Diabetic Exercise Tips

Exercise and Weight Loss in Diabetes

For anyone who has tried to lose weight, they know it is not just dietary changes that need to be made in order to be successful. Exercise plays a key role in weight loss and weight management -- yes, you still have to manage your weight after you lose it.

Persons with diabetics are urged to lose excess weight to reduce total body fat, which impedes proper blood glucose metabolism. Large quantities of body fats can also increase the risk for ketoacidosis --- a toxic process where your body uses fats for fuel.

Exercise, along with a balanced meal plan, can help with weight loss by burning calories and raising your basal metabolic rate. This is rate at which your body burns fuel when you are rest.

Regular exercise is best, at least 3 times each week. Low impact activities that raise your heart rate -- aerobic exercise -- is optimal, as it helps to not only drop the excess pounds, but also to stimulate circulation, and promote heart health.

Start slow with an activity that you enjoy, such as walking or swimming. Gradually increase your time and pace, as your strength and endurance improve and, with proper diet, weight loss and better blood sugar control is within your grasp.

Overcoming the Barriers to Exercise #2

For diabetics, exercise is an important part of the diabetic life plan.

The key to getting the exercise ball rolling is to identify your own personal barriers to exercise, and finding ways to overcome them!

Here are five common barriers to exercise, and solutions to help you get started:

1. I am afraid I will get low blood sugar: take your blood sugar frequently when you first start exercising, so you can gauge what your body does in response to the activity. Keep snacks and water with you, to recharge when you feel your sugar dropping or get a low reading on your glucose meter.

2. I am afraid it will make my condition worse: Talk to your doctor before starting any exercise program. Get a fitness check-up, and ask for help in planning an exercise routine that will help, not hurt, you. Ask for a referral to an exercise specialist or physical trainer to help map out your plan for exercise success!

3. I cannot afford to join a fitness center or buy equipment: Many exercises do not require fancy equipment or gym memberships, including walking, using cans of food for weights, swimming in the local public pool or lake, climbing stairs at the high school football stadium, or shooting hoops at the park. Finding inexpensive exercise solutions is easy and can be fun, in the process!

4. Exercise is just plain boring: Find out what you enjoy. Like rock hunting? Hike in the hills to find just the right specimens. Love animals? Volunteer to walk to the dogs at your local animal shelter. Enjoy children? Coach a neighborhood baseball, volleyball or basketball team and join in the conditioning exercises along with the rest of the team!

5. It is too hot/too cold to exercise: Finding temperature-appropriate locations to exercise can be a close as your nearest mall or shopping center. Find a superstore in your area, and walk up and down the aisles. Try the high school gym or community center.

Getting started on an exercise program can be challenging, but once you identify the barriers that keep you from getting fit, you are sure to find creative ways to overcome them. Start with baby steps - even little steps will get you to your fitness goal!

Men, Diabetes and Sex

Up to 75% of men with diabetes experience some type of difficulty achieving or maintaining an erection.

Erection is a cooperative effort between nerves and blood vessels. Uncontrolled diabetes can cause damage to nerves (peripheral neuropathy) and blood vessels, impairing their ability to work together.

The key to managing erectile dysfunction related to diabetes is to control your blood sugars! Medications can be used, including Viagra, Muse and Papavarine. Pumps can improve blood flow to the penis, and implants are a last option if other, more conservative measures were ineffective.

However, despite the best efforts of man and machine, no medication or device will truly compensate for permanent damage caused by out of control blood sugars.

Your physician or urologist can help find the best approach to treat the dysfunction, but the onus remains on you, to follow your diet plan, take your medications and lose the excess weight, to better control your sugars.

Water and Diabetes

Most of us carry a water bottle with us when we exercise, whether it is going for a walk or working out in the gym. Water is important for a variety of reasons, and not just for exercise, especially for those with diabetes.

