Diabetes and diet | The role of exercise in the treatment of diabetes | Diabetic neuropathy | Diabetic retinopathy | Exercise for patients with diabetes
Proper nutrition plays a crucial role in the treatment of most diseases, but with diabetes it is of key importance. So, in patients with type 2 diabetes mellitus, a diet contributing to weight loss, can often stop the progression of the disease and the development of dangerous complications.
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Basic principles of nutrition for patients with diabetes
There are basic principles of nutrition for patients with diabetes mellitus:
- The patient’s diet should include the entire spectrum of macronutrients – proteins (15%), fats (25%) and carbohydrates (60%).
- You cannot exclude carbohydrates from the diet or limit their volume: this will not lead to a decrease in glucose levels – it will be synthesized in the body from fats and proteins. It is important to minimize the consumption of carbohydrates that are easily digested (sugar, sugary drinks, refined cereals) – they lead to a sharp spike in blood glucose levels, which are difficult to quickly compensate for by the administration of insulin or sugar-lowering drugs. It is necessary to choose “complex” carbohydrates, such as vegetables, fruits, whole grains – they are slowly digested and the level of glucose in the blood rises gradually.
- It is necessary to reduce the content of animal fats in the diet, contributing to the development of atherosclerosis, and give preference to vegetable fats, fatty varieties of fish are also useful.
- You should eat often, fractionally and in small portions, in order to avoid sharp “surges” in the level of glucose in the blood.
- The diet should be rich in vitamins and minerals: their deficiency in diabetes exacerbates metabolic disorders.
- In patients with normal weight, the daily calorie intake should correspond to energy consumption, and overweight patients (which is more often observed with type 2 diabetes) should consume less calories than they spend in order to gradually and smoothly get rid of extra pounds. This is the easiest and most effective way to lose weight! A doctor – a nutritionist can help with this.
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The role of exercise (exercise therapy) in the treatment of diabetes
Physical activity plays an important role in the treatment of diabetes and the prevention of complications. Muscle function contributes to the utilization of glucose, helps to reduce weight, and increases the sensitivity of receptors to insulin. In addition, physical exercises create conditions for better blood supply to all organs, primarily the heart and skeletal muscles themselves, the formation of new vessels to replace the destroyed ones, which helps to avoid their “drying out”.
The problem is that choosing an adequate physical activity for patients, especially those insulin-dependent and having complications, is not easy:
It is vital to accurately correlate the dose of insulin and the degree of physical activity. So, with a blood glucose level of more than 14-15 mmol, active exercises are contraindicated, since the injected insulin will not be able to ensure full glucose uptake by working muscles. In such a situation, active physical activity will only exacerbate metabolic disorders. Therefore, an appropriate level of physical activity is selected by the doctor under the control of blood glucose levels.
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Patients with diabetic neuropathy
In patients with diabetic neuropathy, pain sensitivity may decrease, and painless forms of coronary heart disease may develop. As a result, such patients cannot adequately assess their tolerance to physical activity, which can cause heart attacks and death.
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Patients with diabetic retinopathy
In patients with diabetic retinopathy, physical activity, especially running, jumping, weightlifting, can lead to retinal detachment and the development of blindness.
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Patients with impaired blood supply to the lower extremities
In patients with impaired blood supply to the lower extremities (diabetic foot), running and active walking exacerbate disorders of the blood supply to tissues, contribute to the development of ulcers and gangrene.
Many patients with diabetes also suffer from arterial hypertension (high blood pressure): physical activity with high blood pressure significantly increase the risk of strokes.
Diabetes mellitus often develops with those who are overweight and have a habit of a sedentary lifestyle (physical inactivity). Therefore, physical activity for them is stress, against the background of which the sensitivity of cells to insulin decreases, metabolic disorders progress and the risk of complications increases.
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Exercise for patients with diabetes
Thus, despite the obvious usefulness of exercise for patients with diabetes mellitus, it is quite difficult to choose a regimen that would help, but not cause additional harm. The abundance of complications, concomitant diseases that invariably develop with diabetes, often makes even moderate physical activity harmful, and therefore inaccessible to many patients. In this situation, the only way to get some of the positive effects of exercise, while avoiding dangerous consequences, is phoning or vibroacoustic therapy.