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Running Head: EXERCISE PROGRAM FOR PEOPLE WITH TYPE II DIABETES5

Exercise Program for People with Type II Diabetes

Introduction Comment by Amy Allnutt: need a much longer introduction into diabetes and the different types. Comment by Alwaleed Bin Saif:

The key aim of this research is to design an exercise program for diabetic patients. The individuals who suffer from diabetes have higher level of glucose in their blood ( Greenlee , Hill & Umpierrez , 2008). In case of diabetes, glucose is not entered in the cells and instead, it accumulates in the blood. Exercise or physical movement acts like a secret weapon to struggle against diabetes. When a person perform exercise, his or her body becomes more responsive to insulin. It indicates that lesser amount of insulin is needed due to the exercise to maintain the level of diabetes. For most of the individual who suffer from diabetes, only walking for a few miles can reduce the amount of medicines that they take routinely ( Greenlee et al., 2008).

Population Demographics

This exercise plan is designed for the people suffering from Type II diabetes. The approximate age of the patients is 30+ years. The BMI range of the patients is less than 40 kg/m2. The measurement of systolic and diastolic blood pressure in the patients is > 160 systolic and >100 mmHg diastolic blood pressure. People have a background of mild cardiovascular ailments (van Dijk, Tummers, Stehouwer, Hartgens & van Loon, 2012). Comment by Amy Allnutt: so, they are obese as well? Comment by Amy Allnutt: and hypertensive? this is ok but you will need to include information on medications as well.

Special Considerations

People who are suffering from Type II diabetes can indicate some of these problems. Therefore, it is important to arrange for a physician’s consultation if any of these conditions appear.

· Unmanaged levels of glucose in blood Comment by Amy Allnutt: add in hypo/hyperglycemia and values

· Unchecked high blood pressure (Rogers, 2018).

· Unsteady heart orders Comment by Amy Allnutt: what does this mean?

· Retinopathy Comment by Amy Allnutt: explain these a bit more

· Autonomic neuropathy 

· Peripheral neuropathy 

· Nephropathy and Microalbuminuria

Exercise Plan for Six Weeks

Week 1: Aerobic exercise training Comment by Amy Allnutt: needs to be in table form -day 1, day 2, etc, This needs to be fixed for your final paper.

Aerobic workout includes walk, jogging, treadmill or any outdoor activity as shown in figure 1.0. Aerobic training workout will be executed for five days in a week. The exercise will be done for two consecutive days because of the short-lived developments in level of insulin in consequences to the exercise. For the individuals aged 30 years and above, 5 sessions of exercise with moderate intensity are found to be effective (Colberg, Sigal, Fernhall, Regensteiner, Blissmer, Rubin, Chasan-Taber, Albright, Braun, 2010).

Figure 1.0 Aerobic training exercise

The exercise will be performed at moderate strength, ranging from 40 to 60% of maximum aerobic capability. It is recommended to people suffering from Type II diabetes that they should perform brisk walk. Because swift walking is a type of aerobic exercise that has moderate intensity. A moderate intensity falls from 50% to 70% of the maximum heart speed at which a person is still able to speak smoothly (Colberg et al., 2010). More advantages can be obtained from strong workout. The strength of a workout determines the level of development in the regulation of blood glucose as compared to the volume of the exercise. Hence, recommending that the people who are previously doing exercise should consider the vigorous physical activity to achieve extra blood glucose advantages.

Table 1.0. Aerobic Exercises for people with Type II Diabetes

	Aerobic
Type of exercise	Walk, Jogging, Treadmill
Intensity	Moderate to strong
Duration	150 minutes/week. (30min/5days, 20min/3days)
Frequency	3 days/week
Progression	moderate

The individuals will execute the aerobic exercise in the bouts of 10 minutes and it will be divided across the week. The overall duration for aerobic exercise will be 150 minutes for one week, i.e. 30 minutes for each day. It has been suggested by the American Heart Association that 150 minutes of exercise with moderate intensity, i.e. 30 minutes for 5 days a week or 60 minutes of physical activity with strong intensity, i.e. 20 minutes of exercise for three days a week for the adults decreases the frequency of morbidity (Colberg et al, 2010). Comment by Amy Allnutt: Use FITT for this part. It can be bullet form. Also, target heart rate recommendations using Karvonen.

