Update and Exercise


By: Ron Zacker

There are many factors to consider before adding exercise to your diabetes management. The benefits of physical activity are often celebrated and touted; however, safely and effectively incorporating these benefits into your workout is not always obvious.

There are some general considerations to take into account before and during your exercise:

1) Do get approval from your doctor before beginning an exercise regimen.

If it has been several years since you have done any physical activity, you should discuss your plans with your physician. For those over the age of 50, it is generally recommended that you have a resting ECG (electrocardiogram) performed and, if warranted, a stress test (performed on a treadmill in the clinic).

2) Do consider how other medical conditions or diabetes complications will affect your ability to participate in physical activities.

Co-existing diseases (hypertension, congestive heart failure, peripheral vascular disease, etc.) as well as diabetes complications (autonomic and peripheral neuropathies, retinopathy, etc.) may impose special precautions that you must take into account when considering your exercise selection.

3) Do monitor your blood sugars frequently when adding physical activity into your routine.

To prevent hypoglycemia and learn your body’s response to the activity so that you can adjust your medications or nutrition around the activity, perform more finger-stick monitoring, particularly when your first begin working out. Consider adding a pre- and post -exercise glucose test as a minimum. Also helpful is a test mid-way through the activity, as well as a nocturnal reading (PEL).

4) Do attempt to accumulate 30 minutes of physical activity each day.

This universally agreed upon goal—however generic—is good advice for anyone who isn’t currently doing any exercises beyond their daily living tasks.

Remember that walking to and from your car running errands does not qualify you as being “active.” It simply means that you are not bed-ridden.

The 30 minutes can come from conventional exercises or from activities such as dancing, mowing the lawn or washing and vacuuming the car by hand. Also, the 30 minutes does not necessarily have to come in one bout. For instance, taking three, 10-minute walks during your breaks at work would qualify.

5) Do drink plenty of water before, during, and after exercise.

It is inconceivable to me that many of my patients spend their time scrutinizing the latest herb, supplement or fad diet in an attempt to feel better, while they neglect such a basic component like hydration. You will feel better if you drink the stuff liberally.

6) Do consider the vast array of resources available to assist you in your activity goals.

Within your community, you will likely find senior and community recreation centers, gyms and fitness centers, exercise studios, in-home exercise equipment and personal training, health education centers and cardiac rehab clinics, to name a few. Use these resources!

7) Do Not use the scale as your means of assessing progress.

Think long and hard about why you are trying to become more physically active. To lower your sugar levels? To lower your cholesterol? To improve your performance (not getting short of breath while playing with the grandkids)? Because your doctor told you to?

There are usually many reasons to exercise besides simply ‘losing weight.’ Furthermore, the scale tells you nothing about the composition of the weight. It does not distinguish between fat, skeletal muscle and water weight. And, it doesn’t tell the whole story regarding improving your health, both in subjective (I feel more energy and less stressed) and objective (my blood pressure and blood sugars have dropped) ways.



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