Is exercise absolutely necessary if you have diabetes?

Question

My husband is a late onset type 1 diabetic (33yo) and he just will not exercise. Otherwise he takes good care of himself, eats right and keeps his sugars pretty low. He has no other health problems. He's on cholesterol medication as a precaution (because his diet tends to be a little higher in fat). I'm wondering if he is doing any long term damage by not exercising now. Is it a MUST to exercise or is it just recommended generally.

I should add that one of the reasons he won't work out is that he gets so light headed during/afterwards and I think it scares him. Any strategies for eating to prepare for a workout?

I work out daily and I also walk the dog for an hour daily. He won't come with me.

Answer 1

No. There is little evidence to suggest that exercise is very important to Type 1 diabetics (the severe non-preventable kind not related to lifestyle) for their long-term outcome. If he is at a healthy weight, and his blood sugars are in a decent range, I would not worry at this point.

Many Type 1's actually find that exercise makes their control WORSE (i.e low blood sugars hours after they work out, or the surge in adrenaline causes high glucose levels). Of course it can be managed for the most part, and many Type 1's are atheletes, but for some, there appears to be more of a loss than gain. Paticularily if he finds it hard to keep his BG stable or he is prone to lows.

Exercise is good for everyone in general, but less than half of the studies I have seen show any long-term benefit in Type 1 diabetes in terms of glucose control. Most show no difference. Of course, exercise is great for preventing heart disease, but we have to remember that heart disease in Type 1 diabetics is caused by hyperglycemia and inflammation, and possibly autoimmune (antibodies to the blood vessel walls) mechanisms as well. Meaning, exercise might not make a huge difference in the outcomes of this group for heart disease.

If he is experincing light-headnedness, has he checked to make sure his blood sugar isn't low due to the exercise? Has he been instructed for how to adjust for exercise?

Does he have low blood pressure or take medication for high blood pressure (called an ACE inhibitor-used to protect the kidneys)? Does he have nerve damage? All of these things can dizziness.

He should also have an EKG and full physical before he attempts to exercise again. Tell his doctor about the lightheadedness if it is not related to his BG levels.

Try to get him out for a walk or bike ride if you can, but don't worry TOO much about it right now. If he has good control with his BG levels, he is doing better than most. It's an overwhelming disease, so take it as it comes.

I would try to cut down on the fat, unless it is the good "healthy" kind, as in mono or polyunsaturated.

EDIT: I want to add that TYPE 1 diabetics do not have insulin resistance. That is Type 2 diabetes. Of course, one can have both types of diabetes, but most Type 1's do not. They also usually have normal cholesterol levesl unless thay are in very poor control.

The bottom line is that a Type 1 will more than likely develop heart disease from: exposure to hyperglycemia, inflammation, possible autoimmune mechanisms in the blood vessels, and autonomic neuropathy (nerve damage) to the nerves that control the heart. They also have a higher risk of heart attack/failure if they have diabetic kidney disease. Exercise may help in general, but if the other issues aren't treated (and some you can't), the person will have heart disease anyway, exercise or not. It will keep you LOOKING good at least though, I agree. ;)

Type 1's need to be very cautious about maintaining control when exercising. Exercise while even moderately high, and your body will be under damaging oxidative stress because it can't access the needed glucose for energy in your blood easily due to a lack of insulin. Exercise if normal or too low, and you could have a reaction. Adjusting insulin doses are better, as eating every time you workout to counteract lows can actually make you GAIN weight, leading to a new problem. Type 1 is much harder to manage than Type 2, and exercise plays a less clear role.

Answer 2

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Answer 3

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Answer 4

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Answer 5

Remember that it's a balancing act. If he works out, the insulin becomes more efficient at transporting glucose into muscle. Hence, he needs a lesser quantity of insulin. If he wants to work out, he must pump up with carbohydrates and pump down with insulin. It's not always about keeping your bg's low. You need fuel for the fire. A low bg and then exercising is like running your car on fumes and an empty gas tank.

The benefits to exercise are: Reducing insulin purchases, feeling better, looking better, combatting insulin resistance, keeping joints from freezing up, and keeping circulation active.

Injected insulin works more efficiently through muscle, not fat. So if you are fat, you will require more insulin to overcome the fat's resistance.

Also, excess insulin will cause you to get fatter because the energy stored in your bg gets converted into fat. You will also have to eat more to combat the hypos, hence, more glucose turning to fat.

Although this is easier said than done, you really should force yourself to exercise frequently. Plan your carb intake and injection quantity and timing appropriately.

Three simple rules: 1) Intense exercise = high carbs, less bolus insulin 2) Lethargy = low carbs, more bolus insulin 3) Always maintain a level of basal insulin, whether it's a Humalog trickle from a pump or an injection from Lantus, Levermir, etc.

Answer 6

Exercise is necessary... at this stage you really are preparing yourself for those years later in life.

What worked for me was to get a treadmill that I can put in front of a TV in the basement to walk a few miles AND get my news shows in the morning. No going out, or undue fuss about throwing on some shorts and shoes and waking up with some gentle cardio work.

That has expanded to a new recumbent exercise bike, to mix it up a bit, but still allows me to workout and I am beginning to depend on my morning workouts to feel good.

The most important thing is to get over that hump of initial resistance to exercise!

Keep up the gentle encouragement!

Answer 7

Yes you can turn the test down, that is your choice. Almost all doctors run the test for GB even if a woman has no previous indicators of having GB. I never had any problems with my urine at my doctors appointments and took the GB test. The drink is gross and I felt like crap after drinking it, but the way I looked at it was that if something was wrong, I'd want to know for the health of my baby girl and because diabetes runs in both sides of my family.

Answer 8

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Answer 9

Yes, if he wants to live 15 or more years longer. He needs to get his circulatory system healthy, because that's where the damage from diabetes is worst. Exercise will help his heart and blood vessels.

Just tell him to be ready with gel glucose in case of low blood sugar, and monitor his feet for injuries he may not feel. Please, get him walking or jogging (or something) soon! If you join him, it will be fun for you both.

Answer 10

Get out and walk with him. EVERYONE should exercise, not just diabetics. Walking is easy and really, really helps. Get him interested and let it work for both of you.