Managing Diabetes with Exercise
Two years ago, when
Jennifer Auyer's father died at age 64 from complications related to type 2
diabetes, she faced a turning point in her own struggle with the disease.
Her father's diabetes
had led to heart disease, a quadruple bypass, a foot amputation, and vision
problems, among other serious health troubles. "It was a really painful
experience, for him and for all of us," says Auyer, 40, of Nashua, N.H.
Recommended Related to Diabetes
The four things you
have to do every day to lower high blood sugar are: 1. Eat healthy food 2. Get
regular exercise 3. Take your diabetes medicine 4. Test your blood sugar.
Experts say most people with diabetes should try to keep their blood sugar
level as close as possible to the level of someone who does not have diabetes.
This may not be possible or right for everyone. Check with your doctor about
the right range of blood sugar for you. You will get plenty of help in
learning...
Four years ago, she,
too, was diagnosed with type 2 diabetes, shortly after giving birth to her
child, Grace. "If I were to pass away in 20 years, where would my daughter
be?" she asks.
Deciding to
"Do Differently" with Type 2
When Auyer was
growing up, she never saw her father, a heavy man, exercise. She had become
overweight, too. In addition to caring for Grace, she commutes to Boston to
work as director of sales for a hotel company. But she eventually decided her
busy life could no longer be an excuse to keep from getting into shape.
"I said, 'I
don't want to go through what he went through.' I was following the same path,
and what am I going to do differently? I wanted to find something to help me. I
was desperate."
When she found out
about a weight loss and exercise class at Joslin Diabetes Center in Boston, she
signed up fast. In the course, Jacqueline Shahar, MEd, a clinical exercise
physiologist at Joslin, taught her to do the best exercises for people with
type 2 diabetes.
Strength and
Interval Training for Diabetes
For example, Auyer is
now a believer in resistance training and works out with elastic bands to improve
muscle strength. This form of strength training helps patients use glucose more
efficiently, Shahar says. "If we can get them to do some resistance
training, they're going to be able to increase their muscle mass so they're
actually burning more glucose."
Other payoffs come,
too. "They increase their metabolism and they lose weight," Shahar
says. Resistance training also helps people with diabetes improve their
cardiovascular health, lower blood pressure, and reduce abdominal fat. It
benefits posture and helps strengthen muscles to prevent injuries.
In another big step,
Auyer began interval training, which involves repeatedly mixing bouts of
high-intensity aerobic activity with less intense work -- the segments are
called "intervals." For example, you can pedal fast on a bike for 30
seconds, then go at a slower speed for 90 seconds. Altering the speed and
intensity of the workout challenges the muscles, helping burn more calories,
boost fitness, and improve insulin sensitivity, according to Shahar. "That's
actually my favorite," Auyer says of interval training. "It keeps
everything fast-paced and fresh."
At home, long
stretches of treadmill walking bored her. But now, she'll walk on the treadmill
for 10 minutes, then run for another few minutes. "Then I'll jump off and
do the resistance bands for a few minutes, then squats or side steps, then
maybe I'll jump back on the treadmill for 10 minutes," Auyer says.
"The next thing you know, an hour has gone by, and I feel so invigorated
Exercise and Blood
Glucose Levels
Shahar advises Auyer
and other diabetes patients to exercise at least three or four times a week.
Blood glucose levels can keep dropping up to 48 hours after exercising, she
says. "I always use this analogy in people with diabetes: Their muscles
are kind of sleeping, so they're not burning glucose or calories. But if they
exercise, they keep their muscles awake all the time. They keep burning
calories, they lose weight, they make the glucose work more efficiently in
their body."
Auyer is delighted
with her improved blood glucose levels. "Almost immediately, I noticed a
change in my morning blood sugars, which are always really high," she
says. But after she started exercising, "they were dropping from an
average of about 140 to 110. I was so excited one day -- I had one under
100."
She exercises in
class once a week to make sure she's doing it right, then repeats the routines
at home. She aims to lose weight gradually -- she has about 80 pounds to go --
and hopes to eventually run a 5-kilometer race.
Grace is already
following by example, playing with the resistance bands when her mom exercises
in her playroom. "Kind of funny -- she's 4 years old and she wants to
exercise, too. Honestly, growing up, I didn't have that," Auyer says.
"One of my goals, besides making myself healthy, is to really instill that
in my daughter so that she doesn't have to go through what I'm going through.
"I'm setting her
up for potentially having diabetes as well because of the history in my
family," Auyer says. "Hopefully, that won't be her curse, but if we
can cut it now -- get her to see that this is what Mommy does, we exercise --
then it's not so foreign."
Like every working
mom, Auyer sometimes gets off her exercise routine for a few days. But she gets
back on track by reminding herself why she started. "For me, that reason
was my father. This is what he would want and this is important," she
says. "That's the motivation to keep going."
Starting an
Exercise Program
Ready to get fit?
Shahar offers these tips for getting started.
·
Talk with your doctor. People with heart
problems might need a stress test, while those with hypertension should make
sure their blood pressure is stable. If you have retinal problems, ask your eye
doctor if you should avoid certain exercises that increase pressure on the
retina, Shahar says. If you have orthopaedic problems, such as knee pain, back
problems, or foot issues, an exercise physiologist can teach you appropriate
exercises, including using a stationary recumbent bike.
·
Check your blood sugar before and after exercise. "No. 1: It's a
motivation tool. When you exercise and see your blood glucose improve, you'll
probably do more because it's going in the right direction," Shahar says.
In time, your doctor might be able to reduce your insulin or oral diabetes
medication. But you should also be checking to make sure your blood sugar isn't
too high or too low.
·
Keep snacks on hand for low blood sugar. Be prepared. Bring
fast-acting snacks to the gym or along on your outdoor workout in case your
blood sugar drops too low while you're exercising.
·
Wear a diabetes ID. Wear a bracelet or
necklace or carry something that identifies you as having diabetes. List an emergency
contact, and indicate whether you take insulin.
·
Wear comfortable shoes. Good shoes will
help you avoid foot problems, which can be more serious when you have diabetes
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