Dyschezia: Causes, Symptoms, and Treatment
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In this article, we delve into the relationship between physical activity and type 2 diabetes mellitus, a prevalent metabolic disorder. We'll explore the disease's general characteristics, the role of physical activity in its management, and how to design an effective exercise regimen for those affected.
Type 2 diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels. This condition arises from two primary dysfunctions:
The disorder often develops in adulthood and is the most common form of diabetes. Its causes can be hereditary or environmental, with factors such as obesity, sedentary lifestyle, poor diet, stress, other illnesses, and certain medications playing a significant role.
Obesity is a key factor in over 80% of type 2 diabetes mellitus cases. Excess adipose tissue produces substances that contribute to insulin resistance if present in large amounts. Moreover, obesity fosters a state of chronic, low-intensity inflammation, which aggravates insulin resistance.
Type 2 diabetes mellitus increases the risk of premature death and disability, primarily through heightened cardiovascular risk. This risk is further exacerbated by other conditions, such as arterial hypertension and dyslipidemia.
Physical activity plays an important part in both preventing and managing type 2 diabetes mellitus. Regular exercise positively impacts metabolism, both during the activity and over the long term.
Training enhances insulin sensitivity and improves cellular glucose transport, leading to lower blood glucose levels, insulin levels, triglycerides, and glycated proteins. Regular physical activity also improves the body's ability to manage dietary carbohydrates, thereby aiding weight loss.
Insulin resistance impairs insulin-mediated glucose absorption by 35-40% compared to healthy individuals. Physical activity can increase insulin sensitivity for up to 72 hours after training, even in individuals with type 2 diabetes mellitus.
Physical training improves muscle blood flow, which is crucial for glucose and oxygen delivery to muscles and waste disposal. Training also stimulates the emergence of glucose transporters, enhancing the cell's ability to capture glucose.
Regular physical activity improves the body's ability to manage post-prandial glycemic load, thanks to metabolic and functional changes. Exercise also depletes hepatic and muscular glycogen reserves, increasing these tissues' demand for glucose.
Creating a safe and effective exercise regimen for individuals with type 2 diabetes mellitus requires careful consideration of several factors. These include the type of exercise, frequency, duration, and intensity, as well as any specific health complications related to diabetes.
The recommended frequency is 3 to 5 sessions per week for most individuals. Ideally, aim for no more than two consecutive days without physical activity to maintain consistent glycemic control.
Each session should last at least 20 to 30 minutes, progressively increasing to 45–60 minutes as tolerance improves. For beginners or individuals with limited fitness levels, breaking the session into smaller, manageable intervals (e.g., three 10-minute sessions) may be beneficial.
Start with low-intensity exercises, such as leisurely walking, especially for sedentary individuals or those with complications. Gradually progress to moderate-intensity levels (e.g., brisk walking or light jogging), where the individual can talk but not sing during the activity. Use tools like the Rate of Perceived Exertion (RPE) or heart rate monitoring for guidance.
Before starting a physical activity program, patients should be aware of the precautions to take before, during, and after the activity. Glycemic control is crucial, and hydration levels should be maintained.
In the presence of complications such as ischemic heart disease, diabetic nephropathy, retinopathy, sensorimotor neuropathy, and autonomic neuropathy, the exercise protocol should be adapted accordingly.