Proper hydration promotes:

1) Kidney function - assists in
flushing out toxins and waste
products
2) Stabilization of blood pressure -
low pressure contributes to
dizziness and falls
3) Dilution of sugars in the blood, so
that dehydration-related
hyperglycemia does not occur
4) Transport of sugar as fuel, and the
insulin to utilize it
5) Bowel function - dehydration
contributes to constipation
6) Lower risk for ketoacidosis - toxic
state caused by use of body fat as
fuel
7) Better circulation to the extremities

Water supports many body systems and is a key element in any healthy eating plan. Talk to your doctor about how much water you need each day, and then grab a bottle "to go."

Exercise and Blood Sugar

Exercise is an important part of diabetic management, not only in terms of losing excess weight, but also in stabilizing your metabolism to provide a consistent "burn" of your body sugars for fuel.

Low-impact exercise which elevates your heart rate also elevates your metabolism, which tends to stay at a more constant level if your exercise regularly. This helps to moderate sugar usages so that you do not have the dramatic highs and lows, and associated symptoms of blood sugar fluctuation.

Stable blood sugars decrease the risk of complications, such as heart disease, kidney disease and stroke.

Talk with your physician about how exercise impacts your disease. He or she can help you find the right exercise program to help stabilize your metabolism to better control your blood sugars.

The Benefits of Exercise

Why should you bother to exercise when you have diabetes? Being diabetic comes with a myriad of serious potential complications, including, but not limited to:

* kidney disease
* anemia
* heart problems
* vision loss
* nerve damage

Studies have proven the benefits of exercise in improving circulation, lowering blood glucose, and in reducing blood pressure and cholesterol. Exercise lowers your risk for heart attack and stroke, decreases stress, promotes joint function and flexibility, and it even helps insulin work better, in addition to strengthening bones and muscles!

Since obesity increases blood sugar and further increases your risk for heart disease and stroke, the best exercise programs for diabetics include a combination of dietary changes and physical activity, to stimulate your metabolism and increase your energy.

Flexibility Exercises

Flexibility exercises are designed to:

* keep joints flexible
* improve your balance
* reduce your risk for injury during
other activities
* improve your range of motion

Examples of some types of flexibility exercises include:

* Yoga
* Pilates - combines flexibility and
strength-training exercises
* Tai Chi
* Stretching
* Thai Massage

1) Yoga combines slow controlled movements
that stretch your limbs, with core
breathing. Persons who do Yoga find
they have improved balance and
coordination, are more flexible, feel
stronger and also better muscle tone.
2) Pilates also combines stretching
movements, with strengthening exercises,
but are generally more intense than Yoga
and involve active repetitive movements
to achieve toned muscles, greater
balance and strength.
3) Tai Chi is a series of slow, controlled
movements, called "forms," performed
while standing up, following an ancient
Chinese discipline. It enhances
strength, balance and flexibility, while
promoting calm and a sense of well-being.
4) Stretching is the simple systematic
lengthening of your muscles by reaching
or pulling, to extend the muscle to its
greatest length. This is achieved while
the muscle is relaxed, and decreases
risk for muscle spasms, muscle injury
and joint pain.
5) Thai Massage, also called Passive Yoga,
involves the Massage Practitioner moving
your body and limbs through traditional
Yoga positions to provide the benefits
of Yoga, including flexibility,
strengthening and improved breathing and
balance.

Flexibility exercises also have many of the other benefits associated with exercise including:

* relaxation
* improved blood flow/circulation
* more restful sleep
* feelings of well-being
* moderation of appetite (important in
weight loss)
* decrease in feelings of depression
* improved sexual function

As with any exercise program, talk with your doctor before you begin, and set reasonable goals for your progress. Exercising with a friend can make it more fun, or join a gym or fitness club. If you are shy about exercising around others, there is a vast array of videos that you can exercise along with, right in your own home.

The important thing is to exercise. For the diabetic, exercise will help you to lose excess weight, stabilize your metabolism, and control your blood sugars.

I-Don't-Want-To-Exercise Exercises

Yes, exercise will help you lose weight, stabilize your blood sugar, increase your metabolic rate and improve your blood circulation. But, not all exercise is formalized, needs work-out clothes, or happens in a gym or club.

