The New Year is here and like most individuals, you may be putting together a list of changes you would like to make in this coming year. Humans tend to be goal-oriented which makes us different from other species. Being human also prevents us from always achieving the goals we set. Trying to create reasonable and suitable goals is worth the effort but, “reaching for the moon” is not. Goals for people with diabetes should remain basic and include lifestyle changes, if you are not already on track. Every study points to “lifestyle” as a first step in diabetes management if it can be achieved. When not, diabetes medication is started. Goals for lifestyle change should be “specific, measurable, realistic and time bound.” Goals should focus on only you and not be competitive with others. They should be based on the very near future and not forecasted out into the months and years ahead. Goals need some form of “immediate feedback” either through documentation such as a spread sheet, a Smartphone app, a diary, change in the scale/BMI (body mass index), or in blood glucose changes. Let’s examine what should and should not be some of your focuses for the New Year:
Do Not Focus on Weight Loss as the Primary Goal
Trying to lose a specific amount of weight in a specific amount of time is one of the most frustrating goals and rarely is achieved. Daily weight can vary due to bloating, salt intake, fever, dehydration or congestive heart failure. Remember that muscle does weigh more than fat. Weight loss will follow when other changes are implemented.
DO Set Specific Health Improvement Goals
Do set specific goals to improve your overall health including your diabetes. Consider how you feel. Could you use more stamina or energy? Should you be eating more whole, real foods? Should you reduce unnecessary snacking? Are your snack choices the best they can be? Is your balance failing? Is your body so tight and rigid because you do not stretch? Are you strong enough to carry 1-2 bags of groceries? Do you sleep between 7-8 hours each night? Do you take medications correctly and on time? Are you properly hydrated? Do you keep your doctor visits? Have you started strength training? Do you carry products for low blood sugars?
Only Pick 1-3 Realistic Goals
Pick 1-3 goals to start and be realistic. For example, if you decide to start a walking program, literally start with 5-10 minutes and then add 5 extra minutes when you still feel energized. Starting with high expectations “out of the gate” shuts down that goal quickly. Find your weak spot and work on it. See how new habits make you feel and don’t over commit. Down-shift if you must, but do not stop. Signing up for a 10 K race is unrealistic if you walk 20 minutes two times a week.
Keep Free of Injuries and Free of Hunger
The beginning of the year signals big change for many which results in overdoing activities and becoming injured early on. This halts your progress immediately and takes you down a path you can’t complete. Start cutting back on food slowly, don’t go “cold turkey” and stop eating portion sizes that you’re used to. Severely cutting back on food and skipping meals can lead to feeling miserable, weak, dizzy and causing low blood sugars depending on the diabetes medication you take. Be reasonable in your changes from the start. Fine tune them as you go.
You Look Good Just The Way You Are But You Should Still Exercise!
Do not try to look like “that specific person.” It may sound like high school, yet many people have a preconceived notion of what they should or want to look like after starting a food/ exercise/lifestyle program. Most people are a combination of many kinds of different body types and each person will react in different ways to weight loss or gain. If the intention remains to feel better and obtain improved health and diabetes control, keep it. If the intention is simply to look better, then reevaluate your goal.
Choose Something You Love to Do
There is no certain exercise preferred, just the one you will stick with indefinitely. It could be dancing, ice skating, skiing, sledding, fencing, cleaning/vacuuming, playing tennis, gardening, rowing a boat, using an elliptical, playing beach volleyball, joining a ballet class, swimming laps or doing jumping jacks, push-ups, or squats at home. Any movement that pleases you will be helpful. The first step is to start to feel good on the inside. Be consistent and you will see outward changes, too.
Group Exercise is a Winner for Motivation
Researchers have found that, “individuals who participated in a group exercise program improved their health by 25%, mental health by 12.6% and decreased stress levels by 26.2% over 12 weeks compared to those in individual fitness routines.” These findings were presented in The Journal of the American Osteopathic Association. “Couples taking on activities together have better glycemic control than couples who don’t commit to healthy choices together.” Find a buddy who will notice when you are a “no show.”
