar.

There are three different types of exercise that can affect your blood
sugar levels.

Anaerobic exercise is high-intensity exercise over a short amount of time.

Aerobic exercise is lower-intensity exercise that you do over a longer

amount of time.

'Stop, start' is when you do aerobic exercise broken up by short spurts of

high-intensity exercise.

What are the challenges?

Exercising when you have 'insulin on board' (IOB) – for example, when you
exercise soon after a meal and still have some rapid insulin in your system
– may result in a greater risk of hypoglycaemia and a greater need for
carbohydrate to offset the IOB. This variable means that doing the same
exercise, but at different times, can result in varying effects on blood
glucose. It’s essential to know how much IOB you have at the start of
exercise.

Studies show that there is a large variation in how subjects respond to

exercise. What this means is that guidelines are very useful, as well as
learning from others, but remember that you’re an individual and your
body may respond differently to another.

Learn how different types of sports or training sessions affect your blood
glucose by testing before, during and after exercise, keeping a detailed
record to refer back to. Remember, you're an individual so don't be
alarmed if your blood glucose level behaves differently to what you
expected.
- Aesthetics
Try to stick to the whole food, lesser processed varieties of fat and low-
glycemic carbs, rather than the Frankenfoods that have been sitting on
the shelf at the grocery store for ages.

The other key is HOW MUCH of each to eat.

At the end of the day, it truly comes down to what works best for you and
your blood sugar management. Maybe fewer carbs work for you but more
carbs work for me.

But, after determining calorie and protein needs, try to partition the
remaining calories pretty evenly for fat and carbs.

For example, if your calorie requirement is 2000 per day and your protein
needs require 800 calories, try to split the remaining 1200 calories evenly
between fat and carbs (600 calories each) and work from there to
determine the optimal amount for you and your goals.[ CITATION How2 \l 1033 ]
 Figure 2: Diabetes Aesthetic

 Exercise is great, but nutrition is the key

Raise your hand if you’ve heard the saying “you can’t out-train a bad
diet.”

Maybe you’ve heard it, maybe not.  Either way, it is very true. It’s really
difficult to overcome a poor nutritional intake. Really, REALLY difficult.

Don’t get me wrong. Exercise is CRUCIAL for a healthy lifestyle and for a
successful weight loss initiative. It provides a ton of benefits that
otherwise wouldn’t be attainable. But, in isolation, exercise alone will not
result in as much weight loss as dieting will.[ CITATION How2 \l 1033 ]
Works Cited
Diabetes and exercise. (n.d.). Retrieved from DIABETES UK: https://www.diabetes.org.uk/guide-to-
diabetes/managing-your-diabetes/exercise

How to Lose Weight with Type 1 Diabetes. (n.d.). Retrieved from DIABETES STRONG:
https://diabetesstrong.com/how-to-lose-weight-when-you-live-with-diabetes/

Sports nutrition and Type 1 diabetes. (n.d.). Retrieved from DIABETES UK:
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/out-and-
about/sports-nutrition-and-type-1-diabetes