Here are a few I-don't-want-to-exercise exercises that you can do, or may already be doing and didn't even know it:

* fold clothes - hold the clothes away
from your body and move your arms
through their full range of motion for
some strength training
* push the vacuum cleaner or lawn mower -
the effort of walking, pushing and
pulling the vacuum or mower combines
aerobics and strength training.
* play ball with your dog - throwing,
bending and walking with your dog is
both aerobic and flexibility exercise
* gardening - bending, digging, pulling and
pushing is great exercise - aerobic,
flexibility and strengthening - and this
is combined with fresh air, the smell of
clean dirt and a bit of sunshine to lift
your mood, improve oxygen stores and get
the blood flowing
* cook - grating cheese, cutting
vegetables, and pounding meats provide
some aerobic and strength training
benefits

These are just a few examples of the ways that you can take advantage of everyday tasks to add a little bit of exercise to each of your days, without thinking about it as exercise.

Remember these keys points:

1. move your limbs through their full range
of motion with each activity

2. keep a steady pace in activities that
include walking, and walk for at least
20 minutes

3. engage in the activities with energy and
intention - your body will know the
difference!

4. breath deeply, fully inhaling and
exhaling

5. plan routine activities every day, in
which you can combine some aerobics,
flexibility and strength training
elements

Exercise doesn't have to be formal, intense, costly or inconvenient. You can take advantage of your routine, every-day, activities and get the benefits of exercise.

Exercise and Metabolism

Persons with a slow metabolic set point tend to gain weight easily and store fat more readily. Persons with a high metabolic set point seem to be able to eat anything and not gain any weight or get any fatter. Studies have shown that you can reset your metabolic set point with changes in your diet and exercise.

When you exercise, you burn all three primary fuel sources: carbs, fats and proteins. Generally speaking, moderate exercise burns these fuels fairly equally. As the intensity of your training increases, the amount of fats and proteins used for fuel actually decreases, with carbs being the primary fuel source.

As your body fat decreases - the product of aerobic exercise at least three times a week for not less than 20 minutes - your metabolism picks up. This is also true as yous increase muscle mass, as well, as the more muscle you have, the faster your metabolism is.

In relation to diabetes, we already know that improved metabolism assists in stabilizing blood sugar. So, it stands to reason that, by exercising, changing your body shape and chemical composition, you will gain more stable blood sugars and more consistent metabolism to promote weight management.

Weight loss and increase in your body's percentage of muscle improve your ability to manage your diabetes and decrease the risk for complications associated with diabetes.

Talk to you doctor before starting any new exercise program, then suit up and get the metabolism moving!

Aerobic Exercise

The goal of aerobic exercise is to improve oxygen flow throughout the body by enhancing breathing, while promoting the pumping action of your heart to carry the oxygen out to your body's tissues.

There are many exercises and activites that provide aerobic benefit:

* dancing - dance in your living room, take a dance class, take a friend,
significant other or your spouse out
dancing
* running - start slow, wear supportive
footwear and take a friend with you,
whether a human or animal
* swimming or water aerobic classes
provide amazing aerobic benefits, and
are easy on the joints for those with
arthritis or other joint problems
* tennis is not just a sport of the
young, and the tennis skirt is
optional
* bicycling - indoor or out, riding a
bike is fairly easy on the knees and
has good aearobic effects
* walking - start with a stroll and
gradually increase your pace, to get
your heart rate up. You can walk
outside, with your dog, at a gym, in
a Mall, or community center. You
don't need any special equipment and
you don't have to travel far to find
a place to take a walk.
* stairs - not everyone's favorite, but
a good way to combine aerobics and
getting to the next floor

Exercise will help reduce the risk for serious complications associated with diabetes, including: heart disease, kidney disease, anemia, vision loss, and nerve damage, in addition to reducing edema, constipation, and obesity.

