Therapeutic exercise in diabetes mellitus

Therapeutic exercise( exercise therapy) in diabetes, combined with other importantelements of treatment( insulin therapy, medication, diet and self-control), plays a crucial role in compensating the disease and has a beneficial effectie on the patient, helping to maintain good health and performance.

The role of curative physical education in diabetes mellitus ^

Therapeutic exercise in diabetes mellitus( SD) is designed:

• to activate and normalize disrupted carbohydrate, fat and protein metabolism to prevent the occurrence of life-threatening complications of diabetes mellitus like hypoglycemic shock and diabetic coma,
• also stop the development of concomitant diseases( hypertension, atherosclerosis, pustular skin lesions, kidney disease, gangrene of the lower extremities, infections, and others).
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Due to the violation of protein and fat metabolism, toxic substances accumulate in the body and it is poisoned by products of incomplete combustion of fats. In addition, the violation of fat metabolism leads to the fact that the blood is filled with fat, it increases the level of bad cholesterol, resulting in a multiply increased risk of atherosclerosis and other cardiovascular diseases.

Therapeutic exercise is shown not only for all types of diabetes mellitus( except for the depleted because of untreated or ill-treated diabetes patients), but also in the pre-diabetes state. Modern research proves that if strictly adhering to the prescribed diet, exercise therapy and abandon bad habits - overeating, smoking and alcohol, then the transition of pre-diabetes to diabetes can be avoided.

According to the available data, the most frequent occurrence and development of diabetes is caused by overeating. That is why people who are prone to fatness and having metabolic disorders must understand that as soon as the carbohydrate metabolism is involved in the painful metabolic process, diabetes will inevitably develop.

In this regard, people who are overweight, at risk of diabetes, should periodically be examined for the presence of sugar in the blood and urine in time to detect the first symptoms of the disease and begin treatment.

In addition to excess weight, you should pay attention to the following common symptoms of beginning diabetes:

• prolonged non-healing of wounds,
• unresponsive furunculosis,
• pruritus,
• gum bleeding,
• loosening of teeth,
• sexual weakness.

Features of exercise therapy for diabetes mellitus ^

The main tasks of exercise therapy in diabetes:

• improvement of cardiovascular and respiratory systems;
• increased patient performance;
• decreased hyperglycemia in insulin-independent( type 2 diabetes) and increased insulin action in insulin-dependent patients( type 1 diabetes);
• counteract the development of micro- and macroangiopathies.

In diabetes, in addition to insulin deficiency, oxidative processes in muscles are violated, which is why they can not utilize glucose. With a physical load, the oxidative activity of enzymes is significantly increased, alkaline reserves are raised in the blood, which increases the absorption and consumption of sugar by muscles, decreases hyperglycemia and increases the body's tolerance of carbohydrates.

In addition, exercise in combination with insulin therapy enhances the therapeutic effect of insulin, strengthens the nervous and cardiovascular system of the patient, increases the body's resistance and prevents the development of atherosclerosis.

A distinctive feature of exercise therapy in diabetes mellitus is that the recommended exercises should be performed at a moderate( non-rapid) rate, as well as with muscular effort. In this case, not anaerobic, but oxidative processes occur in the body, which contribute to an increase in glucose consumption by muscles.

• It is recommended to begin exercises of therapeutic gymnastics from elementary exercises for muscles of legs, arms and trunk without weights, combining with breathing exercises.
• In the future, you can include exercises for weaning and resistance with dumbbells or expanders.
• In addition to exercise therapy, useful dosed walking, rowing, biking, swimming, skiing, gardening, easy physical work.

When practicing physiotherapy exercises, you should carefully monitor your well-being:

• If after training a feeling of weakness or fatigue arises, the load must be reduced.
• If during training the hands began to tremble, there was a feeling of hunger and strong weakness, you need to eat 1 -2 pieces of sugar and immediately stop exercising.
• You can resume training only the day after the disappearance of symptoms of hypoglycemia, while decreasing the dosage.
• Patients with diabetes mellitus on insulin therapy are recommended to lower the insulin dose( after agreement with the attending physician) on days of prolonged and intensive physical activities.

