DIABETES AND EXERCISE THERAPY: EXERCISE & INSULIN AND EVALUATION OF THE PATIENT BEFORE EXERCISE EXERCISE & INSULIN EXERCISE CAUSES
1. Increase in sensitivity of muscles to insulin. Major site – Skeletal muscles, followed by adipose tissue to a lesser extent.
2. Increases in insulin action (could be mediated by several factors)-
i) Increase in insulin binding receptors sites in the muscles and increase in the number of receptors.
ii) Increase in cytoplasmic and mitochondrial activity.
iii) Increase in muscles, capillary density.
iv) Increase in GLUT -4 protein &mRNA.
RESPONSE TO EXERCISE DEPENDS UPON
Diabetic status of patient.
Blood glucose level.
Availability of insulin.
State of hydration.
EVALUATION OF THE PATIENT BEFORE EXERCISE
Before beginning an exercise program, the examination of diabetes patients should include careful screen for the presence of macrovascular and microvascular complications that may be worsened by the exercise.
A careful medical history and physical examination should focus on the symptoms and signs of disease affecting the heart, blood vessels, eyes, kidneys, nervous system and diabetic foot etc.
Before an exercise therapy is initiated a fair control of diabetes is to be ensured.
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