Canadian Health: Treatment without insulin
EXERCISE
I’ve heard that exercise is good for people with diabetes – is this true? If so, I’m not the sporty type and have never found going to the gym has any appeal to me. What should I do?
Exercise is good for people with diabetes (and for everyone else as well), and indeed it is one of the few things that have been shown to reduce the risk of developing diabetes. Exercise does not have to involve sports, and you can usually find something to suit your lifestyle. The staff at your local fitness centre are specially trained to help you with this, and these centres are a good place to start. They will work out an exercise programme with you and show you how to improve your fitness. 
If you don’t want to visit a fitness centre, here are some other suggestions.
- Walk whenever you can and avoid using the car.
- Climb stairs rather than take the lift.
- Walk to and from work.
- Take your dog for more or longer walks.
- Consider buying a bicycle or exercise bike.
- Make a point of taking at least three half-hour walks a week at a fast pace.
- Take up swimming.
I have been told that it is important to take exercise now I have been found to have Type 2 diabetes. I’m not sure exactly what I need to do. Could you give me some specific advice?
The exercise programmes that have been used in large research projects were designed to prevent diabetes in people with a high risk. However, there is no reason why the same programmes should not be useful in treating Type 2 diabetes. The recommended time spent in exercise is 150 minutes a week, which is 30 minutes a day with a couple of rest days.
The type of exercise can be anything that makes you short of breath, such as fast walking, swimming, cycling, visiting a gym, dancing, taking up a sport or using an exercise machine. Choose a form of exercise which you find pleasurable. You may enjoy the experience more if you exercise with a friend or partner.
Exercise can of course bring down your blood glucose, and if you are using insulin you may need to reduce the dose before you are physically active. If you take a sulphonylurea (such as gliclazide) you should be on the look-out for hypoglycaemia and possibly reduce the dose if this happens.
If I keep to a good diet, why do I need to exercise as well?
Regular exercise stimulates a series of events in the body that result in changes in body composition. It reduces the amount of fat and increases the amount of lean tissue: muscle, fibres and bone. This increases your metabolic rate and improves your fitness, which is the amount of exercise that you can do without getting tired or exhausted. This not only makes you feel better but also reduces blood pressure and the ‘bad’ cholesterol (low density, LDL) and increases the ‘good’ cholesterol (high density, HDL). (See the question below on cholesterol.) Increasing fitness also increases the body’s sensitivity to insulin and lowers blood glucose levels. It may also increase the tendency to develop hypoglycaemia and you might be able to reduce your insulin dose as your fitness improves.
by Canadian health and care Mall.