Fitness in Diabetes, What it Means? -Miss Kanika Malhotra, Senior Nutritionist, HealthCare atHome
You can be fit even if you have diabetes
Diabetes and Fitness
Redefining fitness in diabetes
India has the world’s second largest population of people with diabetes after China with 69.2 million people suffering from diabetes. This number is projected to increase to 101.2 million in the next 15 years. Diabetes is projected to be the 7th largest killer in the world by 2030. Despite the alarming number, a survey conducted by the Association of Physicians of India in 2015 showed that 9 out of 10 people with uncontrolled diabetes believed their blood sugar was under control.
Poor glucose control and non-adherence to the physician’s instructions results in high chances of diabetes related complications such as heart attacks, nephropathy, stroke, retinopathy, neuropathy, amputation, etc. Diabetes and other lifestyle associated diseases (such as hypertension, heart diseases, obesity etc) are on the rise. All these ultimately lead to increase in diabetes related healthcare costs and expenditure.
However, this burden can be reduced if people with diabetes are fit. Very often when we talk about “fitness” for people living with diabetes we focus on physical fitness because of numerous visible benefits like it lowers high blood sugar, cholesterol & blood pressure levels and helps you lose excess weight.
However, living with diabetes triggers a roller coaster of emotions and feelings that we don’t focus on. Diabetes is of many types like Type 1 or type 2 diabetes or latent autoimmune diabetes in (of) adults (LADA), maturity-onset diabetes of the young (MODY), or gestational (during pregnancy) diabetes mellitus (GDM). Individuals suffering from these are in various age categories, have different mental make-up and have to be dealt in a personalized manner. They feeling overwhelmed, and could suffer from depression, anxiety, anger, burnout, and denial. What is of concern is that there are no definite “signs / symptoms” for these. According to WHO, depression is currently estimated to affect 340 million people with diabetes globally. People with diabetes and depression/poor mental health are more prone to reduced work productivity, lower adherence to medication, diet and exercise & lower quality of life.
So, ideally “fitness” for people living with diabetes should be a combination of fitness of the body and mind. What is helpful here is that physical activity helps in boosting the mental fitness as it releases endorphins, which make a person feel happier and increases the feel good quotient. Needless to say as you lose weight, you look and feel better and this also will make you more positive towards life.
So, what exercises can you do? You can choose what suits you the best from walking, weight training, cycling, swimming, gardening, active housework, dancing, playing and moving with children/grandchildren/pets etc. How long should you exercise? Well, 30 minutes every day for good health and 45 to 60 minutes a day if you aim to lose weight.
However, since you have diabetes, follow a few precautions to exercise safely. Before exercising, check your feet, blood sugar levels, and stretch your muscles to avoid injuries and sprains. Carry some juice / glucose with you in case you have low blood sugar. Do not exercise if blood sugars are below 70 mg/dl. Stop exercise if you feel faint or dizzy or have chest pain or headache or have shortness of breath. Always keep a medical ID with you. After exercise check feet again for redness or blisters, check blood sugar levels and drink water to hydrate yourself.
What can we do about mental fitness? We need to integrate diabetes & mental health care with mandatory screening of mental health status. There should be diabetes management, monitoring and support programs to address all concerns and queries and help people with diabetes achieve their goals as expected by their physicians.
However, physicians may necessarily not be trained on this aspect and don’t have necessary time for counseling. Therefore tele-health technology can help and provide holistic diabetes care even in patient’s home. Diabetes management programs such as ‘Diabee’ by Healthcare atHome (HCAH), pioneers in home healthcare, can be of huge help to physicians, and people with diabetes. Diabee gives ‘On Call’ support for day to day handling of challenges and decision making, online community support (peer to peer interaction and learning), real time chat support (one to one learning with the counsellor), and has an app for better real time data reporting and intervention and ongoing education. Several patients have successfully overcome depression and uncontrolled sugar levels by following the Diabee program.
Physical and mental fitness through active monitoring and data driven interventions will ultimately lead to better adherence to diabetes management, better clinical outcomes & decrease in diabetes complications. All this will ultimately lead to better blood glucose levels and hence reduced healthcare costs.