To conduct exercise therapy should be in a well-ventilated room or in the open air, breathing should be free and rhythmic through the nose, and the exhalation is longer than the inspiration. Physical exercises need to alternate for different muscle groups and perform with a large amplitude in the joints.

Repeat each exercise you need 5-6 times, later, as you train, you can increase the load by reducing the pauses, increasing the pace and the number of repetitions. Age is not an obstacle for practicing physical therapy, only the patient's well-being and changes in hyperglycemia and weight are the control.

As the patient's blood sugar level rises after a night's sleep,( which is partly explained by the rest of the sleeper), gymnastics, walks and light physical exercise in the morning are most useful, since they not only lower the glucose level, but also contribute to the release of insulin in larger quantities, which is most effective at this time.

But, if possible, try to exercise and in the evening( 1.5 to 2 hours before bedtime) to provide yourself with an equivalent physical load during the day.

Complex of therapeutic gymnastics for diabetes mellitus ^

• The starting position is the main rack. Put your foot back, raise your hands upwards - inhale, return to i.p.- Exhalation. Repeat 4-5 times.
• For 2-4 minutes, go alternately with a high hip lift, with the movements of the hands up and to the sides, with attacks. Breathe freely.
• Stand upright, hands behind your head, elbows in front of your face. At the expense of 1-2 dilute to the side, inhale. At the expense of 3-4, go back to the starting position, tilt your head forward, exhale.
• Legs shoulder width apart. Divide your arms to the sides, turn your body to the left to the left, the right hand should be in front of the chest. Then turn right to the right( left arm in front of the chest, right hand to the side).Lean forward to the left foot, taking out the sock with your right hand. Repeat on the other side.
• The starting position is arms to the sides, legs apart. Make 3 spring tilts to the left( the right leg is bent, the left arm behind the back, the right hand is lifted up).
• Makhi feet, reaching out to the palms of the hands folded in front.
• The starting position is the main rack. Lean forward, trying to reach the floor with your hands, without bending your legs. Then go down to the point of view, kneeling, alternately moving the legs back take the emphasis lying down. Without bending arms and legs and not shifting them from their seats, raise the pelvis higher by tilting forward, lowering your head between your hands. Lower the pelvis, taking the emphasis lying down. Then alternately move the legs forward, take the emphasis on your knees, lift the pelvis up, straighten your legs and arms.
• Stab sitting, fingers pull back. Bend over to the back of the bed. Without shifting the heels and hands from the seat, sit down to the heels of the bent legs, then, without lifting your hands from the floor, stretch your legs and put them apart. Connect and bend your legs, then straighten( without moving the heel from the seat) and return to the starting position. Repeat 6-8 times.
• Lie on your back, arms bend over your chest( forearms are parallel one above the other).Raise them upwards, not unbending and not disconnecting( inhaling) and lowering into place( exhalation).
• Lie on your stomach, palms under your shoulders. Spread your arms out to the sides( put your hands on the floor), bend your legs back, then straighten them and bend over, tearing away the straight legs and hands from the floor, taking your head back. Hold in this position for a few seconds, again dilute and reduce legs, return to the starting position.
• Lie on your back, lift your feet vertically. At the expense of 1-2 dilute and reduce your legs, at the expense of 3-4 flex and straighten. Repeat 4-6 times without holding your breath.
• The starting position is the main rack. Raise your hands to your shoulders( inhale), then relax "drop" them, lowering your head and rounding your shoulders.
• Perform a calm walk for 2 minutes.

At the end of classes it is useful to take a cool shower, bath or wipe, since water procedures well activate the oxidative processes in the body:

• To start wiping, you need a towel soaked in water at room temperature( not lower), gradually lowering the water temperature by one degree in a few days.
• Movement during wiping should be directed from the periphery to the heart.

Despite the fact that diabetes is a life-long disease, with good self-control and compliance with all prescriptions of the doctor, diabetics can lead labor and socially useful life along with healthy people and live to a very old age.