Updated 17 November 2016

How exercise can help you manage your diabetes

Exercising as a diabetic can be tricky. However, a tailor-made programme that includes light exercise such as walking can help you achieve optimal health and fitness.

About 6% of the population (three-and-a-half million South Africans) have been diagnosed with diabetes mellitus, but there are many more who remain  undiagnosed.

It is estimated that another five million South Africans have pre-diabetes, a condition where insulin resistance causes blood glucose levels to be higher than normal, but not high enough yet to be type 2 diabetes.

Most patients have type 2 (90% of all cases), followed by type 1 (5%–10% of all cases). Although Type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people over 40.

How exercise can help

With exercise and movement an essential component in the management of diabetes alongside diet and weight control, the Biokinetics Association of South Africa (BASA) urges the three-and-a-half million South Africans – about six percent of the population – who have been diagnosed with the disease to consult a biokineticist for advice on the most appropriate exercise programme.

With a further five million South Africans estimated to be pre-diabetic, BASA also advises everyone to have their glucose levels tested.

Read: How to exercise as a diabetic

“The longer diabetes goes undiagnosed and unmanaged, the more damage it can cause to your cardiovascular system, nerves, kidneys, eyes and feet.

"It can also increase your risk of Alzheimer's disease, and affect your hearing and even your skin,” says Dr Jeanne Grace, BASA’s director of health promotion. “Different tests can be conducted to determine whether you have diabetes.

"Biokineticists are trained to conduct random and fasting glucose tests. Depending on your test result you will be referred for more specialised tests if necessary.”

The primary function of a biokineticist (who is registered with the Health Professions Council of South Africa [HPCSA]) as an allied medical professional alongside, among others, physiotherapists, occupational therapists, psychologists and dietitians, is health promotion and the improvement of physical functioning and health care through scientifically-based physical activity or exercise programme prescription.

Read: Exercise combats diabetes

According to Dr Grace, a diagnosis of diabetes is no reason to stop exercising – and every reason to start if you have been physically inactive. “A diagnosis of diabetes is also no reason for an elite athlete to give up, regardless of their sport.

"The most serious problem for people with diabetes mellitus who exercise is hypoglycaemia (also called low blood glucose or low blood sugar). This mainly affects those taking insulin or oral hypoglycemic medications that increase insulin secretion.

Read: More in obesity and diabetes

"A person who has been diagnosed with diabetes can do anything their non-diabetic peers can do, provided they are able to manage their condition effectively. A biokineticist can play a key role in this,” she says.

She emphasises that dealing with diabetes effectively requires a multidisciplinary approach. She advises anyone with raised glucose levels to be checked by a GP, physician or health nurse for other diabetes-related risk factors.

Read: Exercise protects diabetics hearts

“Once you know what your glucose level is and whether you have any of the diabetes-related risk factors, the biokineticist will prescribe an exercise or movement programme that is designed to reduce your glucose level and fat mass, while taking account of your state of health.

“The exercise programme prescribed by the biokineticist has to be combined with an appropriate individualised eating programme, which should be formulated by a registered dietitian.

"Should you have any of the side-effects of diabetes,  they will be taken into account by the biokineticist and dietitian when formulating appropriate exercise and eating programmes,” Dr Grace explains.

The benefits of an exercise programme for diabetics are:

- Improved glucose control and improved insulin sensitivity

- A reduction in medication required

- A decrease in body fat and the risk of developing cardiovascular diseases

- The prevention of type 2 diabetes

The most serious problem for people with diabetes mellitus who exercise is hypoglycaemia (also called low blood glucose or low blood sugar).

Read: Is exercise important if I have diabetes?

This mainly affects those taking insulin or oral hypoglycemic medications that increase insulin secretion.

Dr Grace therefore recommends that people with diabetes consult a biokineticst prior to exercising because biokineticist are trained with regards to:

 - Blood glucose monitoring before and for several hours following exercise, especially when beginning or modifying the exercise programme

 - The timing of exercise in individuals taking insulin or hypoglycaemic medications

 - Developing effective strategies to prevent hypoglycemia both during and after exercise in people who use insulin. (This could include changing insulin timing, reducing insulin dose, and/or increasing carbohydrate consumption.)

 - Individuals with retinopathy who are at risk for retinal detachment associated with vigorous intensity exercise

Get up and go

Some of the walks/runs scheduled to mark World Diabetes Day on November 14 include:

- Gauteng Global Diabetes Walk/Run at the Altrek stadium in Alexandra

- Port Elizabeth Global Diabetes Walk at the Nelson Mandela Bay Stadium on Saturday November 14

- Durban Global Diabetes Walk in Durban at the Amphitheatre at the Bay of Plenty on November 29

Read more: 

Cardio and resistance training manages diabetes  

Exercise helps diabetics with sleep apnoea  

Gestational diabetes mellitus and exercise 


Ask the Expert

Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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