How Pune marathoner is determined to reverse diabetes: Running is a good exercise for lowering blood sugar levels, says endocrinologist

Rishikesh is among the increasing number of persons who have dealt with health problems by taking up moderate to high-intensity sports. While running is the best possible exercise and helps people with diabetes regulate their blood sugar levels, endocrinologists sound a note of caution and say it has to be tailored to meet the specific needs of each type of diabetes patient. Supervised training is required for high-intensity runs, says Dr Vaishali Deshmukh, Head of Endocrinology department, Deenanath Mangeshkar Hospital and Research Centre. She answers a few FAQs:

How much should diabetic patients run?

Running has many advantages in patients with diabetes as it improves insulin control, musculoskeletal fitness and helps in losing fat/weight. This in turn improves sugar levels and reduces the need for medicine. There is an overall improved mental health and a sense of well-being. Apart from assessing pre-running fitness, diabetic patients need to carry glucose tablets/glucose drinks while running so as to avoid sudden sugar dips or hypoglycemia. If your sugar levels are very high to begin with, then watch out for dehydration, especially during summer. Apart from maintaining blood sugar levels, you also need to have sufficient haemoglobin and vitamin levels. You must use running shoes that can absorb foot pressure.

Running plans need to be customised as per medical advice

Most adults with diabetes should engage in 150 minutes or more of moderate-to-vigorous intensity activity weekly, spread over at least three days/week, with no more than two consecutive days without activity. Shorter durations (minimum 75 minutes/week) of vigorous-intensity or interval training may be sufficient for younger and more physically fit individuals.

Severely affected patients and those living with complications can walk instead of run. For obese patients, who suffer from foot and knee joint problems, it is better to walk instead of run.

Those with mild diabetes and no complications can run. For patients with moderate to severe diabetes, the running plan needs to be tailor-made according to their doctor’s advice. Dietary habits are important and need to be correlated. For instance, if the person is engaged in a short run of 20-45 minutes, he needs to eat healthy and begin with a pre-run snack. For a longish run of one to two hours, hydration and glucose levels may be affected and so provision for adverse conditions. A marathon runner may need a reduction in medication or insulin dose.

Cardiac fitness needs to be ensured prior to starting any exercise

Even as a cardiac ECG, stress test and 2D Echo are important prior to starting any exercise, tests for sugar levels, HbA1c, haemoglobin, vitamins and kidney and liver function also need to be done. Physical activity does carry some potential health risks for people with diabetes, including acute complications like cardiac events, hypoglycemia and hyperglycemia. In low- and moderate-intensity activity undertaken by adults with Type 2 diabetes, the risk of exercise-induced adverse events is low. In individuals with Type 1 diabetes (any age), the only common exercise-induced adverse event is hypoglycemia.

On a structured and scientific training programme

So, what does Rishikesh’s trainer Atul Godbole, founder and head coach of Motiv8 and who provides personalised coaching programmes for runners and triathletes, have to say? “With a proper diet and training regimen for running, diabetes patients are often able to reduce and sometimes eliminate their symptoms. After an all-clear from the doctor, the person with diabetes can consult a coach for devising a structured and scientific training programme. It could start with short workout sessions of up to 30 minutes, three times a week. After a few weeks, the duration of each session can be gradually increased as well as the number of workouts. After two to three months of such base workouts at an easy effort level, some intense workouts of up to a few minutes at a time can be introduced. Maintaining consistency and sticking to the devised training plan helped Rishikesh not only stay fit and regulate his blood sugar levels, it has made him confident about his diabetes going into remission,” he explains.