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Dr. Harry Gruenspan Content Administrator Updated on: 07/09/2024 Next review: 07/03/2025

Diabetes — the root cause of a lot of problems

Diabetes is a chronic disease that has affected 425 million people worldwide. It is, by definition, a consistently elevated level of glucose in the blood. This happens either due to a lack of a hormone called insulin or it’s resistance by the body. Insulin regulates normal blood glucose levels by transferring the excessive glucose to muscles and liver for storage. This stored glucose can further be used when there is less amount of glucose in the blood due to exertion or starvation.

There are two types of diabetes: type 1 and type 2. In type-1 diabetes, the cells that produce insulin are attacked and destroyed by our own body (also known as auto-immune) this causes the body to not produce insulin at all and the only management is taking insulin directly. While in case of type 2 diabetes the body becomes resistant to insulin. The production of insulin starts to decline with the progression of the disease.

Though type 1 requires insulin replacement, type 2 is managed by medications that increase the sensitivity of the cells of the body towards insulin. These medications are a lifelong support for the diabetes patients and its chronic use causes adverse effects on kidneys and muscles.

About 95% of diabetes patients in America are type 2. There’s a misconception that the reason for type 2 diabetes is increased sugar intake. But in reality, it is due to obesity, stress and a sedentary lifestyle. All of which can be managed by diet and lifestyle modification. Dietary modifications are most commonly acquired by diabetes patients as they have a restriction of carbohydrates and sugar intake, but lifestyle modification is almost never taken into consideration. The complications of diabetes include heart diseases, retinopathy, and neuropathic pain and kidney diseases. These complications are due to an inactive lifestyle. Diabetes further makes the body weak and tired, this is where exercise can help. Diabetes greatly increases the risk of heart disease due to obesity which means a raised cholesterol level. Regular exercise has proven to be a great way to manage diabetes type 2 and its complications as most of them are stemmed by obesity.

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Here are some ways in which regular physical activity affects diabetes 2 patients:

  • The weight control greatly influences the progression of the disease and decreases the chances of other complications such as heart diseases and neuropathic pain.
  • Excessive glucose can be transported to the muscles without the need for insulin. The excessive glucose is utilized by the muscles during exercise and thus, the glucose level in the blood drops to a normal level.
  • Exercise can reduce the body’s resistance to insulin, in other words, exercise makes the body more sensitive to insulin and allows it to function properly. It is, however, necessary to exercise on a regular basis as the sensitivity deteriorates within 72hrs of the last session of exercise. Any exercise that is slow but effective can help increase the sensitivity.
  • Obesity in diabetes increases the risk of atherosclerosis (blocking of an artery by cholesterol) and heart attack. Physical activity reduces the cholesterol and subsequently, chances of a heart attack as well. It improves overall blood flow to the heart and makes it strong. It is, however important to keep in mind that even if you are not able to reduce weight initially, continue to work out. Anything that increases the heart rate is good to maintain health in the long run.
  • Physical activity also reduces the risk of diabetes-related kidney disease. It helps improve the flow of blood in the kidney and improve the overall structure of kidneys. This negates the adverse effects imposed by medications.
  • High blood pressure and diabetes together can cause severe eye problems. Exercise controls the blood pressure and prevents eye problems associated with diabetes. In this regard, yoga can be very convenient. It does not require too much of the effort initially and through proper instructions, you can ease into the more difficult poses. You can join Yoga classes where it is done in groups and a group activity keeps you motivated.

Although there is sufficient evidence of benefits of exercise on diabetes patients, it is still important to consult your doctor for a thorough check-up for heart health in case you have any underlying heart conditions like high blood pressure or nerve damage before starting exercises.

Once there is a go-ahead from the doctors, it is important to set the goals. Start with realistic goals, something that is achievable; especially if you haven’t been active in a while and from there onwards increase the duration and intensity of your exercise. It is extremely important to stay hydrated and keep some kind of instant snack with you while you exercise in case there is a sudden drop in blood glucose levels. Everybody has a different response towards exercise. In some people, it might temporarily boost the glucose levels in blood so it necessary to keep a glucometer with you to check before and after exercise.

Some of the exercises that diabetes patients can include in their routine are aerobics, yoga, strength training and flexibility, swimming and aquacise.

