Exercise offers diabetics surprising benefits

by Rintos Mail features@theborneopost.com. Posted on March 29, 2015, Sunday

SOME may consider exercise a nuisance, a chore, or simply a bore. But if one has been diagnosed with Type 2 diabetes, one may need to look at physical activity in a whole new light. Now, exercising has been acknowledged worldwide as a tool to control diabetes. Just like taking a drug or altering one’s diet, exercise can lower blood sugar on its own even if one does not lose weight.

Although its benefit has been acknowledged throughout the world, exercising is still the most under-used treatment among us here. In fact, exercising has been found to be very powerful in controlling diabetes, a few studies have claimed.

Malaysian Diabetic Association Sarawak secretary Daniel Voon said tai chi is one of the good forms of exercise to control diabetes. He believes tai chi works in the same way as other mind-body therapies, and there is ample evidence that paying attention to the connection between the mind and the body can relieve stress, combat disease, and enhance physical well-being. Tai chi has three major components — movement, meditation, and deep breathing.

Voon said he used to do the 18-step tai chi but has stopped due to age. “I’m 83 now and at my age, the 18 steps are too much for me. I did it for a long time before but stopping as I could no longer cope,” admitted Voon, who has lived with diabetes for 28 years.

He said instead of doing all the steps, he modified some in order to continue with his daily exercise.

He does a few steps for about five minutes before continuing with walking or jogging for another 10 minutes. “I’m doing exercise every day,” said the former lecturer of the then Batu Lintang Teachers College.

Voon took up tai chi after a bladder operation in 1990. Before that, his fitness regime included swimming and badminton.

“Because I couldn’t swim and play badminton after my operation, I decided to do light exercise. I learnt the 18 steps of tai chi in Tabuan Jaya. They are for the older people like me,” he said.

Tai chi is a gentle exercise with slow, deliberate movements, meditation and deep breathing, believed to enhance physical health and emotional well-being. Voon shows the normal, pre-diabetes and diabetic readings of blood sugar.

Need for balance

According to Voon, serious tai chi is based on spiritual and philosophical ideas that advocate a need for balance in body, mind and spirit. “My modified tai chi exercise also suits the older people because we don’t have to run. We just stand and move a little bit but it can still burn glucose if we do it seriously.” Voon said tai chi could be done in a sitting position, adding that while sitting, one could still move, breathe and meditate, and the movement involved is also a form of exercise.

Tai chi is a Chinese martial art combining diaphragmatic breathing and relaxation with soft, gentle movements. It is considered moderate exercise, previously shown to improve immune system response in contrast to strenuous physical activity which depresses it.

Previous studies have shown tai chi improves respiratory and cardiovascular function while  improving flexibility and relieving stress.Voon said the United States is already introducing tai chi as a health-enhancing activity while a few studies had suggested tai chi could help control diabetes.

According to a University of Florida study, a regular tai chi exercise programme may help lower blood glucose levels, allowing people with diabetes to better control their condition. Looking at adults with Type 2 diabetes, the study found that participants, following a supervised tai chi exercise programme two days a week,  supplemented with three days of home practice for six months, lowered their fasting blood glucose levels, better managed their condition and improved their overall quality of life compared to those at a much lower level of intervention. Earlier, two small studies published in the British Journal of Sports Medicine in April 2008, found that tai chi exercises could also improve blood glucose levels as well as the control of Type 2 diabetes and immune system response.

In 2009, researchers at the University of Florida studied 62 Korean women assigned to one of two groups — a control group and an exercise group that began  regular practice of tai chi.

Those who completed the tai chi sessions showed significant improvement in blood sugar control. They also reported increased vitality, energy and mental health. 

Voon said tai chi is great for patients who do not like to exercise and those who could not participate in games and sports.

The style and movements of tai chi are very slow, circular and fluid, and this is a good way for patients to think of them.

Two types of exercise

There are two main types of exercise — aerobic and anaerobic. According to Voon, tai chi belongs to the former. Aside from tai chi, other aerobic exercises include running, dancing, games and sports whereas anaerobic exercises work the muscles like in weightlifting. Voon said all aerobic exercises worked better for diabetics as they enhance the entry of glucose into cells, even without insulin, and increase cell metabolism. “This results in the breakdown of glucose to provide energy, and therefore, the lowering of glucose. This is clearly shown again and again when we measure people’s blood sugar before and after exercise.”

Voon pointed out that exercise and training increased muscle bulk, which in turn increased the utilisation of glucose and further lowered blood sugar. He said aerobic exercise actually helped burn glucose as it used a lot of oxygen whereas anaerobic exercise did not. “Therefore the latter does not help diabetics much,” he noted. Voon also said most Type 2 diabetes came about because the visceral fat or the inner fat was markedly increased where people tended to look overweight and obese.

“When the visceral fat becomes too much, it causes insulin resistance as if one is short of insulin. That’s why, we ask people to keep reducing weight because when the inner fat is reduced, the insulin is better.”

He said insulin opened up cells to the entry of glucose, adding that cells used glucose to metabolise — which then produced energy. He noted if cells lacked glucose, they might starve and die.

So, if you have diabetes, exercise offers surprising benefits. As it lowers your stress levels, it also lowers your blood sugar level.

The right exercise regime

But how much exercise is right for you? For diabetics, Voon recommends at least three times a week, each taking about 30 minutes. Exercise is so important for people with diabetes that the Malaysian Diabetes Association Sarawak branch invites patients in Kuching to join them for aerobic exercise at its premises compound at Jalan Maxwell at 5.30pm every Friday. For patients wishing to work out on their own, there are many exercises that will benefit them as well such as walking, jogging, tai chi and swimming. Because anyone can do it almost anywhere, walking is the most popular form of exercise. Thirty minutes to one hour of brisk walking, three times a week is a great and easy way to increase your physical activity. It is also reported that swimming stretches and relaxes the muscles and doesn’t put pressure on the joints, which is great for diabetics. For those with diabetes or at risk of developing diabetes, studies show swimming improves cholesterol levels, burns calories and lowers stress levels. To get the most benefit from swimming, it is recommended that patients swim at least three times a week for at least 10 minutes and gradually increase the length of the workout.

As for dancing, it is believed to be great for the body not only physically as the mental work to remember dance steps and sequences actually boosts brain power and improves memory.

For diabetics, dancing is a fun and exciting way to increase physical activity, promote weight loss, improve flexibility, lower blood sugar and reduce stress. Voon pointed out that aerobic exercise not only reduces blood sugar but also preserves the heart. He said during exercise, the heart becomes stronger and exercise markedly reduces the chances of narrowing of blood vessels.

“Exercise not only strengthens the heart but also protects the heart,” he added.

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