Try to Use Targeted Exercises
Be specific. Pure and simple, strength training can make your muscles absorb more glucose as it does the work and lower blood sugars. Weight/strength training creates more muscle mass which in turn raises metabolic rate and raised metabolic rate burns more calories. This sequence also helps with weight loss which is frequently goal for people with diabetes. Always check with your health care provider when starting any exercise program. Weight/strength training should be performed 3 times a week for 30 minutes a session. It is wise to work with a certified trainer when starting a lifting program to avoid or reduce injuries. Start with resistance bands which you can purchase in big box stores or online and progress to small hand-held free weights. Never arch your back when training and “lift” from the specific muscle group. Since weight training may cause blood sugars to plummet, be prepared with glucose testing equipment, glucose tablets, fruit and nuts or a granola bar. Doing weight lifting correctly can get your heart rate into an “aerobic zone” and lessen your need for walking/cycling/ swimming the day you train.
What About Balance?
Aging, changes in vision, changes in our inner ears, different medications, stroke, arthritis, MS and Parkinson’s, can have strong influence on our balance. This gets tricky, since possible falls could mean a broken hip and long hospitalization followed by rehab. Now is the time to start a balance program even it is not yet an issue. Many senior centers, YMCA’s and community centers offer informal balance training programs. Strengthening your leg muscles will also aid your balance. Start by using a recumbent bike and as balance increases walk on a treadmill using arm rails until you feel comfortable enough to swing your arms while walking. Yoga and Tai Chi classes increase balance along with offering many other benefits. Tai Chi, “involves shifting weight gradually from one foot to another along with lengthening the limbs and rotating the trunk.”
Remember to Stretch!
People will spend plenty of time doing a routine without including some sort of stretching. This can lead to tight muscles, leg or foot cramps and spasms, injuries and frustration towards exercise. Some people like to stretch prior to beginning their program and others would rather be warmed up before stretching. See which timeframe makes you more comfortable. Learn the terms involved with flexibility. Static stretching is holding the stretch for 10-30 seconds until you feel slight discomfort. This will increase flexibility. Active stretching is when you engage and contract the muscle group opposite the one being stretched. Passive stretching is when you use an outside force such as a band, strap or personal trainer. The stretch is assisted while the person remains passive. This type of stretch increases range of motion and decrease muscle tension and spasms. Lastly, dynamic stretching is used control and gradually increase movement. This is the stretching that helps the body warm up.
What Else Can Exercise Do for Me When I Have Diabetes?
The answer is long but here are just a few of the benefits especially targeted for you. Exercise reduces the risk of heart disease, which is “the leading killer in those with diabetes.” Exercise lowers body fat, raises HDL or healthy cholesterol, increases lung capacity, reduces blood pressure, tones and builds muscle, ups the metabolic rate, improves circulation, helps retain bone mass, lowers stress, improves sleep, raises quality of life and improves insulin sensitivity. Exercise may help keep blood sugars lower for up to 24 hours after performing. By testing with a glucose meter, you will see the actual benefits in your blood sugar numbers, almost immediately. When comparing exercise to medications in treating initial diagnosis of diabetes, “lifestyle changes always win.” In the short term, exercise can reduce daily blood sugars and in the long term it can influence your A1C to go down.
Remember, the Real Basics
Be prepared with medical ID, a telephone, ICE (in case of emergency) phone numbers, glucose tablets for lows and plain water for hydration. Your phone should also have a log of your medical conditions, medications and doses as well as MD phone numbers. Feeling safe when you exercise with diabetes is extremely important.
The New Year is here and most everyone would like to make at least one life style change. If you have diabetes, that change should include some form of exercise! To a healthy and happy New Year!
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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.