An article presented in Medicine and Science in Sports and Exercise (December 2010 – Vol 42 / Issue 12-2282-2303) states that “before we only assumed exercise would help people with diabetes, now we have multiple high quality studies that confirm it improves blood glucose control, it positively affect lipids, blood pressure, decreases cardiovascular events, decreases mortality and improves quality of life. It also states that a combination of aerobics and resistance training are needed to get the benefits more effectively than either exercise alone.”
This information embraces the joint position of the American Diabetes Association (ADA) and the American College of Sports Medicine (ACSM). Another study states that “39% of adults with diabetes exercise regularly compared to 58% of adults who do not have diabetes”. We need that percentage to increase for those with diabetes to obtain multiple rewards. I would like to review the four components of an exercise program that should be included in your life to help reduce blood sugars, increase strength and improve general well-being.
- Aerobic Exercise – the most up-to date information continues to be 150 minutes of moderate to vigorous aerobic exercise that uses the large muscle groups and increases the heart rate. Brisk walking, swimming laps or walking in the pool, stationery or outdoor bicycle riding are among a few suggestions. This should be done over a minimum of three days with no more than a day break, but exercising up to five days is even better. Using an Omron pedometer is also recommended since studies have shown that it helps increase activity by 27%. This eventual goal should be 10,000 steps a day or 5 miles for those who are able. Remember to take precautions and check with your physician before starting any aerobic program. Be aware of hypoglycemia especially if on insulin, peripheral neuropathy, proliferative retinopathy, osteoporosis, arthritis, intermittent claudication, or any other problem which could present more of a risk.
- Resistance or weight training – utilizing either machines or free weights like dumb bells or bar bells can help control blood sugars by adding muscle mass. This increases your insulin sensitivity and blood sugar uptake. Remember to start slowly and work with a trainer at the beginning to learn your routine and reduce your injury risk. Your goal should be two-three times a week for about 30 minutes and incorporate 5-10 machines. Start with 10-15 light weight repetitions and increase weight gradually until you can get 8-12 heavier repetitions with good form and proper posture.
- Stretching – several studies support stretching prior to exercise and several do not. Add a 5 minute warm-up prior to stretching to increase blood flow and leave most of the stretching to after the main activity when the muscles are limber. The ACSM suggests it include static (holding) and dynamic (moving) stretches. Remember that flexibility adds to your range of motion which can help with resistance training and easier movement. Never hold your breath, stretch until you feel muscle tension and then try to slowly relax. Stretching can improve posture and blood circulation.
- Balance – as we age, we all suffer from decreased balance but people with diabetes are at increased risk due to neuropathy, problems with proprioception, medication side effects, vision problems, or vertigo. Balance is a motor skill that needs to be practiced and should be part of a fitness protocol. Yoga or Tai Chi can increase balance, improve posture, create a strong core, as well as increase endurance and strength. Practice balance exercises daily by standing on one foot until you can reach one minute and then close your eyes to make this activity more difficult. You can do this when you are waiting in line or while brushing your teeth. Also, getting up from a chair without holding on to the sides increases balance.
Exercise must be done consistently to maintain the benefits. Consider adding social support to keep you motivated and add unstructured activity like taking the steps as much as possible through out your day. There are so many positive things about exercise especially if you have diabetes!
NOTE: Consult your doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.