diabetes and exercise dr jubbin jagan jacob md department of endocrinology cmc vellore
TRANSCRIPT
![Page 1: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/1.jpg)
Diabetes and Exercise
Dr Jubbin Jagan Jacob MD
Department of Endocrinology
CMC Vellore
![Page 2: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/2.jpg)
Exercise is the best insulin sensitizer on the market; better than any medication we currently have available" Bartol
![Page 3: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/3.jpg)
Clinical Implications
Even short-term (2-week), regular aerobic exercise in type 2 diabetic patients results in significant improvement in both aerobic capacity and whole-body insulin sensitivity.
![Page 4: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/4.jpg)
Clinical Implications
Long-term endurance training in diabetic patients markedly improves whole-body insulin sensitivity and the expression of key muscle enzymes regulated by insulin. However, the maintenance of this effect seems to require dedication to a regular and uninterrupted exercise regimen
![Page 5: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/5.jpg)
Clinical Implications
Intramyocellular lipid accumulation, which is associated with insulin resistance in muscle, can be acutely decreased by even a single bout of sustained endurance exercise, in a manner that depends on both duration of exercise and workload.
![Page 6: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/6.jpg)
Clinical Implications
Exercise is beneficial for both glucose uptake mechanisms and the antilipolytic effects of insulin.
![Page 7: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/7.jpg)
THE EXERCISE PRESCRIPTION
1. Before beginning an exercise program, the individual with diabetes mellitus should undergo a detailed medical evaluation
2. A careful medical history and physical examination should focus on the symptoms and signs of disease affecting the heart and blood vessels, eyes, kidneys, and nervous system.
![Page 8: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/8.jpg)
`Potential adverse effect of exercise
Cardiovascular Microvascular Metabolic Musculoskeletal and traumatic
![Page 9: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/9.jpg)
Cardiovascular
Cardiac Dysfunction and Arrythmias due to silent IHD
Excessive increments in Blood pressure
Post Exercise Orthostatic hypotension
![Page 10: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/10.jpg)
Microvascular
Retinal Haemorrhage Increased proteinuria Acceleration of other
microvascular lesions
![Page 11: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/11.jpg)
Metabolic
Worsening of Hyperglycemia and ketosis Hypoglycemia
![Page 12: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/12.jpg)
Musculoskeletal and traumatic Foot ulcers Accelerated
degeneration of joints
![Page 13: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/13.jpg)
Preparing For Exercise
proper warm-up consisting of 5–10 min of aerobic activity
activity session, a cool-down should be structured similarly to
the warm-up and should last about 5–10 min
![Page 14: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/14.jpg)
Avoiding Complications
Proper Footwear Avoid Exercise in extreme Heat or Cold Inspect Feet daily before and after Exercise Avoid Exercise when metabolic control is
poor Maintain good water intake Prevent hypoglycemia
![Page 15: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/15.jpg)
Practical considerationsHow much exercise? A good goal for many people is to work up to
exercising 4 to 6 times a week for 30 to 60 minutes at a time. Remember, though, that exercise has so many benefits that any amount is better than no exercise.
![Page 16: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/16.jpg)
How to get the patient started? Begin with a 10-minute period of light
exercise or a brisk walk every day and gradually increase the duration of exercise.
![Page 17: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/17.jpg)
Tips that will help the patient start and stick with an exercise program: Choose something the patient likes to do. Get a partner. Vary the routine. Choose a comfortable time of day. Forget "no pain, no gain." Make exercise fun.
![Page 18: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/18.jpg)
Aerobic exercise
Aerobic exercise is the type that moves large muscle groups and causes you to breathe more deeply and your heart to work harder to pump blood. It's also called cardiovascular exercise. It improves the health of your heart and lungs.
![Page 19: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/19.jpg)
Aerobic exercise include
Jogging
Swimming
![Page 20: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/20.jpg)
And also
Walking Rowing Bicycling
![Page 21: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/21.jpg)
Weight-bearing exercise
The term weight-bearing is used to describe exercises that work against the force of gravity. Weight-bearing exercise is important for building strong bones.
![Page 22: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/22.jpg)
Weight-bearing exercise
Weight lifting Walking Jogging Climbing Stairs
![Page 23: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/23.jpg)
What is the best exercise?
The best exercise is the one that your patient will stick to
Walking is considered one of the best choices because it's easy, safe and cheap. Brisk walking can burn as many calories as running, but is less likely than running or jogging to cause injuries.
![Page 24: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/24.jpg)
What about weight training? Weight training, or strength training, builds
strength and muscles. Calisthenics like push-ups are weight-training exercises too
![Page 25: Diabetes and Exercise Dr Jubbin Jagan Jacob MD Department of Endocrinology CMC Vellore](https://reader030.vdocuments.us/reader030/viewer/2022033019/56649e2f5503460f94b1f1ff/html5/thumbnails/25.jpg)
Thank You