Frequency of progression: Moderate progress in aerobic exercise is suggested for the patients with Type II diabetes to prevent the probability of injury, specifically in the presence of health difficulties and to increase compliance.

Week 2: Resistance exercise training

Resistance training is effectual for diabetic people as it increases insulin sensitivity of the people suffering from diabetes (Eves & Plotnikoff, 2006). Dissimilar to aerobic exercise, a resistance training exercise is conducted with the help of an apparatus as shown in the figure 2.0. Resistance training workout will be conducted for three times in a week on alternate days. For the rest of three days, aerobic exercises will be performed. Thus, resistance training exercise will be combined with the aerobic workouts for the people with Type II diabetes.

Figure 2.0. Resistance training exercise

The intensity of resistance training workout will be kept moderate in order to achieve optimal benefits in level of insulin. It is important for people with diabetes to arrange for resistance training at their homes as it is more effective in regulating the level of blood glucose as compared to the training that is done at the gym. Each session of training will involve 5 to 8 exercises targeting the main muscle group in core, upper and lower parts of the body. 10 to 15 repetitions in each set will be completed (Eves & Plotnikoff, 2006).

Rate of progression: To prevent would, the development of the exercise in terms of duration, rate and strength will be kept slow as shown in table 2.0. Initially, increase in resistance is recommended, following the increase in number of sets and ultimately, the frequency of training. It is recommended that an individual with type II diabetes must perform moderate to strong resistance training for 2 to three days in a week alongside the aerobic workout.

Table. 2.0. Resistance training exercise for people with Type II diabetes

	Resistance Training Exercise
Type of exercise	Exercise with resistance band
Intensity	Moderate
Duration	2 to 3 times in a week
Frequency	60 minutes (20 minutes each day)
Progression	slow

Week 3: Flexibility and balance trainingFlexibility training will be added as a section of physical activity plan. The exercise mainly include stretching and yoga (Colberg, 2017). This type of exercise is specifically useful for the old aged individuals having Type II diabetes. Comment by Amy Allnutt: every week should include cardio, resistance and flexibility. You have it separated out into different weeks but it should be all weeks. However, the number of days may change per week.

The flexibility exercise like yoga and stretching is mostly suggested as a way of enhancing range of motion of the joint and decreasing the chance of injury. It has been examined through a research that flexibility workouts if combined with the resistance training exercise result in enhancing range of motion (ROM) in the people having type II diabetes. Furthermore, people with type II diabetes can easily involve in such movements which need more range of motion across joints (Colberg et al., 2010).

It is suggested that for people with type II diabetes, the duration of unstructured physical activity should be increased. Flexibility training can be added in exercise plan but it cannot take the place of aerobic and resistance training exercises. The duration of flexibility training can be from 10 to 20 seconds and every exercise will be repeated for 2 to 3 times (Table 3.0).

Table 3.0. Exercises for people with Type II Diabetes

	Flexibility and balance Comment by Amy Allnutt: Is this your FITT for flexibility? Please label if so
Type of exercise	Stretching, Yoga
Intensity	Stretching till modest discomfort
Duration	Static for 10 to 20 seconds, 2 to 3 repetitions
Frequency	2 days
Progression	Increase duration with passage of time

Week 4: Tai Chi

Tai Chi exercise involves a sequence of motions that are conducted in a moderate and unhurried way across a duration of 30 minutes. This exercise has been implemented since ages. It has been validated by a small research that this exercise offers amazing outcomes for individuals with type two diabetes (Orenstein, n,.d.). This exercise not only offers fitness benefits but also reduces the level of stress in the people with Type II. It also decreases the chance of damage to nerves that is a very usual problem among people with diabetes.

