Diabetes: exercise prescription | Health, Medicine and Fitness

chris woolston

Every time Natalie Wayne climbs a mountain or goes speed skating, sugar pills are part of her gear. Wright, who lives in Wakefield, Rhode Island, is a certified diabetes educator, exercise physiologist, and self-proclaimed “exercise nut” who has type 1 diabetes. In addition to rock climbing and skating , she enjoys working out on a trampoline and, just to keep things interesting, swinging on a trapeze. Wayne must take steps to keep her blood sugar from crashing while she exercises, but diabetes has never slowed her down. She knows that a good workout stimulates both her body and her mind.

Exercise can improve anyone’s health, but it’s especially helpful for people with diabetes. Exercise can be crucial for people with diabetes if they are also overweight, especially those with type 2 diabetes, whose weight likely contributes to their disease.

Wayne urges all of his clients with diabetes to exercise regularly. It may be a tough sell, but she believes in her product. After all, regular exercise significantly reduces the risk of cardiovascular disease, by far the leading cause of death in people with diabetes. Exercise also helps keep the body limber and avoid depression.

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For many patients with type 2 diabetes, physical exertion can often curb high blood sugar as effectively as medication. Not only does exercise burn extra blood sugar, but it also helps make the body more sensitive to insulin. While diabetic patients will always need medication, some people with type 2 diabetes who practice exercise and a healthy diet may be able to reduce their medication (under the supervision of their doctor).

In fact, current guidelines from the American Diabetes Association emphasize that exercise can help patients control their blood sugar. In a study of nearly 20,000 pediatric patients with type 1 diabetes, researchers concluded that regular physical activity was “a major factor” influencing children’s ability to control their blood sugar levels.

If you have type 1 or type 2 diabetes, your doctor has probably already advised you to exercise more. If not, it’s time to talk to your doctor about the safest and most effective way to incorporate regular exercise into your plans for staying healthy.

What type of exercise is best?

The American Diabetes Association recommends at least 150 minutes a week of moderate exercise — that’s just over 20 minutes a day — and two sessions of resistance exercise a week unless your doctor advises against it. There is no single plan that works for everyone. In general, the best exercises are the ones you will actually do and enjoy. If you’re otherwise healthy, there’s no limit to the types of workouts you can try. People with diabetes play football, climb rock faces and run marathons. They also walk around the block, take water aerobics classes and play ball with their children. And they’re all doing something good for their bodies.

Why should I consult my doctor before starting to exercise?

Your doctor can help you choose the exercises that best suit your abilities and needs. Depending on your condition, some activities may be inadvisable. In some cases, doctors will recommend testing a patient’s heart health before allowing them to participate in a strenuous exercise program. If you have numbness in your feet, for example, jogging can cause wounds or even fractures; your doctor may recommend that you switch to swimming or cycling. If you experience any unusual symptoms when exercising, such as severe shortness of breath or chest pain, further testing may be needed to make sure you can exercise safely. Your doctor may recommend that you swim, cycle, or take short walks instead.

Remember: exercise is powerful therapy – so powerful that you shouldn’t try it without some professional guidance. (After all, you’ll never start taking extra-strength diabetes pills without your doctor’s approval.) Your doctor can help you incorporate exercise into your overall health plan. You may need to adjust your medications, bring snacks or drinks, or change your diet to help prevent hypoglycemia (low blood sugar). It can happen to people with type 2 diabetes, but it’s much more common in people with type 1 diabetes. If you have this type of diabetes, you’ll need to work closely with your doctor to find the good balance between exercise, diet, and medication.

However careful they are, people with type 1 diabetes should expect some setbacks. Their sugar levels could plummet unexpectedly, briefly putting them back on the sidelines. “With all my intelligence from the book and my experience, sometimes things just don’t work out the way they should,” Wayne says. “But tomorrow is a clean slate.” Any diabetic who exercises should carry glucose tablets or an equivalent, such as Lifesavers, with them in case the sugar level drops unexpectedly.

If you are having trouble controlling your blood sugar levels during exercise, your doctor may refer you to an exercise physiologist specially trained to treat diabetics.

What other precautions should I take?

Your doctor or exercise physiologist can give you safety tips for your particular workouts. Here are some general guidelines:

Warm up with five to 10 minutes of gentle stretching and five to 10 minutes of light aerobic activity (such as walking or jogging in place).

Proper footwear is essential, especially if you have poor circulation or numbness in your feet. A gel insert and polyester or polyester-blend socks will help keep your feet comfortable, dry, and blister-free.

Check your feet carefully for blisters and other sores before and after exercise.

Dehydration can affect your sugar levels, so be sure to drink plenty of fluids before, during, and after exercise. Water is often an excellent choice. Your doctor may suggest that you take fruit juice or a sugary sports drink if you are at risk for low blood sugar.

Wear a diabetes identification bracelet or tag. This precaution is particularly important if there is a risk that you may lose consciousness due to low blood sugar.

People with diabetes are like everyone else – if they’re not used to sweating, it can be really hard to get started. Wayne motivates his clients by having them check their blood sugar before and after a walk. “When they see the numbers go down, it really clicks,” she says. If they’re still struggling to take that first step, she encourages them to find a friend or family member who will walk, run or ride a bike with them. It’s much easier to stick to an exercise routine if you don’t have to do it alone.

Exercise isn’t a miracle cure, but it’s still one of the best things you can do for your body. So talk to your doctor, get moving and have fun.

Interview with Natalie Wayne, Certified Diabetes Educator, Exercise Physiologist.

American Diabetes Association: Now is a great time to get moving: https://www.diabetes.org/healthy-living/fitness

American Diabetes Association. Physical activity/exercise and diabetes mellitus. Diabetic treatments. 26: S73-S77.

Diabetes and physical activity. American Association of Diabetes Educators, February 9 American Diabetes Association. Frequently asked questions about exercise.

American Diabetes Association. Position statement: physical activity/exercise and diabetes. Diabetic treatments. 27:S58-S62.

Herbst A et al. Effects of regular physical activity on glycemic control in pediatric patients with type 1 diabetes mellitus. Archives of Pediatrics and Adolescent Medicine. Flight. 160:573-577. http://archpedi.ama-assn.org/cgi/content/full/160/…

Originally published on consumer.healthday.com, as part of TownNews Content Exchange.

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