D I A B E T E S A N D E X E R C I S E


It is known that a clear correlation exists between having a more active lifestyle andhaving less
disease/illness
.People who exercise have lower blood pressure, lower heart rates, and improvedcirculation. They also havelower cholesterol, lower blood glucose levels, lower body mass indices (BMI) and less bodyfat; as well as highermetabolic rates and better weight control. They sleep better, have more energy, are lessstressed/anxious and arehappier and more confident. Exercise can improve someone’s social life and regularexercisers are also able tomaintain independence for longer in their own homes

?Why is exercise especially important for someone with diabetes


Unlike medication, exercise is low cost and side-effect free. Those with diabetes who don’texercise are three times more likely to havepoor blood glucose control and are more likely to suffer diabetes complications. However,those who exercise regularly— apart fromgetting the benefits listed above—have improved sensitivity to their body’s own insulinand their bodies become better at transportingglucose. This happens because exercise stimulates the body’s muscles.Exercise also reduces the level of fat in the body, particularly around the abdominal area.It is thought that it is this mobilization of thebody’s fat stores by exercising that might improve the person with diabetes’ blood glucosecontrol. There is less glucose in the blood becauseit’s now stored in the body’s muscle, which means improved blood glucose controland reduction in the complications associatedwith diabetes

?How long do these effects from exercise last

The good news is that if someone regularly exercises these benefits can be permanent,and for someone with diabetes it can meanreducing their medication. For those with a family history of Type 2 diabetes, engaging in aroutine exercise program may prevent or atleast delay the onset of Type 2 diabetes.A single session of exercise can benefit the body’s sensitivity to insulin for 16-18 hours—exerting effects on blood glucose control for 24-48 hours, but these effects have worn offby 60-72 hours. Even a little bit of exercise is better than none at all, and an “a-little-andoften”approach to exercise can be of benefit.

?How much exercise should I be doing

To obtain health benefits, it is recommended that adults should be aiming to exercise at amoderate intensity for 30 minutes a day fora minimum of five days a week (preferably seven days). However, the same healthbenefits can be gained by breaking this down into 10minute intervals of moderate activity. The overall aim should be to accumulate at least150 minutes of moderate activity per week.Before you start! •Get a medical clearance if you have not exercised in over a year, if you are a man over 45years old or a women over 55 years old. •Start with 5-10 minutes of activity per day for the first week, then add on 5 minutes perday each week until the target goal of 150minutes of moderate activity is reached. •Build up slowly and gently increase activity levels over a series of weeks. •If using a pedometer, aim initially to build up an extra 3,000 steps/day; alter this eachweek by just doing a little more within the dailyroutine (see below for some ideas) until the target 10,000 steps/day is reached

?What do we mean by moderate activity

A scale known as Borg’s scale of Rate of Perceived Exertion (RPE) is usedto rate how hard the exerciser is working. Moderate activity means theexerciser should feel some breathlessness, be aware that his/her pulseis raised, be sweating, know that he/she is using his/her muscles butstill be able to hold some brief conversation

?What types of exercise should be performed

Three S’s make up the components of all-round exercise. These are strength, supplenessand stamina. To gain the benefits of exercise allof these components should be included in the exercise routine, as this will mean havingsufficient power, strength and range of movementto repeatedly undertake activities of daily living.Traditional exercise prescriptions focused on aerobic exercise, but it is now recognizedthat health benefits—particularly for peoplewith diabetes—are best conferred by doing some strength (resistance) exercises too. Todevelop these components and achieve thebenefits of exercise you don’t have to join a gym or an exercise class, but these methodsare recommended—as you will have companyexercising, someone is likely to be supervising what you are doing, and if in the gym you will probably have been prescribed apersonal exercise plan by a professional trainer.But if the gym or exercise class is not for you, there are still waysto exercise in and around your home and during your dailyroutines. •Walking is an inexpensive and easy way of getting exerciseand can be built into daily routines by parking the carfurther away from work, getting off the bus a stop earlier, orintentionally going for a walk at lunchtime or after work. •Purchase a pedometer; as counting the number of steps youtake each day can be a good motivational tool and demonstrates your progress inreaching your target. •Use the stairs instead of elevators. •If doing a home-based exercise routine, instructor-led exercise videos/DVDs can bereadily bought or borrowed from the library, or a range of simple and not too expensiveexercise equipment can be purchased. Check the want ads or thrift stores for usedequipment.

?How do I get started

•Check with your health care professional that your diabetes is presently stable enough toallow you to begin an exercise routine. •Start with small sessions of exercise of low intensity and build up gradually. •Find an exercise partner — this could be a family member, your child or grandchild, or afriend or work colleague — and make it fun. •Choose something you enjoy, as you are more likely to stick with it.

?How do I make sure I’m exercising safely

In order to prepare the body for exercise there must always be some kind of warm-up,which involves gently raising the pulse and getting the muscles warm for 5-10 minutesbefore the main exercise activity. Instructor-led sessions will build this into the activity.However, if you are exercising independently, and this includes doing heavy housework,work around the house, and gardening, rememberto start the activity gently and build up.It is also important to cool-down following exercise, to avoid feeling faint and dizzy and tohelp the body return to a resting state.Again instructor-led sessions should automatically include this, but if exercisingindependently, spend 5-10 minutes repeating theactivities undertaken in the warm-up.

?How to avoid becoming an exercise casualty

Build up slowly—this is both within a single exercise session as well as within a wholeexercise program. •Don’t ever try to lift maximum weights, and never hold your breath when doing anyweight or resistance-based exercises. •Don’t try to do too much or advance too quickly; stick to moderate intensity exercise. •If new to exercise it may be best for you to monitor your blood glucose before, during,and after exercise until a routine is established. If doing any prolonged exercise or heavyhousehold, gardening, or DIY chores—check blood glucose during the activity andadjust food as necessary. You may need to discuss your medication regiment with yourhealth care professional. •Do not exercise if you are feeling ill, vomiting, or have an infection. •Exercise is very important during a pregnancy for you and the baby. Talk to your healthcare professional about your exercise program. •Be sure you are wearing proper, well-fitting shoes and inspect your feet daily. •If you’ve been diagnosed with retinopathy you may not be able to engage in strength training activities. Besure to contact your health care professional for guidance. •If you have been diagnosed with autonomic neuropathy or peripheral neuropathy, besure to contact yourhealth care professional for special guidance in developing an exercise program.And finally...To have all the benefits of exercise you must do it regularly and stick with it; somake sure you find something that is enjoyable and fun. Taking up exercise orbecoming more active won’t just benefit your diabetes, it can also impact on anyother disease and age-related problems you may have. A more active you will alsobenefit your family, friends, and work colleagues too