I Decide to Be More Active
By M. Sue Kirkman, MD, Vice President, Clinical Affairs American Diabetes Association
February is American Heart Month. In observance, HealthMatters is pleased to present the following information about exercise and diabetes — the third in a series of articles from the American diabetes Association® (AdA) to help you better manage your diabetes.
The journey to better health begins with one step — or stretch or bicep curl. You don’t have to be an athlete to reap the rewards of exercise
Imagine a diabetes treatment that a) lowered your blood glucose level, b) was fantastic for your overall health, c) didn’t involve taking medicine, and d) was enjoyable. Wouldn’t you want to try it? We’re talking, of course, about exercise. Aside from its many wellknown benefits — reduced risk of heart disease and stroke, stronger muscles and bones, leaner body and improved mental health — exercise packs a punch against diabetes. By building muscle and burning fat, it can decrease insulin resistance and lower your blood glucose level. Bonus for waist watchers: The more muscle you have, the more calories you burn, even at rest.
Which exercises are best?
For total-body benefit, combine aerobic exercise, strength training and stretching. Aerobic exercise: Try walking, jogging, low-impact aerobics, bicycling, water aerobics, swimming, dancing or skating. Most people should aim for a total of about 30 minutes a day, at least five days a week. If you want to lose weight, go beyond a half hour. If you’re not used to aerobic exercise, start with a gentler activity, such as walking slowly, and, if possible, gradually increase your speed. Start with 5 or 10 minutes a day, and increase your time each week. Or split up your daily workout — for example, take a brisk 10-minute walk after each meal. Strength training: Use weights, elastic bands, plastic tubes or gym equipment several times a week. First, learn how to use these items correctly — and avoid injury — by taking a class at a local Y, community center, adult education program or health club. Some clubs provide personal trainers for a fee. If you’re not used to strength training, start with light weights or beginner bands. Stretching: Flexible muscles and joints can help you avoid injury. But don’t stretch when your muscles are cold. First, warm up with moderately paced walking, then stretch for 5 to 10 minutes, then launch into your aerobic activity. Afterward, cool down with another stretching session. Seek out tips on proper stretching techniques, or take a yoga or tai chi course.
Pointers for people with diabetes
- Ask your health care team which exercises are safe for you. They may recommend an exercise stress test to give your heart the all-clear.
- Check your blood glucose level before and after exercise. The results can help you prevent glucose lows (hypoglycemia) and highs.
- A long or strenuous workout can lower your blood glucose level, especially if you take insulin or haven’t eaten. To prevent hypoglycemia, eat before exercising, and ask your health care team if your medication should be adjusted. If you feel hungry, nervous, shaky or sweaty while exercising, check your glucose level. If it’s 70 or below, have three to fi ve glucose tablets, a half-cup (4 ounces) of fruit juice or a half-cup of a non-diet soft drink. Wait 15 minutes and recheck your glucose level. If it’s still below 70, repeat these steps until you reach or exceed 70.
- But exercise can actually increase blood glucose levels that are already high (type 2: over 250; type 1: over 250 plus ketones). Wait to exercise until your blood glucose is under better control.
- Drink plenty of water before, during and after exercise.
- Wear a medical ID bracelet, necklace or tag.
“BUT” BUSTERS
“But I don’t have time to exercise.”
Work out at home while watching a movie. Combine couples night with exercise night by taking partner dance classes. Do the chores you’ve been putting off: yard work, housework, washing the car. Sneak in exercise by getting off the bus a few stops earlier, walking versus driving to nearby locations, parking the car at the far end of the lot, taking the stairs instead of the elevator, or walking the dog. For more ideas, check out the American Diabetes Association’s fun and interactive “Activities Count!” at http://www.diabetes.org/
“But I’m too tired after work.”
Exercise before work, during lunch and on the weekend. Try exercising after work; you may find that it’s a pick-me-up.
“But I’m too self-conscious to exercise in a group.”
Use home workout equipment or an exercise DVD. Take a walk.
“But it’s too hot/cold/unsafe to walk/bike outside.”
Walk inside a mall. Work out at home using a low-impact aerobics DVD, treadmill or stationary bike. Find a Y or health club with an indoor track.
“But exercise is boring.”
Find an activity you enjoy. Exercise with friends or in a class with a fun instructor. Work out to music or while watching your favorite TV show. Mix it up — do different activities on different days.
As many as one-third of people with diabetes will have a diabetes-related skin disorder at some time in their lives. What does blood glucose have to do with your skin? Think of it as a chain reaction — or a diabetes quintuple whammy.
First, excess blood glucose causes your body to excrete fluid, which dries your skin. Second, diabetes-related nerve damage can reduce your sweat production, which also dries skin. Dry skin may crack, allowing bacteria and fungi to enter and cause infection. If you scratch and break your skin, the same thing can happen. Third, nerve damage can lead to loss of feeling, especially in the feet, so you may not feel a blister or sore.
Fourth — literally adding insult to injury — excess blood glucose affects your immune system's ability to fight off infections.
In a fifth and final twist, people with diabetes tend to get atherosclerosis (hardened, clogged arteries) at a relatively young age. The reduced blood flow can change the skin on your legs, which becomes hairless, thin, shiny — and slower to heal. Minor scrapes can turn into open sores, and infections can become severe.
But there is good news: Most diabetes-related skin problems can be prevented or treated easily if caught early. Decide to be skin smart and follow these tips.HM
What is the "I Decide to Fight DiabetesSM" campaign?
The "I Decide To Fight DiabetesSM" campaign seeks to inspire people to live healthier lives and make better choices when it comes to preventing and managing diabetes. The campaign is designed to empower Americans to become a voice for the cause and get more involved in activities to support ADA's mission.
Through this campaign, people with diabetes, their friends and families, as well as those at risk, are encouraged to display their commitment by wearing an I Decide To Fight DiabetesSM charm, which can be worn on a keychain, necklace or bracelet. In addition, they can upload a picture of themselves or a loved one, and have it transformed into a personalized logo printed on items such as t-shirts, tote bags or mugs. Participating in the campaign means that Americans everywhere can become an active, visual champion in the fight against diabetes.
For more information on diabetes and the I Decide campaign, visit http://diabetes.org/IDecide or call 1-800-DIABETES.
Over the next several issues, we'll present helpful tips to empower you to take action, take control—and improve your health and your life.