Diabetes and Exercise

Diabetes Exercise Guide For Seniors

Did you know that the amount of seniors among us is growing? In fact, the elderly population around the world has exploded over the past few decades. This is expected to continue over the coming years.

Between the years 2000 and 2050, the number of people over 60 will double. In that time, the number of people over the age of 80 will quadruple!

Diabetes is also growing worldwide. This is especially true of the elderly population. Seniors with diabetes are more likely to fall, experience depression, and become frail. Diabetes is associated with disability in older patients. Older patients with diabetes may have more difficulty with basic and instrumental activities of daily living. They tend to have more difficulty going from sitting to standing. They also have weaker handgrip strength and take longer to get up and going.

Diabetic seniors are a special population when it comes to exercise. This is because they tend to have an altered gait pattern. They have lower velocity and shorter strides. They have a larger stepping width and require a longer double support time standing on both feet. Their strides also have more variability. All of this is true of seniors with diabetes as compared to those without diabetes.

Benefits of exercise for diabetes

The list of evidence showing the protective effects of exercise against health conditions is extremely long. The benefits of exercise for people with type 2 diabetes mellitus are indisputable. When you look at how energy metabolism works, it becomes obvious that exercise has a vital role in patients with diabetes. With diet (such as limiting carbohydrate snacks) and behavior modifications, exercise is an essential component of obesity and diabetes prevention and lifestyle programs. Researchers have said that exercise is helpful in diabetes because of the insulin-like actions and changes it makes on the immune system.

Exercise also has the following benefits in people with prediabetes, type 2 and type 1 diabetes, as well as gestational diabetes:

  • Improves glycemic control

  • Reduces mortality

  • Prevents cardiovascular disease

  • Improves insulin resistance

  • Improves body composition

  • Improves the body’s aerobic capacity

  • Improves oxidative stress

  • Improves metabolic dysregulation

  • Improves chronic inflammation

  • Improves glucose metabolism

  • Improves lipid metabolism

  • Enhances weight loss

  • Helps with high blood pressure

  • Can help to lower resting heart rate

A study found that physical exercise was able to improve the following health values:

  • Lower fasting insulin by 1.64

  • Lower HOMA-IR by 0.14

  • Lower fasting blood sugar by 5.12

  • Lower hemoglobin A1c by 0.63

  • Lower Body Mass Index (called BMI for short) by 0.36

One study implemented a moderate-intensity exercise program in elders between 55 and 75 years old. They participated in a six-week regular exercise class designed for elderly people who were healthy and those who had arthritis, heart disease, obesity, and type 2 diabetes.

At the end of the program, participants had significantly improved their self-perceived physical health. They had also improved their emotional health and personal appearance compared to their baseline values. They also had lower systolic blood pressure and significantly lower respiration rate compared to at the start of the study. These findings suggest that senior adults who participate in an exercise program can improve their health status.

Exercise for older adults

One study looked at the effects of a long-term community-based exercise program. This program included aerobic, resistance, flexibility, and balance training. Participants were able to improve their health in the following ways:

  • Lower BMI (from 29.3 kilograms per meter squared to 27.6 kilograms per meter squared)

  • Lower hemoglobin A1c (from 6.5 percent to 6.1 percent)

  • Smaller waist circumference (from 104.2 centimeters to 95.6 centimeters)

Aerobic

Examples of aerobic exercises include brisk walking, cycling, swimming, water aerobics, and Zumba. HIIT training can also be helpful. This stands for High-Intensity Interval Training. If this is too intense for you, be sure to stick to something that is reasonable for you.

One study looked at how the heart reacts to aerobic exercise in senior athletes. Researchers did this by studying 178 participants in the World Senior Games. They found that heart function was superior in top-level senior athletes. Researchers concluded that aerobic exercise participation improves the performance of the heart in seniors.

Another study looked at older people with diabetes who did not exercise regularly. They did four weeks of Wii tennis on Nintendo. There were significant improvements in their time spent in moderate physical activity, handgrip strength, and their ability to stand and walk.

Resistance

Examples of resistance exercise activities that are good options for seniors include wall push-ups, abdominal contractions, thigh raises, pelvic tilts, shoulder blade squeezes, toe taps and heel raises.

To perform abdominal contraction:

  1. Lie down on your back.

  2. Take a deep breath, tightening your abdominal muscles.

  3. Hold for three breaths.

  4. Repeat this ten times.

To do thigh raises:

  1. Begin seated in a chair with your feet flat on the ground.

  2. Lift your thigh about two to three inches off the chair.

  3. Repeat this eight to twelve times per leg.

Pelvic tilts are a great core exercise. To do these, you can be standing. Take a deep breath, tightening your glute muscles. Then tilt your hips slightly forward. Hold for three seconds. Then tilt your pelvis backward, and hold for three seconds. Repeat this eight to twelve times.

For upper body strengthening, try shoulder blade squeezes. All you need to do is squeeze your shoulder blades towards each other. Hold this for three seconds. Release, then repeat eight to twelve times.