Managing Your Diabetic Body's Response to Exercise

You have diabetes and your doctor has told you that you need to exercise to help stabilize your blood sugars and decrease your risk for complications of your disease. There are different types of exercises that provide different benefits, including:

1. Aerobic - improved oxygen flow and
decreased body fat
2. Flexibility exercises - improve joint
movement, balance and decrease risk for
injuries
3. Strength Training - improve muscle mass,
muscle strength and bone strength

But how does your body respond to exercise? For the average person, exercise increases metabolism, changes body shape and alters the general chemical composition. It is, therefore, important to understand how these can impact your disease.

1. Metabolism - metabolism is the rate at
which your body burns fuel. Exercise
increases metabolism, with different
exercises burning different percentages
of the three primary fuel sources:
carbs, fats and proteins.

Very intense exercise uses primarily
carbs for fuel, which can rapidly
deplete your carb stores. Low intensity
exercises tend to burn all of the fuels
and a fairly consistent rate.

2. Body shape - apple-shaped people tend to
be at higher risk of heart disease due
to the fat deposits around the waist and
chest. Exercises that reduce total body
fat, especially around the abdomen and
chest, will improve overall health and
decrease the risk for core organ disease

3. Chemical changes in your body include
acid-base balance, fluctuations in
blood sugar, and variations in your
electrolytes potassium, calcium and
sodium).

Intense exercise tends to generate more
acids, adversely effecting your acid-
base balance by producing lactic acid.
Low intensity exercises have less impact
on blood sugar, acid-base and
electrolytes.

In terms of your diabetic body, it is important to consider how the exercise you choose is going to impact your disease, including sugar, body fat and acid-base balance.

When choosing an exercise, aerobic exercises use all three primary fuel sources consistently, tend not to generate lactic acid and do a great job a of reducing body fat, which will stimulate your metabolism to stabilize your blood sugars and promote weight loss.

Talk to your doctor about exercise before starting a program.

Exercise and Neuropathy

Neuropathy is a complication of diabetes that results in loss of sensation, usually in the extremities. Due to this loss of feeling, the hands and feet become at greater risk for injury and infection, as they cannot sense pressure and damage to the skin.

It is important to consider this when choosing an exercise, and exercise equipment, including footwear. Here are a few tips to keep yourself safe during exercise:

1) ALWAYS check out any exercise
program with your medical doctor
before beginning.
2) Wear properly fitting shoes with
cotton or wool socks, to wick away
moisture that can contribute to
infection and skin breakdown.
3) Check your feet before and after
exercise, to assess for pressure
areas or breaks in the skin. Use a
mirror to see your soles.
4) Have your doctor do regular foot
health check-ups.
5) Keep your nails trimmed. Cut
toenails straight across to avoid
nail growth into the corners of your
skin, or pressure from your other
toes, or your shoes. Don't pick at
hangnails or your cuticles.
6) For exercise that involves your
hands, such as racketball, wear the
recommended protective gloves.
7) Stop if you DO feel any sort of
discomfort, as this can signal that
injury has already occurred.

It is important to include exercise as a part of your diabetic plan, just remember to exercise smart, especially if you have peripheral neuropathy.

Avoiding Injury During Exercise

Some of the most common injuries associated with exercise are:

* muscle strain
* sprains
* stress fractures
* pain

"Muscle strain" occurs when the muscle is stretched beyond its normal range. Though the tissue is not torn, the muscle fibers respond to the injury with inflammation, edema and pain.

"Sprain" occurs when muscle fibers, ligaments or tendons are torn, due to over-exertion, or abnormal movements in a joint. A sprain also produces localized inflammation, edema and pain, and may take a considerable amount of time to heal.

"Stress fractures" are the product of repeated stress, pounding (as in running) or repetitive stops and starts. Small cracks occur in the bones subject to the stress and pounding, causing inflammation and pain.

"Pain" is not a normal product of exercise. Though some vague muscle soreness may occur with some types of exercise, pain is an indication of injury, and may be the result of bruising, strains, sprains, fractures, or edema. The phrase "no pain, no gain" is not accurate or healthy.

