In the type 2 diabetic patient, in order to maintain good metabolic control, physical activity is critical, even now, in the deconfinement phase after COVID-19. A sedentary lifestyle, and also being overweight, are two situations that act by blocking the entry of glucose into muscle cells and, as a consequence, if glucose cannot enter the cell it remains in the bloodstream. This excess of glucose in the blood can cause short-term decompensations, but also future complications, such as deterioration of the arteries, accumulation of fat in the liver, inflammation, etc.
There are diabetics who do not control their diet well, especially if they are going out for physical exercise, and have drastic drops in blood sugar. How can they learn to control it?
The diet of diabetic patients must be adapted to exercise but, above all, it will depend on the type of medical treatment they are taking. A patient with type 2 diabetes with a medical treatment that does not produce hypoglycemia should not present complications, while insulin-dependent patients should adjust their diet and insulin units according to the duration and intensity of the physical activity to be performed. In these cases it is very important to know the blood glucose level prior to physical activity and, depending on the intensity and duration, either to administer a lower dose of insulin or to ingest glucose during exercise.
One thing must be clear: the benefits of physical activity, both for diabetes control and at the cardiovascular level, should never be doubted or renounced.
Can diabetics demand a high level of sport, or should they reduce it?
Diabetic patients with a good level of diabetic education are no longer “different” and can normalize a sporting practice. Normalize because excesses, also of physical exercise, can be just as unhealthy, both for a diabetic and a non-diabetic person.
Therefore, controlling the amount of carbohydrates ingested, the intensity of the physical activity to be performed and the medication administered is essential to avoid decompensation and to meet the requirements.
What should a correct diet for diabetics be like in order to keep the disease at bay, especially now?
What was useful before the coronavirus is still valid, although perhaps now it is considered even more relevant. The diabetic patient’s diet should be rich in fiber and complex sugars (nuts, whole grains, legumes and vegetables), minimizing the intake of rapidly absorbed sugars, i.e. those with a higher glycemic index.
Can there be a greater imbalance in sugar levels now that we can take walks and exercise?
There should not. In a well-controlled diabetic, or even in the poorly controlled patient, if anything, activity should help regulate sugar metabolism in a positive way.
Physical activity is, in itself, a treatment to optimize control in diabetic patients.