Past Feature Article

Diabetes and Exercise: Why you should NEVER give up

By: Simone Ginn, Rite Aid Pharmacist and Diabetes Care Specialist at Store 7316 in Baton Rouge, Louisiana

America is a country of convenience. We can purchase food, do our banking, and in some parts of the country, even pay our respects to the deceased, all while sitting comfortably in our vehicles. Even with high gasoline prices, we drive around parking lots looking for a spot that will cut the distance we have to walk into the restaurant.

Last year, Americans spent about $4.2 billion on home exercise equipment, according to the Sporting Goods Manufacturers Association. Still, America is one of the leading countries in obesity. Today, about 64.5 percent of adult Americans (about 127 million) are categorized as being overweight or obese. Less than one-third of U.S. adults exercise regularly. The direct cost of physical inactivity may be as high as $24.3 billion.

Exercise is beneficial to everyone. You are never too unfit, too young or too old to get started. Regardless of your gender, age or lifestyle you can benefit from regular physical activity. Regular exercise can help provide an overall sense of well-being and can even help prevent chronic illnesses or premature death.

Physical activity:

Lowers blood glucose, blood pressure and cholesterol
Relieves stress
Strengthens heart muscles and bones
Reduces the risks of stroke or heart disease
Improves blood circulation
Helps insulin work better
Keeps joints and muscles flexible

The key to a lifetime of fitness is consistency. Here are some tips to help you make exercise a habit.

Choose an activity you enjoy. Experiment with a variety of activities. Try walking with a friend or listen to audio books while on your treadmill. Research what is available in your community. Vary the activities from time to time to prevent burnout and boredom.
Make an appointment with your physician to approve your exercise regimen. Since some activities such as running and heavy weight lifting can exacerbate conditions such as retinopathy or hypertension, it is extremely important to get your physician's approval before starting.
Make time for yourself. Physical activity should be a part of your daily routine. If time commitments are an obstacle, make "an exercise appointment" in writing. Don't be so busy taking care of others that you neglect to care for yourself.
Tailor your program to your own fitness level. Don't go too fast.
Set realistic goals. Start with small goals such as, "I will walk on my treadmill for 10 minutes every other day." Then gradually increase the time and intensity of the activity.
Choose an exercise that fits your lifestyle. Take your grandchildren for a stroll or your pet for a walk. Challenge your teenager to a game of basketball. Enroll in dance lessons with your spouse or a friend.
Don't get discouraged if you don't see immediate results. It takes time for your body to adjust. Don't use the scale as the only measurement of success. Keep a log of blood glucose improvements and how your energy level has improved.
Don't give up if you miss a day; just get back on track the next day. Most people are not successful with their first attempt; they may need three or four attempts before an increase in their physical activity level becomes a long-term habit.
Find a partner for a little motivation and socialization. Use this time to "catch up" with a neighbor. Partners motivate each other. I started a "ladies only" walking group. Everyone walks at her own leisure and calls in the total mileage at the end of the week. We meet once a month for dinner and I plot our progress as a team on a map.
Build some rest days into your exercise schedule. Your body needs recovery time. Listen to your body. If you have difficulty breathing or experience faintness or prolonged weakness during or after exercise, consult your physician.
Membership to a health club is not required. Everyday items in your home can be exercise accessories. Use soup cans to work the muscles in your arms. Exercise your legs and hips by leaning against your kitchen counter and doing leg kicks. Raking and sweeping will help improve muscle tone in your arms.

Safety:

Let someone know where you're going and when you'll be back.
Check your blood sugar before and after exercising. Post-activity late onset hypoglycemia (that is, low blood sugar occurring four or more hours following periods of moderate to high intensity activities) is more common in individuals on insulin.
Preactivity snacks have shown to prevent hypoglycemia when consumed 15 to 30 minutes before an activity of short duration (less than 45 minutes)
Do not inject insulin into muscle groups used in your exercise activity. Doing so can enhance insulin absorption and cause hypoglycemia.
Always carry a form of fast-acting carbohydrate (glucose tablets, lifesavers, etc)
Carry diabetes identification with you when exercising outside the home.
Exercise indoors or try mall-walking during inclement weather and when pollution alerts are issued
Build in warm-up and cool-down periods to decrease risk of injury.
Drink plenty of fluids. Dehydration can even occur in the winter months.
Wear loose fitting clothes on warm, humid days and dress in layers during the winter months.
Wear gloves or mittens to protect your hands from cold
Up to 40 percent of body heat is lost through the neck and head so it is advisable to wear a cap or a hat.
Wear sturdy, well-fitting shoes appropriate for the activity.
Always inspect your shoes for foreign objects before putting them on
Wear helmets and protective gear appropriate for the activity.

If you continue doing what you are currently doing, you will continue getting the same results. Positive changes produce positive results. Most people have the time for exercise; it is the determination and discipline that is lacking.

REMEMBER: The more action taken, the better the chance of progress.

References

Anonymous. American Diabetes Association. Alexandria, VA. Weight loss and exercise. Available from: http://diabetes.org/weightloss-and-exercise Accessed on 12 December 2004.
Anonymous. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Bethesda, MD. Available from: http://win.niddk.nih.gov/statistics Updated 2004 October 6; Accessed on 10 December 2004.
Franz M., Mullooly C., Chalmers K., Diabetes Management Therapies; Physical Activity/Exercise; A Core Curriculum for Diabetes Education, 5th ed., American Association of Diabetes Educators; 2003; 61-90
House, L. Frugal and Fit. Los Angeles Daily News Available from: http://www.dailynews.com/cda/article October 31, 2004. Accessed on 10 December 2004
Polonsky WH, Diabetes Burnout, Virginia: American Diabetes Association; 1999