  • Aerobics includes biking, jogging, walking, swimming or any game like tennis or basketball that requires some extent of running. It is good to start with walking or brisk walking. It is favorable to choose an activity that interests you the most otherwise you might easily get de-motivated. Choose a group activity instead or take someone to walk/jog with so that you will be bound to go out and practice. Before transitioning into anything intense you can incorporate walking into the daily routine by preferring to walk for short distances instead of driving. Once the stamina is built, increase the pace into jogging/running. Set the goal for 30 mints of any exercise. You can break this time into 10 mints period thrice a day. Slow exercising instead of an intense workout is better. Aerobics reduces the risk of diabetes associated kidney diseases as it improves the blood flow in the body and regulates blood glucose levels. Aerobics helps utilize the extra glucose in the blood and turns it into energy thereby preventing the glucose levels to build up in blood.
  • Flexibility training will relax your muscles and help in neuropathic pain associated with diabetes. As the disease progresses, the muscles, bones, and joints start to pain frequently. Flexibility exercise reduces the soreness and tension in the muscles and maintains the activity of muscles and bones.
  • Strength training is a very efficient way to get lean and strong muscles. Diabetes weakens the muscles so, in order to restore its strength weight training and push-ups or pull-up can be done. Pushups and pull-ups uses the weight of your own body to help muscles to strengthen and it can be easily done without an instructor. For weight lifting exercise an instructor might be helpful initially. Once you know how to use all weight lifting equipment in the gym you can set the course and train on your own. As muscles use the most glucose, working the muscles help control the glucose levels.
  • Yoga, as mentioned above, does wonder to the body. It is also the easiest to start with.
  • Getting in touch with organizations that specifically organize training sessions, workouts, and yoga for diabetes patients can be of great help. You can get more education on diabetes and connect with people that are suffering through the same.

You can pick one or more exercises depending on your stamina and time availability. The workouts and physical activity have proven to be so beneficial in some cases that patients of type 2 diabetes have been taken off of the medications. Not needing the medication can provide a better health as all medications pose a degree of adverse effect on the body. Though never stop the medications without doctor’s recommendation even if you feel your symptoms subside. It is to be kept in mind that exercising cannot magically show its effects. It provides long-term benefits even if the effects cannot be seen physically. For those patients who have stress diabetes, exercising is a great way to de-stress. Regular exercise releases hormones from the brain that elevate the mood and along with all of its benefits on the body, stress relief can be of huge importance on your health.

Diabetes type 2 is often taken as some kind of untreatable and unmanageable disease that causes the body to deteriorate continually. This is only true if there is no physical activity and sedentary lifestyle is maintained. But numerous recent researches have proved that diabetes is highly manageable with lifestyle changes, especially exercise. The complications, effects of medications and path physiology of the disease can be easily managed.

Although in type 2 diabetes, if you are obese, then weight reduction is also much important as it may be helpful in reducing LDL (i.e. low-density lipoproteins), triglycerides and cholesterol levels ultimately controlling your blood glucose levels and blood pressure. Usually, diabetes gets controlled by insulin but if you have diabetes type 2, you have to eat healthy to keep the blood glucose level in a normal range.

Likewise, if a diabetic patient is consuming an increased amount of carbohydrates, it will be harmful as large quantities may cause destruction in the blood vessels and nerves, may ultimately cause serious health conditions, and may also affect kidney and heart muscles. So compensate blood glucose levels by taking low carbohydrate diet, so this may reduce diabetes complications.

Certain other food should be avoided if you are diabetic. This includes Tran’s fats that are the unsaturated fatty material that may not directly raise your blood glucose level but may cause insulin tolerance and inflammation and may worsen the condition of diabetes; similarly cereals, which are high in carbs but low in protein. While best is to take high protein meal and low carb diet in diabetes. Also, the processed foods, rice, bread these contain little amount of fibers and may cause slow absorption of sugar metabolites into the blood circulation, thus high blood sugar level is observed.

So regarding diet, it is very much important to understand that which food is helpful in maintaining the normal blood glucose levels and which to avoid. The main targets must include all those food that are healthy and sustain the normal levels while avoiding all high refined carb meals, processed grains, and unhealthy stuff.

Because long-term effects of diabetes may hinder your health ultimately routine activities, If diabetes is damaging large vessels of nervous systems, a heart so the macro vascular problem will be raised, and while if diabetes is damaging small vessels, then micro vascular difficulties will be raised (i.e. problems related to eyes, gums, kidneys etc.) Other complications may be raised; this includes your body defense mechanism (immune systems), skin, digestive system as well as your sexual organs.

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Diabetes can be monitored by have a regular check on your blood pressure (BP), blood glucose level, triglycerides, cholesterol levels, LDL (low-density lipoprotein also called as bad cholesterol), HDL (high-density lipoproteins also called as good cholesterol), electrocardiogram (ECG), exercise stress test, kidney functions, heart physiology, feet, eyes and gums /or teeth problems.

To have a check on eye-related problems (like retinopathy, cataract, and glaucoma) proper eye examination should be done by an ophthalmologist. Similarly for kidney-related problems screening of albumin in urine, and GFR should be done. For foot wounds or related problems visit a podiatrist and treat it properly. For nervous system disorder, psychologist or psychiatrist should issue mental health scheme. For skin related issues, have a check on blood glucose levels and Hb1Ac levels.

So the bottom line for the management of diabetes is to eat healthily, exercise regularly for at least half an hour, take your medications at proper time intervals, manage your lifestyle, avoid drinking alcohol and all unhealthy stuff and routine monitoring is mandatory.

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In conclusion, diabetes is the root cause of a lot of problems, therefore it is necessary to take precautionary steps to not make it worse and constantly monitor your diet and exercise to combat diabetes.
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