Diabetes, also known as diabetes, is a common and chronic disease that we define as an increase in the blood glucose taken into our body through food. Our cell called pancreas secretes the hormone insulin, which draws glucose from the blood and allows it to enter the cells. Glucose entering the cell is used as energy. If more glucose is consumed than needed, it is stored as glycogen in the muscles and liver. In diabetic patients, not enough insulin is produced or the insulin produced is not used effectively. In this case, glucose cannot enter the cell and rises in the blood. There are four types: type 1 diabetes, type 2 diabetes, gestational diabetes and prediabetes. The fasting blood sugar level of an individual without diabetes is 120 mg/dl; The postprandial blood sugar level (two hours after a meal) does not exceed 140 mg/dl. An increase in the blood sugar measured during hunger and satiety above these values indicates the presence of diabetes. It is understood whether a person has diabetes or not by measuring Fasting Blood Sugar (FBG) or Oral Glucose Tolerance Test (OGTT). A fasting blood sugar measurement of 100-125 mg/dl is a signal of prediabetes (hidden sugar). A fasting blood sugar measurement of 126 mg/dl and above indicates the presence of diabetes. If the oral glucose tolerance test (blood sugar measurement taken 2 hours after consuming glucose) is 140-199 mg/dl, it is considered prediabetes (hidden sugar); If it is 200 mg/dl or above, diabetes is diagnosed.
Type 1 diabetes occurs when the insulin-producing beta cells in the pancreas are damaged as a result of the autoimmune process. In type 1 diabetes, there is absolute insulin deficiency, and type 1 diabetic patients must take the insulin hormone externally (via injection) throughout their lives. Because type 1 diabetes often occurs in childhood and adolescence, it is also called 'juvenile diabetes'. It is also called insulin-dependent diabetes. The absolute solution in the treatment of type 1 diabetes is insulin injection. Other methods that help treatment are healthy eating, regular exercise and education.
Type 2 diabetes; It is an excessive increase in blood sugar as a result of the pancreas not producing enough insulin or the insulin produced not being used effectively. The first step in treatment is medical nutrition therapy. Changing eating habits and lifestyle, increasing exercise in daily life, etc. If therapeutic methods are not sufficient to keep blood sugar within normal limits, oral pill treatment is started.
Gestational diabetes; It is a type of diabetes that occurs during pregnancy in a woman who has not had diabetes before and usually disappears after birth. 24-28 weeks of pregnancy. Diagnosis is made with OGTT performed during the week. The most important criteria are fasting blood sugar over 92 mg/dl, over 180 mg/dl at the 1st hour, over 153 mg/dl after the 2nd hour, and over 140 mg/dl after the 3rd hour. If at least two are present, the diagnosis is made.
Why is exercise important for individuals with diabetes? After food enters the body, the food is broken down by physical activity and the resulting sugar is used by muscle tissue, reducing blood sugar. Exercise in people with overweight and diabetes both reduces weight and increases the energy spent. Studies have shown that physical activity lowers blood pressure, increases insulin sensitivity, and reduces depression and anxiety. The incidence of diabetes is higher in obese individuals. As a result of decreased physical activity, obesity increases and, accordingly, the risk of type 2 diabetes increases. Exercise; It reduces plasma glucose and HbA1c level, which indicates the 3-month blood sugar level, reduces postprandial insulin levels, increases insulin sensitivity and regulates the lipid profile. It also helps prevent diabetes in individuals with impaired glucose tolerance. It is recommended that individuals with diabetes do at least 150 minutes of aerobic exercise per week. Exercise; It also helps balance blood sugar by increasing GLUT-4 levels and allowing glucose to pass from the blood to the cells. GLUT-4 is an intracellular protein that moves to the cell membrane with insulin or other stimuli. The point to be considered is that the type of exercise performed is personal. Before starting the exercise program, the person's glucose levels should be checked, HbA1c level should be checked and the cardiovascular system should be evaluated. When exercise is performed, anaerobic metabolism turns into aerobic metabolism and oxygen and glucose entry into the muscles increases. Some studies have shown that obesity is caused by impaired glucose retention in exercises performed for 50 minutes or more for 7 days. It was found that the rate of infection was significantly reduced. Exercise balances blood sugar by increasing insulin effectiveness and reduces the prevalence of obesity. The type of exercise, duration, intensity, and nutrition before and after exercise are also effective factors in weight loss. Exercise intensity is defined as the percentage of maximum aerobic capacity. In individuals who train regularly, free fatty acids are used instead of glucose as an energy source. This is an important factor in increasing endurance. The reason for this is that muscle glycogen stores are emptied more slowly in individuals who exercise regularly than in individuals who do not exercise. As the duration of exercise increases, muscle glycogen stores are depleted within a few hours, and thus the body begins to break down fat to provide the energy needed. It is also known that endurance increases more in individuals who eat a carbohydrate-rich diet before exercise than in individuals who consume a carbohydrate-restricted diet.
Diabetic individuals should be given regular diabetes education. Diabetes education; Many professional groups such as nurses, dietitians, doctors, pharmacists, therapists, clinical psychologists, exercise physiologists and health educators should coexist and be approached in a multidisciplinary manner. The type of exercise given should be completely specific to the individual. An exercise program should be prepared by taking into account the person's history of diabetes, how many years he has had diabetes, blood glucose level, presence of complications, nutritional history, health status, orthopedic condition and lifestyle. Diabetic patients should have an eye examination before starting an exercise program. The psychological state of the patient is also an important factor in preparing the exercise plan. It is known that exercise is good for psychological problems such as depression and anxiety. In some cases, the choice of exercise type, duration and intensity is very important. These situations; Situations such as being over 35 years of age, having type 2 diabetes over 25 years and over 10 years/type 1 diabetes over 15 years, having a chronic disease other than diabetes, having a physical disability or complications of diabetes are examples of these. Heavy exercises should not be recommended for people with respiratory diseases (such as asthma, bronchitis) and cardiovascular diseases. Retinopathy, nephropathy, diabetic It should not be forgotten that exercise should not be recommended to individuals with complications such as foot problems. When to exercise is also an important detail. Exercise, especially on an empty stomach, can cause blood sugar to rise. The best time to exercise is 1-2 hours after eating. Exercise should not be done immediately after eating. Exercises performed 3 hours after meals or on an empty stomach may put the person into hypoglycemia. Exercise should be done at least 3-4 times a week. It is more beneficial if it is done regularly every day. Exercise duration should be at least 5 minutes. It should be increased over time, up to 60 minutes. Exercises that work the whole body should be preferred instead of exercises that work any part of the body. Before starting exercise, blood sugar level should not be below 100mg/dl. If this occurs, hypoglycemia may develop. Blood sugar levels above 240mg/dl can also increase blood sugar and form ketone bodies. If insulin injection is used, the time of exercise should not coincide with the time of action of insulin. Foods containing carbohydrates should be consumed to replenish glycogen stores depleted as a result of long-term exercise.
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