Lee Chung Horn
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  DIABETES MELLITUS

 

DIABETES AND EXERCISE 

Q.  Why is exercise important for people with diabetes?

A.  Exercise is beneficial to the health of people with both types of diabetes in two ways.  First, exercise can take some glucose out of the blood to use for energy during and after exercise, which lowers blood glucose levels. Second, it helps delay or stop large blood vessel and heart (cardiovascular) disease.  Cardiovascular disease is the leading killer of people with diabetes.  All people with diabetes should exercise to counteract their increased risk of cardiovascular disease, to reach and maintain a healthy weight, and to enjoy themselves.  An additional benefit for many people with diabetes is that exercise, plus other healthy lifestyle habits, can help them achieve good blood glucose control.

Getting Started

Q.  How do I get started?

A.  Your first steps toward a more active lifestyle should begin with a thorough medical examination.  This is the only way to make sure your exercise program meets your individual needs.  One exercise program does not fit all. Everyone is different, and your exercise plan needs to be based on your health and your body's needs.  Working with your doctor will give you the confidence of knowing that you're doing all you can to avoid the pitfalls and reap only the benefits of exercise.

Q.  I always procrastinate when it comes to exercise.  How can I get motivated?

A.  The first thing you should do is set some realistic goals for yourself.  For example, this might be as simple as a walking program in which you walk around the block for 15 minutes a day.  Then you should gradually build up your program and set new goals in order to stay motivated.

Q.  Is it smart to exercise with someone else, or should I exercise alone?

A.  Exercising with a partner is an excellent idea.  When we exercise by ourselves we sometimes get discouraged and lose interest.  However, an exercise buddy often provides the necessary encouragement and motivation to help us succeed.

Q.  How can I keep from getting discouraged?

A. The following tips can help you stick with your exercise program:

Set a schedule and keep it.  Make the commitment to exercise just as you would any other important appointment.  Remember ... habits are developed through practice.

Get a training partner.  We all have days when we are easily tempted to skip our workout.  You and your partner can be strong for each other and strengthen your collective resolve.  It also helps if you and your partner have similar goals so that you can exercise at the same level.  A training partner who is aware of your diabetes can also keep your exercise sessions safe for you.

Cross-train.  Doing the same thing every time you exercise can get boring.  Many people alternate exercises daily.  It's called cross-training.  This is a method in which you alternate forms of exercise in order to prevent putting a specific strain on a particular part of the body day after day.  In other words, you might ride a bicycle one day, walk the next, and swim another day.  It not only provides variety to your routine but it also reduces the risk of injury, by letting your body rest and repair between sessions which use the same muscles.

Set goals.  Setting specific goals for yourself and then evaluating how you are doing with your goals is a great way to keep on track.  But goals can work against you, too.  If you set a goal that is not quickly attainable, you might get discouraged when you don't see immediate progress.  Be realistic in your goal-setting.  Like Rome, your healthier body cannot be built in one day.

Reward yourself.  One good way to keep your motivation high is to reward yourself when you accomplish a goal.  For example, decide that if you meet this month's goal,  you will reward yourself with some new clothes, a CD, a new book - anything that will help keep you committed.  Another hint:  do not use food as a reward. 

Q.  Is it a good idea to drink fluids while I exercise?

A.  Drinking fluids while exercising is a good idea.  Actually you should try to drink something not only during the exercise, but also before and after working out.  This helps prevent dehydration and helps to replenish the fluids and nutrients your body loses during exercise.  This is especially important for people with diabetes.  Therefore during strenuous exercise, consider a high-glucose sports drink which can help prevent your blood glucose from going too low.

Q.  I am elderly and it is rather difficult for me to get around.  Should I still try to exercise?

A.  You should try to exercise regardless of your age.  If it is difficult to get out, you can do various stretches in your home, some even while sitting down.  As our bodies age, warming up with stretching exercises becomes more and more important.  You may find that after properly stretching, you can do more than you thought you could.

Q.  I have both diabetes and arthritis.  Can I still workout?

A.  Yes you can, but try two things to make exercising safer.One, make sure you stretch before all exercises, and two, you should plan exercises which will strengthen your muscles and make you feel better.

