We are happy to announce that Sheri Colberg, Ph.D., FACSM will be joining us at Diabetes in Control. Sheri is a professor of exercise science at Old Dominion University in Norfolk, Virginia, and has type 1 diabetes. She will be joining on a frequent basis to share information on how we can help our patients improve their physical activity, and why. This week she starts of with Why Being Active is the Way to Go
By Sheri Colberg, Ph.D., FACSM
Diabetes treatment has been going through dramatic changes in the past two decades. New and improved blood glucose monitoring devices, including continuous ones, are finally becoming a reality, and new medications are opening the door for more people to have even better control over their diabetes. Admittedly, my focus as an exercise physiologist is usually on exercise and physical activity first, everything else second, but nothing is ever really that simple. In times past, exercise was often overlooked even though it was one of the three cornerstones of diabetes management simply because it can be more difficult to maintain blood glucose levels with the additional variability caused by physical activity, particularly for people with type 1 diabetes. However, with the current availability and affordability of self-monitoring devices, very few reasons remain that are truly viable excuses for not becoming more physically active.
Diagnosed with type 1 diabetes myself at the age of four in what I call the “Dark Ages” of diabetes (1968), I went through childhood, adolescence, and early adulthood without the benefit of having a blood glucose meter. Believe me, everything we have available nowadays is better than the old urine tests that would turn bright orange (indicating significant glucose in the urine) even when I was in the middle of a hypoglycemic reaction. I still participated in a variety of sports and physical activities over the years, including swimming, running, racquetball, soccer, tennis, weight training, gymnastics, volleyball, cycling, aerobics, dancing, stair climbing, hiking and backpacking, canoeing, snowshoeing, cross country and downhill skiing, horseback riding, sailing, snorkeling, skydiving, and more! I did many of these things while feeling less than my physical best because I was not able to test my blood glucose levels, and I was often either hyperglycemic or hypoglycemic during my activities. While growing up, though, I always felt better when I did any exercise, although I did not understand the physiology behind it well enough to know why. At a time when diabetes control was so elusive, I always felt more in control when I exercised. So, I began to exercise regularly on my own and through sports team participation as a young teenager, and I have continued exercising – even through three successful pregnancies – to this day.
You certainly do not need to get a doctorate in exercise physiology like I have to understand why physical activity is so beneficial for everyone, especially people with diabetes! Armed with a blood glucose meter you can likely find out almost everything you ever wanted to know about the effects of exercise on blood glucose levels. Not until I had a blood glucose meter did I realize how much better I felt when exercising with more normal glucose levels, though, and every diabetic exerciser I have met since then agrees with me. The more I have learned about exercise, though, the more I have come to realize that it is just as important as – and possibly even more so than – medications and diet in optimizing diabetes control. The normal response to moderate aerobic exercise is a lowering of blood glucose levels. This phenomenon occurs largely because muscular contractions by themselves elicit glucose uptake into muscle that is insulin-independent. If you add in higher circulating levels of insulin as well, you then have two ways that your muscles are removing glucose from your bloodstream whenever you are active. What better way could there be to lower elevated blood glucose levels? Of course, there are caveats to everything, and intense exercise can actually raise blood glucose sometimes, but the overall health benefits are still generally the same.
My personal and professional interest in the benefits of physical activity on diabetes has led me to conduct research on diabetes and exercise, and, ultimately I have put all that I have learned and more into three published books. My current goal is to impart as much knowledge about exercise and its beneficial effects to you as I can, with the welcome assistance of the editors of Diabetes in Control.com. In a biweekly (or occasionally monthly) format, I will be giving you information that you as health care professionals can use to improve the health of your patients or that you can use personally to improve your own health status. In my opinion, what is even worse than the gigantic tidal wave of diabetes cases getting ready to sweep over us is the fact that this now worldwide epidemic of diabetes is unnecessary. In fact, type 2 diabetes could be almost entirely prevented with appropriate lifestyle changes that include regular participation in physical activities, and most diabetes-related complications could be prevented in a similar manner for anyone with diabetes. I personally have found that the same strategies that I use to control type 1 diabetes are essentially the same ones that others can use to prevent and control type 2: regular physical activity and healthier eating.
While I will be mostly sharing parts of my latest book, The 7 Step Diabetes Fitness Plan: Living Well and Being Fit with Diabetes, No Matter Your Weight (2006), in weeks to come, please keep in mind that the information in that book is mainly geared toward people with type 2 diabetes or prediabetes. For the younger generation, I have also written Diabetes-Free Kids: A Take-Charge Plan for Preventing and Treating Type 2 Diabetes in Children (2005). Finally, for the type 1 and other insulin users, specific regimen changes by sport or activity are spelled out in my first book, The Diabetic Athlete: Prescriptions for Exercise and Sports (2001). Information about all of my books, my many articles, my research, and more is available on my web site: www.SheriColberg.com. I look forward to spending more time with all of you in the near future, and if you have any burning questions that my books do not answer, please feel free to e-mail me night or day at Sheri@ SheriColberg.com.
Tip for the day: Get up and move around for a few minutes after every 30 minutes of a sedentary activity. Everything you do during the day that expends calories counts!