A few years ago it was announced that sedentary lifestyles and poor eating habits were poised to overtake smoking as the leading cause of preventable death — yes, preventable. Are your patients aware that exercise is likely the best "medicine" that they will ever come across to prevent this and without any of the bad side effects that medications frequently have?
If you have diabetes (or even if you don’t), physical activity makes your body’s insulin work more effectively, and the result is better blood sugar control — meaning better fasting blood glucose levels and smaller post-meal spikes — which is thought to be one of the keys to prevention of health complications related to diabetes.
What should you do to get started and stay motivated to reap these and other health benefits for the rest of your life? To gain the most from your physical activity, follow these simple tips:
- Do some sort of physical activity on a regular basis (at least every other day, if not more often) for better blood sugar control.
- All of the activity you do counts — both formal exercise programs and any physical exertion – such as cleaning or gardening – you do during your daily routine.
- Whenever you have a few spare minutes, do something active like walking around or in place, doing armchair exercises, or stretching.
- Try to add in some planned exercise, such as brisk walking, stationary cycling, or swimming, on a regular basis.
- Start out slowly, erring on the side of caution with any exercise program or new physical activity, and check your blood sugars frequently.
- Add in some resistance or weight training at least one day a week (preferably two to three nonconsecutive days).
- Stretch all of your major muscle groups at least twice a week to prevent loss of flexibility, improve balance, and reduce risk of falls.
- Respect your physical limitations, and make accommodations for them to avoid any undue injury.
- Make certain to include a warm-up and a cool-down period, especially when undertaking more strenuous exercise.
The key to good blood sugar control is frequent, regular physical activity. Most of the glucose-lowering effects of exercise are due to improved insulin action in muscle, but that effect only lasts for a day or two. To maintain these blood sugar effects, you have to exercise regularly. A minimum of 3 to 5 days per week of aerobic exercise (walking, cycling, swimming, etc…) done at a moderate to intense pace for a total of 150 minutes per week is the current recommendation. For people with Type 2 and gestational diabetes, daily or near daily activities are better for blood sugar control. With Type 1, predictable exercise makes blood sugars easier to manage. Regardless of your type, test your blood sugars regularly to learn your body’s response to different activities for optimal control.
Thankfully, all exercise you accumulate during the day counts. Your new goal should simply be to become as physically active as possible during the day, which fortunately doesn’t necessitate your joining the nearest gym. Almost any activity (including golfing, gardening, mowing the lawn, mild walking, etc…) done for 30 to 45 minutes per day is beneficial to health even if done for only ten minutes at a time and without causing much gain in your overall fitness. Take the stairs instead of the elevator, park your car at the far end of the lot from where you’re headed, walk in place during all the TV commercials, take your dog out for a walk, and move around for a few minutes after every half hour of being sedentary. For motivation, consider investing in an inexpensive pedometer (step counter) and simply try to add 2,000 (or more) steps a day.
Next, begin to add in more planned exercise, such as brisk walking or fitness machines, such as a treadmill, stationary cycle, rower, or elliptical strider. Start out slowly, though, exercising three days a week for 20-30 minutes a day (done five to ten minutes as a time, if necessary), and very gradually work up to 45-60 minutes per day and/or five days per week.
Resistance (weight) training is just as important as aerobic exercise for diabetes control. It increases insulin sensitivity and lowers your risk for thinning bones and age-related loss of muscle mass. Ideally, you should train two to three nonconsecutive days per week and include all the major muscle groups. Pick a weight or resistance that you can lift 8-12 times and do at least one set (preferably 2 to 3) on each exercise. If all you can manage is one set once a week, you’ll still experience some strength gains, particularly if you tire yourself out on that set. You can easily add in resistance work by lifting items found around the house or buying an expensive resistance band. Also include some stretching exercises to maximize strength gains and minimize flexibility loss, which is related to aging and accelerated by elevated blood glucose.
Almost everyone can exercise safely and effectively. Respect your limitations and make accommodations. If you have lost some of the feeling in your feet, check your feet daily for signs of irritation, redness, blisters or sores. If your blood sugars have been running high, drink plenty of fluids during and after exercise to prevent dehydration. If you have diabetic eye disease, avoid jumping, jarring, or breath-holding activities. Also, include proper warm-up and cool-down periods (3 to 5 minutes done at a lesser intensity for moderate to strenuous work) to ease the transition and decrease your risk for injuries. Exercise is admittedly more work than just popping a pill or two to control your diabetes, but it’s well worth the effort. Get started by being as physically active as you can each and every day!
To sign up for 5 free healthy living reports via e-mail, log on to www.lifelongexercise.com, especially to get the report on easy core exercises you can do at home. For more information, also check out my web site at www.shericolberg.com. If you need tips for getting started on an exercise program, I recommend The 7 Step Diabetes Fitness Plan. For people with any type of diabetes who are more active, read Diabetic Athlete’s Handbook.