Paula Pienaar explains the benefits of exercise for diabetic patients, and shares five easy workouts to do at the office.

An abundance of research has shown that a regular dose of physical activity reaps significant benefits to individuals with high blood glucose levels¹. In pre-diabetics, moderate intensity activity has shown to delay the onset of diabetes and may even restore higher blood sugar levels back to the healthy range.

In diabetic patients, regular physical activity has shown to improve blood sugar control, reduce the number of cardiovascular risk factors (high blood pressure, high cholesterol, excess body fat) and use of chronic medication^2,3.  Evidently, being a physically active diabetic patient may lower your risk of heart disease by 29% and risk of mortality by 40% compared to those who are inactive⁴. However, for all these benefits to be effective, exercise must be undertaken regularly.

Benefits of regular physical activity in diabetic patients:

• Improved blood sugar control.
• Increased fitness.
• Improved blood pressure.
• Improved lipid profile (cholesterol and triglyceride levels).
• Reduced abdominal and body fat levels.
• Maintenance of weight loss.
• Improved mobility in overweight and obese diabetic patients.
• Decreased stress and anxiety, and an improvement in overall well-being.

Physical activity recommendations for diabetic patients:

IMPORTANT: first get clearance from your medical doctor before starting with an exercise plan. A biokineticist is ideal to design a personalized exercise programme to suit your needs, personal goals and lifestyle.

Exercise at the workplace

Meeting the guidelines may seem like a challenge, but you can incorporate simple, yet effective exercises throughout the day – all you need is your own body weight.

For cardiovascular exercise, you could set aside three sessions of 10 minutes, or two of 15 minutes to go out for a brisk walk or light jog – grab a colleague if you must, the more the merrier! In addition to the physical benefits you gain, studies have shown that active breaks from the office may also help improve mental performance and work productivity. Meeting the strength training guideline can be accomplished by incorporating the exercises below.

5 easy exercises you can do in your office

Perform 2 to 3 sets of 10 to 15 repetitions

Exercise	Instructions	Adjusting intensity You can lower the amount of repetitions or sets. But can also try the following:
Chair squats	Using a steady chair, start from a seated position and extend or cross your arms in front of you. Exhale as you lift yourself slowly, hovering for 2-3 seconds, then stand all the way up. Sit back down slowly and repeat.	Too easy? Bring your arms to your chest, or hold books or a file to add resistance to the move. Too hard? Increase the height of your sitting surface.
Calf raises An easy exercise for when you’re waiting for the printer, the kettle or the microwave!	Stand up straight, feet shoulder width apart. Keeping your knees straight, rise onto your toes, hold for 2 seconds and lower your heels to the ground and repeat.	Too easy? Try the exercise on one leg, or using the stairs, stand with your heels off the step to do the calf raises.
Desk push-ups	Take a large step away from your desk, feet and hands shoulder width apart. Bend your elbows as you move your chest toward the desk. Hold for 2 seconds and return to starting position. Keep your back straight and abdominals drawn in throughout the movement.	Adjust your arm width to make it easier or more difficult. Too hard? Start by using the wall instead of the desk.
Chair dips	Bring your hands to the front edge of a steady chair with the hands shoulder-width apart and finger tips extended over the edge of the seat. Relax your shoulders and neck, and bend your knees to a 90 degree angle. While inhaling, bend your elbows bringing your buttocks towards the floor. Your back should stay straight and feet hip-width apart, in line with your hips. Exhale slowly as you straighten your arms to return to starting position.	Too easy? Move your feet further away from you. The spacing between your feet and your buttocks can help you adjust the amount of weight you are putting on your arms.
Chair abs: knee pull-ups	Place your hands at your side, on the edge of a steady chair and keep your elbows straight Grip the chair holding firmly While gripping, inhale, and slowly exhale as you bring your knees up toward your chest Hold for 5 seconds Inhale again, and exhale as you lower back to starting position with a slow and controlled motion (± 10 seconds)	To make it a bit harder, perform the movement at a slower pace, making sure you maintain the breathing rate and keeping your abdominals tight.

Take note: Individuals who wish to begin resistance exercises should receive initial instruction and periodic supervision by a qualified exercise specialist like a biokineticist where possible, to maximise benefits while minimising risk of injury. Do not hold your breath during exercises – follow the guidelines in the description.

References:

1. Colberg, Sheri R., et al. “Physical activity/exercise and diabetes: a position statement of the American Diabetes Association.” Diabetes Care 39.11 (2016): 2065-2079.Hu G, Jousilahti P, Barengo NC, et al. Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes. Diabetes Care. 2005; 28:799-805.
2. Gill, Jason MR, and Dalia Malkova. “Physical activity, fitness and cardiovascular disease risk in adults: interactions with insulin resistance and obesity.” Clinical science 110.4 (2006): 409-425.
3. Way, Kimberley L., et al. “The effect of regular exercise on insulin sensitivity in type 2 diabetes mellitus: a systematic review and meta-analysis.” Diabetes & metabolism journal 40.4 (2016): 253-271.
4. Kodama, Satoru, et al. “Association between physical activity and risk of all-cause mortality and cardiovascular disease in patients with diabetes.” Diabetes care 36.2 (2013): 471-479.