There are, however, some things that you can do to decrease your risk of injury while exercising:

1. Warm up before exercise - stretching and
walking are good ways to warm up your
muscles in preparation for more
strenuous exercise.
2. Cool down after exercise - doing some
gentle stretches, less strenous exercise
or walking after exercise will reduce
the risk of injury associated with
sudden changes in activity level.
Cooling down allows your body to relax
before moving on to a new activity.
3. Listen to your body. If you begin to
have pain, pull back or slow down. Pain
is an indication that injury may be
occurring.
4. Start slow and work up - exercise
requires some adaptation by your body.
Starting slow allows your body to
accommodate the changes that exercise
brings.
5. Talk to your doctor - some exercise
regimes may not be recommended based on
your health or condition. Your doctor
can help you determine in a particular
exercise is right for you.

The benefits of exercise are unquestionable, however exercising without injury requires effort, as well, to get the best out of your body and the most benefits out of your exercise.

Diabetes and Choosing an Exercise

One of the key elements in effectively managing diabetes is getting adequate exercise. Exercising stabilizes your metabolism, and improves your body's usage of insulin and sugar.

The type of exercise is less important than whether it is something you can follow through with. In general, you should choose a type of exercise that you enjoy doing, since you will be more likely to keep it up.

Be sure to check with your doctor or diabetes educator first, especially if you have any complications such as neuropathy, since you may need to modify your exercise program.

Here are some ideas on exercises that people often enjoy:

1) walking - pace doesn't matter,
just get out there! Malls are a
great place to walk in foul weather.
2) jogging gently - high impact running
can injure your feet if you have
neuropathy
3) dancing - any kind of dancing will
do, such as folk, expressive,
creative, or belly dancing
4) bicycling
5) swimming and water exercise programs
6) yard work and vigorous gardening

Any activity that gets you up and moving will help you feel better, and have better control of your blood sugars. Invite a friend and make it even more fun!

Strength Training

When you think of exercise, things like walking, running or aerobics generally come to mind, but there are actually three main categories of exercise, which include:

1. Aerobics
2. Flexibility Training
3. Strength Training

Each of these types of exercise offer many different benefits to the body. Let's take a look at strength training.

First, strength training is not body-building. Though I am sure that Arnold Schwartzenegger is very strong, his focus was on building muscle mass, to increase the size and shape of his muscles.

Strength training is more about building strength and stamina in the muscle, and strengthening bones, rather than just adding size or mass.

The keys to strength training include:

1. Sequence and speed - the lifting or
pulling portion of the exercise should
take less time than the release or
extension portion. The release or
extension is where your muscle does the
most work.
2. Sets and Reps - groups of repetitions is
a set. Performing a series of sets with
a brief rest in between each set.
3. Resistance and range - resistance is the
amount of weight you lift. Range refers
to using the full range of motion of the
limb or body part, to exercise the whole
muscle.
4. Progression and frequency - as you get
stronger, you need to increase the reps,
resistance, or sets, so that you
continue to progress.

Benefits of strength training include:

* stronger bones with decreased risk
for fracture
* stronger muscles - aids posture,
balance and safety
* improved stamina - more and longer-
lasting energy

Risks may include:

* overuse injury
* muscle soreness

For the diabetic, the benefits are obvious - exercise supports and stabilizes metabolism, improves circulation, enhances sleep, sex and energy levels, and promotes stabilization of blood sugars.

Talk to your doctor or Diabetic Educator about getting started on your strength training program, then get out your dumbells, elastic bands or plastic tubes and start getting stronger!

Cardiovascular Disease, Exercise and Diabetes

It is a fact that having diabetes increases your risk for heart disease. It is also a fact that exercise is good for your heart. So, wouldn't it then be true that taking care of your heart, when you have diabetes, can decrease your risk for heart disease related to diabetes? YES!

