Exergaming and Diabetes Management

27 - 08 - 2012

Exergaming and Diabetes Management

Diabetes is a global problem, one that has been on a precipitous rise in recent decades. A study conducted by the Centers for Disease Control in Atlanta has revealed that almost a quarter of teenagers in the United States are either diabetic or prediabetic. The rate of young people with blood sugar levels higher than normal has risen from nine to 23 percent within a single decade, which led the authors of the study to recommend diabetes screenings for children aged 10 and older who are overweight or have other risk factors. Similarly, the Canadian Diabetes Association predicts that the rates of Type 2 diabetes, or adult onset diabetes, will rise by 50 percent in the country in the next 15 years, up from the nine million people who already live with the condition. Efforts to find a solution to prevent diabetes rates from rising have intensified in the last decade as well, and motivating people to exercise more has been one of the main goals. Dance games and exergaming in general have played a significant part in the research.

Diabetes and exercise

Exercise is essential in diabetes control and prevention. The CDC (Centers for Disease Control and Prevention in the United States) recommends that people who suffer from diabetes exercise for at least 150 minutes every week and that they do not go more than two days in a row without exercise. Physical activity is one of the safest and most underused ways to manage diabetes, and it can reduce the need for blood sugar lowering medications in Type 2 patients.

Type 2 diabetes in particular is usually associated with sedentary lifestyles and obesity, as well as genetics. Also known as the adult onset diabetes, it accounts for about 90-95 percent of all cases of diabetes.

Because it is usually a consequence of an unhealthy lifestyle, Type 2 diabetes can be delayed or prevented altogether with a healthy diet, physical activity and weight loss. Even if it is too late for prevention, Type 2 diabetes can be reversed with diet and exercise. Physical workouts and a healthy diet help regulate blood sugar and this is crucial in fighting diabetes. With Type 2 and pre-diabetes, doctors recommend 40-60 minutes of exercise per session for patients to keep blood sugar in check and to shed extra weight.

People with Type I diabetes, or juvenile onset diabetes, are in a slightly different position. They need insulin injections because their pancreas produces little to none on its own. With Type 1 patients, experts recommend 20-40 minutes of aerobic exercise per session to regulate blood sugar.

Studies on the benefits of exercise for diabetic patients and people who are at risk of getting diabetes are numerous, but only under a half of people with diabetes stick with any kind of exercise program and follow the doctors' recommendations and guidelines. Research has revealed that despite the obvious health benefits and need to control diabetes with diet and exercise, it is people who do not have diabetes who are more likely to take up an exercise routine than diabetes patients. This is because exercise feels harder to people with diabetes, mostly because they are usually overweight, because they feel discomfort when performing more demanding tasks and engaging in physical activity, and because their joints are under more pressure when they exercise.

The knowledge that a lifestyle change can reverse or alleviate their condition and that the lack of physical activity poses a threat to their health is not strong enough a motivator for most diabetics to take up an exercise routine. Even if they do start working out, they get discouraged pretty quickly if they take up any of the traditional, more vigorous forms of exercise. Moderate physical activities like walking and elliptical training, on the other hand, are not particularly engaging and have little motivational value by themselves, especially to people who are not used to having exercise as part of their daily routine.

For all these reasons, motivation is a significant problem and this is why the medical community is looking to active games for the solution, both for diabetes management and for prevention. The interactive and competitive elements of active video games make it easy for players to forget that they are exerting physical effort and allow them to just get immersed in the game and enjoy themselves. While most exergames won't have the same effect as running on a treadmill, they have a much higher adherence rate because, being as immersive as they are and adapatable to different levels of fitness, they motivate people to keep exercising and therefore lead to greater improvements in health in the long run.

Precautions for diabetic exercise routines

There are cases in which exercise is not recommended to people suffering from diabetes. If they are taking insulin, exercise can induce hypoglycemia, i.e. cause their blood sugar to drop to excessively low levels, and they need to consult with their doctor and possibly have their dosage adjusted before taking up an exercise routine. Other precautions include measuring blood sugar levels before and after exercise, reducing the intake of the short-acting insulin by 33 to 50 percent, and eating extra carbs to make sure their sugar does not go too low after a workout.

Effect of exercise on diabetes

People with Type 2 diabetes reap enormous health benefits from regular exercise. First and foremost, exercise reduces the risk of heart disease and cardiovascular complications resulting from diabetes, which make Type 2 diabetes the sixth leading cause of death.

For people with pre-diabetes, a workout routine can significantly decrease the chances of developing diabetes. A study performed with a group of people at a high risk of developing Type 2 diabetes showed that an exercise program that involved an energy expenditure of 2,000 calories per week reduced the participants' risk of developing diabetes by about 24 percent. This happens because any kind of aerobic exercise improves the body's sensitivity to insulin, which makes it easier for the body to use the blood glucose more effectively. This in turn lowers blood sugar levels and reduces the need for insulin, the hormone that helps glucose leave the blood stream and enter the cells. Blood sugar usually drops after a workout and stays lower for the next day or two.

Whether or not an exercise program results in actual weight loss, and it usually does to some degree, it improves blood pressure and blood cholesterol levels. Research has found that a three-month exercise program can reduce triglyceride levels by 20 percent in Type 2 diabetes patients, and increase their HDL (good cholesterol) by 23 percent. The American Diabetes Association predicts that the number of Americans with diabetes will rise to 30 million by 2030. The rising rates are attributed to the rise in inactive lifestyles and the resulting obesity in developed countries.

A growing number of studies place exercise at the forefront in diabetes management and prevention because it is so effective with insulin resistance and consequently reduces glucose levels in the blood. People who are not accustomed to an active lifestyle, however, usually opt for medication to keep their blood sugar in check. With Type 2 diabetes, drugs can help manage the problem, but they do not make it go away, which is why alternative ways of exercising are becoming more prominent in research on fighting diabetes and the complications that come with it.

With iDANCE and other active games coming into play, exercise has become a compelling alternative to a sedentary lifestyle, and is simply not the strenuous effort that it used to be anymore. This is why a growing number of people are exploring it to improve their health, ward off disease, stay fit, or simply to have fun.


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