This exercise mainly emphasizes on improving balance. Improvement of the balance is particularly significant for the people having diabetes. This exercise will be added in weekly exercise regimen to minimize the threat of falling (Orenstein, n,.d.).

Figure 3.0. Tai Chi exercise

Week 5: Weight Training

Weight training is not only good for the individuals with type II diabetes, but also for every other individual. Weight training work out focuses on building muscle mass which is good for the people with diabetes (Orenstein, n,.d.). Because if such individuals cease to retain muscle accumulation, it becomes arduous for them to manage their blood sugar.

It is important for people with type II diabetes to perform weight training exercise for 2 times in a week. Therefore, it will be performed by the diabetic people on alternate days. In every session, 5 to 10 varying kinds of lifting will be performed. Such lifting engages the key groups of muscles. In order to attain maximum power, it is important to perform 3 to 4 sets of every workout and every set should be repeated for 10 to 15 times (Orenstein, n,.d.).

Week 6: Swimming

Another very useful exercise that is added in exercise plan of the people with type II diabetes is swimming. It has been determined through a research that high intensity swimming provides valuable results to the people with type 2 diabetes.

Swimming should be done for three times in one week and the intensity of swimming must be high to gain the maximum benefit of the exercise. Every session will be composed of 6 to 10 repetitions of front craw at a complete choke for a duration of thirty seconds, with 2 minutes of break in the middle (Qi, Yang, Ren, Fu & Zhang, 2016). It will result in making the people with type II diabetes more prone to insulin.

Thus, brief training sessions of high intensity workouts can assist in stopping type II diabetes.

Figure 4.0. Swimming for diabetics

Conclusion

It can be concluded after designing an exercise program for people with type 2 diabetes that if different exercises are incorporated in workout routine of diabetics, their levels of blood sugar can be maintained easily. They become sensitive to insulin after performing these specified workouts. In other words, their level of insulin is maintained naturally. Besides, the possibility of falling can be decreased. And the range of motion can be enhanced near joints that is particularly mandatory for older people having diabetes. It is noteworthy here that intensity and progression of exercise are more important to consider relative to volume of exercise.

References

Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., Braun, B. (2010). Exercise and type 2 diabetes. Diabetes care, 33(12), e147-67.

Colberg, S. R. (2017). Key points from the updated guidelines on exercise and diabetes. Frontiers in Endocrinology. https://doi.org/10.3389/fendo.2017.00033

Eves, N. D. & Plotnikoff, R. C. (2006). Resistance Training and Type 2 Diabetes. Diabetes Care, 29 (8), 1933-1941.

Greenlee , C., Hill , J. & Umpierrez , G. (2008). Diabetes and exercise. The Journal of Clinical Endocrinology & Metabolism, 93 (6).

Orenstein, B. W. (n,.d.). 6 great exercises for people with diabetes. Retrieved from https://www.everydayhealth.com/type-2-diabetes/living-with/great-exercises-for-people-with-diabetes/

Qi, J., Yang, B., Ren, C., Fu, J. & Zhang, J. (2016). Swimming exercise alleviated insulin resistance by regulating tripartite motif family protein 72 expression and AKT signal pathway in Sprague-Dawley rats fed with high-fat diet. Journal of Diabetes Research. http://dx.doi.org/10.1155/2016/1564386

Rogers, P. (2018).A workout program for diabetes. Retrieved from https://www.verywellhealth.com/a-workout-program-for-diabetes-3498694

Van Dijk, J. W., Tummers, K., Stehouwer, C. D. A., Hartgens, F. & van Loon, L. J.C. (2012). Exercise therapy in type 2 diabetes. Diabetes Care, 35 (5), 948-954.