Written by: Tanya Bellon, Biokineticist
Exercise uses one of two energy systems, aerobic or anaerobic. A good understanding of these 2 energy systems is critical to understanding the exercise challenges faced by individuals with diabetes. Furthermore this knowledge will aid people with diabetes to ingest the correct snacks and make appropriate insulin dosage adjustments before during and after exercise.
What is Aerobic exercise?
In aerobic exercise such as jogging or cycling, the body uses oxygen to produce energy. During these exercises, the muscles use oxygen to convert glucose into usable energy for the body.
Why does aerobic exercise cause Hypoglycaemia?
Aerobic activities increases the blood and oxygen supply to the body, causing an increase in insulin circulation. As the length and intensity of the exercise increases so will the demand for energy. This will make the muscles more insulin sensitive therefore increasing the glucose uptake and lowering blood glucose.
Benefits of Aerobic Exercise for both diabetic and non-diabetic people
· Strengthens heart and lungs
· Improves muscle sensitivity reducing glucose levels
· Reduces blood pressure and cholesterol
What is Anaerobic Exercise?
Anaerobic exercise is short and intense, just think of Brian Habana sprinting 50metres to the try line, or a person doing a gym circuit with rest intervals between exercises. The energy to perform this is created without using oxygen. Energy (glycogen) stored in the muscles and liver is converted into usable energy (glucose).
Most sports involve a combination of aerobic and anaerobic energy systems for example rugby and soccer.
Benefits of Anaerobic Exercise for both diabetic and non-diabetic people
· Builds muscle
· Strengthens bones
· Improves speed and power
· Increases muscle metabolism
Effect of high intensity anaerobic type exercise on a person with Type 1 diabetes
Glucose levels may spike within twenty minutes of starting to a high intensity anaerobic type activity like squash. This reaction known as “Liver dumping” happens because the liver literally “dumps” large amounts of glucose into the blood stream. Intense exercise can cause an adrenal stress response (“flight or fight”) causing increased glucose allowing one to move rapidly or lift a heavy weight. Consult your doctor or nurse educator when making insulin dosage adjustments or snack adjustements with this type of activity.
Effects of combining Aerobic and Anaerobic exercise for people with Type II diabetes
Research shows that a combination of aerobic and resistance (Anaerobic) training has far greater benefits than only aerobic or resistance training. Patients who walk on the treadmill and do weight training had a greater improvement in their HbA1c than just walking or weight training alone.
In type 1 diabetes the combination of moderate intensity (aerobic) and high intensity (anaerobic exercise) may prevent hypoglycaemia post exercise because of the adrenal response keeping the blood glucose levels higher after exercise.
Conclusion and Recommendations
It is recommended that aerobic and anaerobic type exercises are incorporated into an exercise programme. People with Type 2 diabetes will experience improvements in overall glucose control, decreased body fat percentages and reduced coronary heart risk factors.
People with Type 1 diabetes will also show an improvement in glucose control, lowered coronary risk and lowered body fat percentage if they exercise daily or alternate days. However they need to monitor their blood glucose response to various exercises and then make changes to insulin and snacks accordingly. In Type 1 diabetes preventing hypoglycaemia during and after activity will improve long term compliance and enjoyment of exercise.
Before starting any exercise programme it is important to have a medical check up with your doctor to ensure that you are safe to exercise.
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