Exercise has excellent effects on the cardiovascular system - your heart and blood vessels. Some of the effects of regular exercise (at least 20 minutes, a minimum of 3 times a week) include:

1) strengthened heart muscle
2) increased aerobic capacity
3) lower blood pressure
4) increase in HDL ("good cholesterol")
5) decrease in LDL ("bad cholesterol")
6) decreased insulin resistance
7) weight loss
8) improved circulation

These are all good reasons for exercising, and each of these benefits improves your chances of keeping a healthy heart, despite having diabetes. It can also lower your risk for stroke and peripheral vascular disease (decreased circulation in your legs that can result in sores), stabilize your metabolism and improve your outlook, too.

Remember,if you are new to exercise, or have any underlying medical conditions, it is important to check with your doctor before beginning any exercise program, so he or she can help you find an exercise plan that is right for you.

Preventing Hypoglycemia When Exercising

Exercise is important both for its health benefits and its role in helping to control blood sugars.

But there can be some risk of hypoglycemia (low blood sugar) with prolonged and/or strenuous exercise, especially if the person exercising has not eaten in several hours.

Here are some tips on preventing hypoglycemia:

1) Check your glucose level before
exercising. If it is below 90, and
you plan to exercise vigorously for
a period, have a snack first.
2) ALWAYS carry a fast acting
carbohydrate source (such as glucose
tablets) with you when exercising.
You don't want to be stranded
without it if a reaction should
occur.
3) Learn how your body reacts to
exercise by monitoring your glucoses
immediately before, after, and 1/1/2
hours after exercising the first few
times. You can balance your snacks
and insulin or medication to
maintain good blood sugars once you
know how your body reacts.
4) If exercising for prolonged periods,
it is best to check your sugar every
half hour, and to have a snack if
your blood sugar begins to drop
5) Try to avoid exercising just before
meals, when you are more vulnerable
to glucose lows. It is better to
exercise after eating.
6) Be aware that prolonged exercise can
use up glycogen stores in your
muscles and cause delayed
hypoglycemia. Check more frequently
in the hours after exercising if you
are exercising for a prolonged
period, and especially before
bedtime to prevent a low during the
night.
7) Keep a blood sugar "diary." Make
notes about the times of your
sugars, their values, your eating
patterns and what type of exercise
you are doing. Make special notes
if you have low blood sugar, i.e.
what you had eaten, what you were
doing before it was low, any changes
in your medications.

Being aware of the risk of low blood sugar during exercise is the first step in prevention any complications that may arise.
Like the Boy Scouts say, "Be Prepared."

Overcoming the Barriers to Exercise #1

Diabetics are encouraged to exercise regularly, and check in with your doctor periodically to review your exercise plan. Here are six tips to help you get started on your workout plan:

1. If you are just starting out, try 10 minutes a day and gradually work up to 30 minutes. Walk around the block at lunch, or take the stairs to the next floor rather than the elevator. Make every step count!

2. Take a walk before you go to work, or during the day. Walk around the block with a co-worker, do stretching exercises at your desk during a quick break, walk that proposal over to the next building instead of sending for a courier. Find little ways during the day to stretch your legs and strengthen your resolve!

3. Bring a change of clothes. All you need are comfortable clothes and well-fitting shoes. No one is going to notice that your sweats are 10 years old, or that your T-shirt has a picture of Jefferson Airplane on it. Get comfortable and get going!

4. If group exercise isn't for you, pick an activity that you can do alone. Walking around your neighborhood, walking on a treadmill in your home, or doing video aerobics are just a few suggestions. The nice thing about exercise is that you don't need an audience!

5. Exercise doesn't have to hurt. Pick something that does not traditionally cause muscle soreness, like swimming. Make sure your warm up and stretch before and after any exercise. Start slow and make sure to cool down afterwards.

6. If you have problem knees, try something that does not include high impact, such as swimming or yoga. Tai Chi or other low impact exercises that promote core strengthening and flexibility are also good choices.

The first step to starting an effective exercise program is acknowledging the barriers that are keeping you from getting started, and finding creative ways to deal with them. Start with baby steps: even small steps will eventually get you there!