FOR DIABETIC VETERANS, STRAIGHT TALK ON EXERCISE

Exercise: An Essential Part of the Diabetic Lifestyle

BY CAROL DUFF RN

For both Type 1 and Type 2 diabetics exercise will reduce the need for insulin and oral hypoglycemic medications, improve the ability of the body to improve glycemic (sugar) control, and increase the ability to control body weight.  Exercise also helps the heart by decreasing lipid (fat in blood) levels, moderating blood pressure, and restore heart function after a heart attack.  The act of exercising can decrease depression, improve bone health, and help us maintain cognitive (brain) function as we age.

Since about 80% of the people who have Type 2 diabetes are grossly overweight or obese, they are less likely to feel motivated to exercise and are stuck in the inactive mode. It is possible that the diabetic has never had an exercise regime or has had disappointing experiences with previous attempts at initiating exercise programs.  Quite possibly exercise had been combined with unsuccessful tries at completing diet programs…

Exercise does not have to be intense or physically challenging or punishing. A brisk walk in the woods or the neighborhood several times weekly will more than suffice for exercising.  Decreasing intake of food to whatever degree is possible and nutritiously responsible while adopting the several times a week brisk walk will result in weight loss as well as improved heart function, increased blood circulation, altered muscle tone, and improvement in the body’s ability to deal with sugar control.

Do not view exercise as an unpleasant activity.  You can be accompanied by a pet, friend, family member, someone else who wants and needs to exercise, or perhaps this could be a time to enjoy being alone.

Walking outdoors offers more sights, sounds, and smells, but on those days when the weather is just too harsh, briskly strolling around the mall will work nicely.  Exercising will reduce feelings of stress and depression and increase feelings of well being.  You do not need to wear spandex and walk till you drop. Consistently walking for 30 minutes per day, at least five days per week will work nicely for an exercise program.  If 30 minutes is too long to walk at one time, then break up the walks into smaller time frames.

If five days a week is too much for you to fit into your life style then try three or four.   No need for spandex, but properly fitting, cushioned shoes will make your feet and legs happier.

You may want to indulge in a more rigorous exercise program.  First consult your health care provider for the go ahead.  Select an activity program that you will enjoy.  Exercise should not become something to dread.  Finding the exercise program that fits with how you live is most imperative.  Develop a schedule and stick with it.  If you want company, find someone or a pet that will enjoy the same activity.

Set realistic goals.  Do not get hung up in the “I am not doing well enough” mode.  Be a friend to yourself.  Backsliding is not the same as failure.  There may be off days, but that does not mean you give up.

If you have not been exercising and start to do so, please check with you health care provider.  Exercise will improve your body’s use of glucose and may affect the dosage of insulin medication you have been taking.

The specific areas of retinopathy (eye), neuropathy (nervous system), autonomic neuropathy (what the body does without your conscience control), and peripheral neuropathy (nerve supply to hands and legs) may be affected by exercising.

The risks to the eye are an elevation in blood pressure (not necessarily a bad thing when associated with exercise, but not good for an eye that is already damaged) and possible retinal detachment due to jarring.  Use low impact activities (walking), and perhaps monitor blood pressure during exercise.  Some low impact exercises are stationary cycling, swimming, walking, and low intensity rowing.

Avoid lifting heavy weights, breath-holding stretches, bearing down maneuvers, strenuous upper arm exercise, and high intensity exercising.  If you have medical eye issues consult your health care provider before starting your exercise program.  For neuropathy the risks are changes in blood flow, elevations in blood pressure, and also the presence of retinopathy.  Recommendations are to include low impact activity with dynamic weight bearing, only light weight lifting when blood pressure is controlled and the left ventricle (the chamber of the heart that pumps oxygenated blood to the body) of the heart is functioning properly, and the diabetic on hemodialysis will need a specific exercise program.

Avoid bearing down, heavy weight lifting, aerobic exercise, use cushioned soles gel/air, and maintain hydration which is a good measure for everyone to follow. For autonomic neuropathy (autonomic nervous system) there are the risks of too low blood sugar, abnormal heart rate and blood pressure response, and dehydration.  To avoid issues related to this area of the body you can use water activities, cycling or both.  Avoid high intensity activity, extreme temperatures, and rapid alteration in body position.

Peripheral neuropathy risks are numbness or weakness in hands, impaired balance reflexes, decreased perception of where the body is in relation to the environment due to lack of sensation, and weakness or atrophy of thigh muscles.  It is recommended that activities be used to improve balance and that they be non-weight bearing Do not be afraid to start an exercise program.  Check with you health care provider and inform him or her about what you have in mind for “your” exercise program.  You are the best person to choose the activity or activities that will fit into your lifestyle.  You decide what you can accomplish and remember that exercise will help you control your diabetes and will make you feel better in the process.

Carol Duff

Carol graduated from Riverside White Cross School of Nursing in Columbus, Ohio and received her diploma as a registered nurse. She attended Bowling Green State University where she received a Bachelor of Arts Degree in History and Literature. She attended the University of Toledo, College of Nursing, and received a Master’s of Nursing Science Degree as an Educator.

She has traveled extensively, is a photographer, and writes on medical issues. Carol has three children RJ, Katherine, and Stephen – one daughter-in-law; Katie – two granddaughters; Isabella Marianna and Zoe Olivia – and one grandson, Alexander Paul. She also shares her life with her husband Gordon Duff, many cats, and two rescues.

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