Toe taps are performed seated in a chair. Keep your heels on the ground, and lift your toes. Repeat this 20 times.

Heel raises are like the opposite of toe taps. Sitting in your chair, keep your toes on the ground and lift your heels. Repeat this 20 times.

Muscle mass and muscle strength are strong determinants of a person’s quality of life and ability to function on their own as they age. Resistance training is the most effective intervention to fight against sarcopenia. Sarcopenia is the age-related atrophy of muscles.

One study looked at the effect of resistance exercise compared to aerobic exercise in patients with type 2 diabetes. There was actually more maximal oxygen consumption for the resistance exercise. Researchers in this study concluded that resistance exercise effectively promotes an increase in maximal oxygen consumption.

Losing muscle mass, structure and function are responsible for lower strength and endurance. This can lead to decreased postural control. That can then lead to a higher risk of falling. Falling can then lead to a lack of independence and lower quality of life. Strength training has been proven to slow down and even stop age-related declines in nerve and muscle function in the elderly.

High-quality randomized controlled studies show that strength training affects mobility, independence, and quality of life. In fact, resistance exercise can reduce the risk of falling by up to 50 percent. Evidence also shows that resistance training has preventative and therapeutic effects on type 2 diabetes and other chronic conditions. In fact, the effect resistance training has on diabetes is comparable to that of medication intake!

Another study looked at a community-dwelling elderly population with a mild disability. They took a three-month group-based progressive resistance exercise program, which improved their quality of life.

Flexibility

Flexibility exercises include stretching various muscle groups.

You can perform ankle rotations, where you rotate your ankle one way and then the other. Do this on both sides.

One study looked at 204 older adults with diabetes at community centers for the elderly. They found that by increasing people’s number of steps in a day, they improved their physical activity level and physical fitness. This was especially true of lower limb flexibility. So although it may not seem like a flexibility exercise, walking can help with this!

Balance

Balance exercises include yoga, tai chi, and standing on one leg.

As you probably know, there is a high prevalence of falls among the elderly. One systematic review study looked at postural balance in elderly people. They sought to find out how to prevent the amount of falls in the elderly population. They found that the most important factor was regular physical activity. Another study showed that balance training helps to improve the capacity of nerves and muscles.

1-week exercise plan

The CDC recommends 150 minutes of moderate endurance activity per week for generally fit Americans age 65 and older. Below you will see a suggested one-week exercise plan:

 

Monday

  • Aerobic activity: 30-minute walk

  • Resistance activity: 10 wall push-ups

  • Balance activity: 15 minutes yoga

  • Flexibility stretches

Tuesday

  • Aerobic activity: 30 minutes of cycling

  • Balance activity: 15 minutes of tai chi

  • Flexibility stretches

Wednesday

  • Aerobic activity: 30 minutes of swimming

  • Resistance activity: Thigh raises (10 reps per leg)

  • Balance activity: Standing on one leg for 10 seconds each side

  • Flexibility stretches

Thursday

  • Balance activity: 30 minutes of yoga

  • Flexibility stretches

Friday

  • Aerobic activity: 30 minutes of Zumba

  • Resistance activity: Abdominal tightening exercise, 10 reps

  • Balance activity: Tai chi

  • Flexibility stretches

Saturday

  • Aerobic activity: 30 minutes of water aerobics

  • Balance activity: Standing on one leg for 10 seconds each side

  • Flexibility stretches

Sunday

  • Balance activity: 30 minutes of yoga

  • Flexibility stretches

Precautions to take

When blood sugar levels are not excessively high or low at the time of exercise, there aren’t many precautions to take. However, it’s always better to be safe rather than sorry. If someone’s diabetes is poorly controlled, there may be structural changes to muscle fibers. This is what we call myopathy and can happen if someone with diabetes has blood glucose levels out of control.

Even in patients with well-controlled diabetes, the balancing mechanisms in the body that regulate carbs’ metabolism can become impaired. This can lead to low blood sugar levels or high blood sugar during or after exercise.

One study looked at a community-dwelling elderly population with mild disabilities. They undertook a three-month group-based progressive resistance exercise program. Those who had diabetes had worse outcomes. The researchers in this study concluded that those with diabetes are more likely to experience a lower quality of life with a resistance training program. This is why it’s important that health care providers carefully monitor patients with diabetes who are doing intense resistance exercises.

Please note that all this shouldn’t necessarily discourage you from exercising if you have diabetes. However, you should be sure to do types of exercise that will maximize beneficial health effects.

Conclusion

Exercise clearly has many benefits for seniors. It is also helpful for people with diabetes. And it is also great for seniors with diabetes! If you are beginning an exercise program, be sure to include aerobic, resistance, flexibility, and balance exercises. It’s always a good idea to speak to your health care provider before starting any exercise program. It can also be helpful to get in touch with a diabetes educator in your area. If you don’t have one already, ask your health care provider if they can recommend one.

Sources

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