Q.  What is the best way to gain flexibility before I start working out?

A.  The best way is to stretch as much as possible to decrease tension in your muscles.  Flexibility can also help prevent injuries, so be sure to stretch plenty before you exercise.

Types of Exercise

Q.  Is there a limit to the types of exercise a person with diabetes can do?

A.  There is no limit to what people with diabetes can do.  Barring another medical condition, people with diabetes can do anything and everything.  You can walk or bike, swim or hike for exercise.  These are only examples.  Everyone is different, so be sure to ask your physician if you should have any limits in your exercise program.

Q.  If I workout at the gym, what is the best machine I can use on a daily basis?

A.  Stairsteppers and treadmills are excellent machines to use at the gym.  They simulate walking and climbing which can help burn fat, build endurance, and strengthen the cardiovascular system.  Weight lifting can also provide a great workout.  The important thing is to find something you enjoy, and exercise safely.

Q.  What is the best exercise to improve my blood glucose levels?

A.  Walking seems to be excellent exercise for a majority of people.  Again, it is best to consult your physician to tailor an exercise program to fit your particular situation.

Q. As part of my workout, is it helpful to ride a stationary bicycle?

A.  Riding a stationary bicycle not only gives you a great aerobic workout, but it also strengthens your legs and helps build muscular endurance.

Diabetes, Exercise & Weight Loss

Q.  If I lower my blood glucose level, is there a possibility I could gain weight?

A.  Yes, there is that possibility.  To decrease your chances of gaining weight, begin to exercise more often and more intensely, and reduce the amount of food that you eat.  Consult your health care professional to adjust your diet and exercise program accordingly.

Q.  If I have diabetes, what is the most effective way to lose weight?

A.  Regular exercise and good nutrition are key to weight loss.  Regular exercise helps you lose weight by burning calories and increasing your metabolism.  Eating well-balanced meals and controlling your caloric intake can also further your weight loss efforts.

Q.  If I want to lose weight, why can't I just diet instead of exercising?

A.  If you want to achieve permanent weight loss, most diets don't work by themselves.   A diet that severely restricts calories is dangerous for anyone, especially for those with diabetes.  Exercise, combined with your diet plan, helps maintain the weight loss and strengthens your body. 

Exercise and type 1 diabetes

Q.  My child has diabetes.  Can she still play sports?

A.  Yes, it is good to let your children be competitive and show their interests.  If they enjoy sports, tell them about professional athletes with diabetes such as NFL Quarterback Wade Wilson or Olympic gold medal swimmer Gary Hall, Jr.  This can help show them that anything is possible, and that if they pursue their dreams, anything can happen.

Q.  What can my child get out of playing sports if he or she has diabetes?

A.  Playing sports can provide children many benefits.  It gives them a chance to make new friends, develop physical confidence and it can improve their self-esteem.  As children with diabetes discover they can play and be competitive with other children, it might improve their outlook for their future.

Q.  I have type 1 diabetes.  How is exercise different for me?

A.  Exercise alone will not improve glucose control in type 1 diabetes. Increased exercise should help keep your weight under control with intensive management, but hypoglycemia is a very real risk.  Adding exercise to your diabetes care plan will require the careful balance of food, insulin, and physical activity.  You and your health care team should work together to find out what's best for you.  There are strategies to get good blood glucose control, and still let you lead an active life that promotes fitness. 

Other Questions

Q.  How can I be sure to avoid injury while exercising?

A.  You can do two things to prevent injuries.One is to stretch before and after you exercise as a way to warm-up and cool-down.  Second, you should gradually increase the intensity and duration of your exercise over many weeks or months to be sure that you do not overdo it.

Q.  How can I prevent low blood glucose at night when I exercised that day?

A.  You need to balance your insulin, your food intake, and your exercise in order to have fewer low blood glucose episodes at night.  You should work with your physician to maintain this balance.

Q.  Type 2 diabetes runs in my family.  Does this mean I'm destined to develop diabetes?

A.  No, exercise can help protect you from ever developing type 2 diabetes .  Regular exercise fights insulin resistance and obesity, allowing people to avoid developing diabetes in the first place.


 

Copyright of Lee Chung Horn Diabetes & Endocrinology 2009