THE ROLE OF EXERCISE IN MANAGING TYPE 2 DIABETES. WHAT’S YOUR NEW YEAR’S RESOLUTION?
With the beginning of a new year, many of us set out with resolutions to improve our health by losing weight, starting an exercise program, or both. Over the past year, teleworking and spending more time behind a desk or computer, have accentuated the need to get moving.
But when managing diabetes, the choice to exercise is a necessary one, to achieve healthy blood glucose levels and reduce complications. Furthermore, exercise improves our mood and mental health, important for managing the toll diabetes plays on our emotional well-being.
WHY IS EXERCISE IMPORTANT?
Exercise helps put you in control of your diabetes. When you exercise, your cells become more sensitive to insulin, lowering blood sugar and converting it to the energy your body needs.
Exercise also helps you feel better and improve your mood. Feeling confident that you are in control of your diabetes reduces stress and the distress of managing the disease.
In addition, physical activity helps to lower blood pressure, reduce the risk for heart disease and promote weight loss, all factors that can lead to or worsen complications of diabetes.
WHAT DO I NEED TO KNOW BEFORE I START EXERCISING?
If you haven’t been very active, start slowly.
–Consult with your doctor regarding any limitations you may have, or exercises you should avoid. Walking is tolerated by most people with diabetes and is a good place to start.
–Set realistic goals and track your progress.
–Check your blood sugar before you begin. If it is lower than 100 mg/dl eat a small snack containing 15 to 30 grams of carbohydrates, such as fruit juice, fruit, or crackers before starting. If it is higher than 250 ml/dl it is better to wait until it has come down below 200 mg/dl.
–Have glucose tabs with you in case you feel shaky or weak.
–Check your blood sugar after exercise. A small snack containing 15 to 30 grams of carbohydrate will help prevent a post-exercise drop in blood glucose.
Make sure to stay safe and avoid injury.
–Warm up and cool down for at least 5 minutes before and after exercising.
-Exercise indoors as needed to avoid weather extremes.
–Drink plenty of water before, during and after exercising.
–Wear a medical ID bracelet and carry a cell phone in case of an emergency.
–Protect your feet and wear comfortable shoes and well fitting socks.
–If you feel pain or discomfort stop or slow down.
WHAT TYPE OF EXERCISES SHOULD I DO?
All forms of exercise are good and beneficial for managing blood glucose and reducing diabetes complications. Try to include all of these:
-Resistance or strength training
-Balance and flexibility
Aerobic exercises are continuous and use large muscle groups such as our legs and arms. They include running, jogging, swimming, bicycling, and climbing stairs.
Aerobic exercise lowers blood glucose by improving insulin sensitivity. This type of exercise also works to improve overall fitness and helps to lower cholesterol levels and blood pressure. Aerobic exercises burn calories and promote weight loss.
RESISTANCE OR STRENGTH TRAINING EXERCISES
Resistance or strength training exercises are those that involve lifting weights or using your own body weight, such as when doing squats, planks, leg raises, sit-ups, and push-ups.
Resistance training helps improve muscle strength. It also lowers blood glucose but does so more slowly. The risk of hypoglycemia is lower with strength training exercises.
BALANCE AND FLEXIBILITY EXERCISES
Balance and flexibility exercises enhance stability and improve mobility. They lower your risk for falls and incurring injuries.
Stretching is an example of a flexibility exercise. It can serve as a warm-up or cool down before and after other exercises. Yoga or Pilates, and tai chi are other examples of flexibility exercises.
To improve balance, stand on one foot for 20 to 30 seconds. Try walking in a straight line heel-to-toe or walk backward for a short distance. Stand up from a chair without using arms or plank with elbows on a balance ball.
The most important thing is to find an exercise or activity that you enjoy! Don’t let it become a chore.
In addition to formal exercise, incorporate increased physical activity throughout the day. For example, park further from the door when running errands, take the stairs instead of the escalator or get up from your desk every hour.
WHEN SHOULD I EXERCISE?
Glucose levels are highest about 90 minutes after meals. Guidelines suggest exercising about 30 minutes after eating. However, it is safest to check your blood sugar first.
Since exercise can raise blood glucose initially, starting with a high glucose level can be risky. A healthy range to start is between 150 and 180 mg/dl.
Remember to also check blood sugar after exercise. Blood sugar levels can continue to drop for several hours. Until you know how your body reacts, guidelines suggest checking blood glucose 4-5 hours after post-meal exercise especially when exercising in the evening.
CAN I EXERCISE TOO MUCH?
Diabetics taking insulin or oral medications that increase insulin production are at risk of hypoglycemia, or low blood glucose, when exercising. Knowing your blood sugar before you start is key to reducing that risk.
Exercise after a meal or adjust your carbohydrate intake. Add a snack containing 15-30 grams of carbs before starting. The longer you plan to exercise, the larger your snack should be, up to 30 grams of carbs.
You will get to know how your body reacts to exercise and be able to make adjustments. To be safe, carry glucose tabs or gel with you.
If you experience symptoms such as dizziness, confusion, or weakness check your blood sugar and follow the 15-15 rule:
1. If blood sugar is below 100, eat 15 grams of easily digestible carbohydrate such as 4 glucose tablets, a glucose gel or 4 oz. of juice or soda
2. Recheck blood sugar in 15 minutes.
3. If blood sugar is still below 100, repeat step 1.
4. Repeat these steps until blood sugar is greater than 100 mg/dl
THE BOTTOM LINE
Making a commitment to add exercise to your daily regime should be more than a New Year’s resolution. Let it be a commitment to a lifestyle change that will become a daily habit. Consider it a necessary part of your diabetes management plan, along with eating a healthy diet and adhering to your medication.
Find an exercise regime that you are comfortable with and one that you enjoy. Exercising with a friend will add to the fun and help keep you accountable.
Keep a close eye on your blood sugar. You will learn how much and how quickly your body responds to exercise and how to adjust your carbohydrate intake. But stay safe and always keep a glucose source with you.
Always check with your doctor before beginning a new exercise program or when making any significant changes to your usual routines. Consistency is the best way to maximize glucose control.
If you would like help with preventing or managing diabetes, consider a One-on-one Nutrition Counseling session with one of our experienced registered dietitians or join the Diabetes Prevention Program (DPP) designed to help you make better food choices and decrease your risk for developing diabetes. Additionally, our Diabetes Self-Management Education and Support(DSME) group helps improve your skills for managing blood sugars to reduce your risk for developing diabetes-related complications. Schedule an Appointment Today! (240) 449-3094. Many of our services are covered by insurance.