By Dr. Alberto Beconcini
Type 2 diabetes is the most frequent form of diabetes and represents about 90% of all cases. This type of disease, also known as diabetes of old age, occurs initially asymptomatically and the typical symptoms, such as frequent exhaustion, dryness and diuresis, do not initially manifest themselves. It is mostly in the presence of a combination of peripheral insulin resistance and pancreatic hyposecretion. Type 1 diabetes, on the other hand, is the consequence of an autoimmune destruction of beta cells (responsible for the production of insulin), which causes an absolute lack of this hormone.
The rapid socio-economic transformations, and the incorrect eating habits, have seen the possibility of contracting this type of disease increase dramatically.
This increases the awareness on the part of physicians (especially the basic ones) of the importance of physical activity as a drug, especially as a supportive therapy to the standard pharmacological one, in this type of patient.
Unlike other metabolic diseases, in type 2 diabetes the body's response to exercise is excellent; the classic symptoms of the diabetic, such as asthenia, the difficulty in remembering things, not to mention some postural, walking or articular problems due to damage caused by high glycemic peaks, can be significantly improved thanks to the attentive eye of the personal trainer.
In light of these facts and based on my experience, I believe that circuit training (circuit training) is the optimal training for this type of patient. The circuit training combines strength training with the use of overloads to machinery, alternating periods of cardiorespiratory work.
Clearly the circuit work that we are going to propose to this type of subject will be different from the classic circuit work, because it will have to be subjective and adapted to each specific case; below an example.
In the organization of circuit training in diabetic subjects it is recommended to use only polyarticular and closed kinetic chain isotonic machinery, such as the leg press for the lower limbs, the lat machine reverse socket for the biceps and the large back, the shoulder press for the shoulders and chest press for pectoral muscles and triceps.
The objective is to raise a maximum of 30% of the maximum liftable weight (following the execution of the indirect sub-maximal test with the brziky formula) for 12/15 repetitions on each specific machine
It is important to alternate an isotonic machine with a cardio station, which will be a step placed at the minimum height where the personal trainer will teach the basic steps of the step.
The use of the step with the teaching of the basic steps has a dual function; first and foremost it improves the cardiovascular system, but it also greatly improves balance and coordination, which is often inadequate in this type of subjects.
It is very important that the maximum duration of each station is not more than 30 seconds.
As for beginners it is very important to set a correct load, which allows the right execution of the exercise; over time the strength will increase, and the weight will also be increased. Those who have a reasonable state of form will start with a weight that allows them to perform a maximum of 15 repetitions.
Completing a circuit means performing all the planned exercises in sequence without a break. It starts with a complete circuit and then passes, after having reached the right level of training, to 3 complete circuits interspersed with 3-5 minutes of recovery between one and the other.
Here is an example of circuit training:
chest press max 30 '' -step 30 ''
leg press-step max 30 '' - step 30 ''
shoulder press max 30 '' - step 30 ''
lat machine max 30 '' - step 30 ''
abdominal max 30 '' - step 30 ''
pull down max 30 '' - step 30 ''
Effects and benefits
In circuit training we move quickly from a strength exercise to a cardiorespiratory exercise, without any recovery, and this "forces" the heart to maintain quite high frequencies, for the duration of the training.
All this promotes a cardiovascular conditioning in the diabetic subject, in order to train the cardiovascular component.
In this type of subjects this variable is very important, because 80% of type 2 diabetics is often also obese and a reduction in adipose mass can be very important in diabetic complications, among which, that of cardiac problems is among the most important .
The benefits of greater capillarisation in diabetics are of fundamental importance, given the enormous resistance that, especially in the lower limbs, creates major problems. This type of training creates a great benefit.
Also important is the effect of this type of training on the reduction of maximum and minimum arterial pressure, on the increase of 'good' HDL cholesterol and, consequently, on the reduction of the risk of contracting heart disease.
