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November 25, 2009
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Diabetic Home Care and Monitoring (cont.)

Exercise therapy

Regular aerobic exercise improves blood circulation and lowers blood glucose levels. Exercise also strengthens the heart and helps maintain an ideal body weight. The chosen aerobic exercise should use large muscle groups. Running, walking, biking, and swimming are excellent activities for most people. The frequency, type, and duration of exercise depend on the individual's age, treatment goals, and physical ability. An exercise program should be designed with the help of a healthcare provider.

Exercise increases or decreases blood glucose levels depending on the concentration of glucose and insulin in the blood at the time of the exercise. If blood glucose is low or normal, exercise may cause hypoglycemia (low blood glucose) due to the utilization of glucose by the active muscles. On the other hand, exercise may cause hyperglycemia (high blood glucose) if there isn't enough insulin to allow the active muscles to utilize blood glucose. As a result, the muscles signal the body to produce more glucose, and the glucose accumulates in the blood. Therefore, food intake and insulin doses should be adjusted based on the intensity and duration of the anticipated exercise.

Diet therapy

Diet is another very important part of the management of diabetes. Some adult onset (non–insulin dependent or type 2) diabetics can be controlled with diet and exercise alone. The right diet can help control blood glucose levels, reduce blood cholesterol, maintain an ideal body weight, and delay the complications of diabetes. Like exercise, diet therapy is tailored for each person. A successful diet should ideally take into consideration the person's ethnic background, financial situation, and lifestyle. It also should be simple since it may be more difficult to stick to diet plans with complex food exchanges.

Diabetics are often advised to use alternative ("artificial") sweeteners. Sweeteners are either nutritive or non–nutritive. Nutritive sweeteners such as sorbitol and fructose provide calories but may not raise blood glucose levels as much as regular sugar. Non–nutritive sweeteners such as saccharin and aspartame do not contain calories. Both types of sweeteners are acceptable, but the caloric content of the nutritive sweeteners should be considered when calculating the daily intake of calories. In addition, large quantities of sorbitol can cause diarrhea, and fructose may contribute to some of the complications of diabetes.



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