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Mehr von Carol Gray, MHA
Diabetes
- 1. The Management and Benefits of Physical Activity with Diabetes Carol D. Gray, MHA Exercise Physiologist October 15, 2002
- 2. Diabetes Mellitus General information Risks of disease mismanagement Exercise benefits Exercise recommendations Special exercise concerns
- 3. Diabetes Factoids 14 million Americans have diabetes Many people do not know they are affected. Complications include… kidney failure hypertension cardiovascular disease retinopathy neuropathy
- 4. Complications . . . NOT Inevitable result Risk is reduced by 50% if blood sugars are kept close to normal. Good blood sugar control can help to slow complications that have begun. Inevitable when disease state is mismanaged
- 5. What Is Optimal Blood Sugar? Optimal defined as •Hemoglobin A1c = 7.0 or lower •Plasma blood sugars less than 180 mg/dl two hours after eating •Plasma blood sugars less than 140 mg/dl before eating
- 6. Risks of Mismanagement Hastened Complications Kidney failure Hypertension Cardiovascular Disease Retinopathy Neuropathy Foot ulcers Amputation Blindness Poor Health Low Quality of Life
- 7. Risks- Cardiovascular Disease Leading cause of premature death among diabetics 65% of diabetics die from heart attack or stroke Smoking doubles the risk CVD for diabetics
- 8. Risks- Neuropathy One of the most common complications Damage to nerves outside the brain and spinal cord Symptoms Muscular weakness Loss of feeling Loss of function not under conscious control, i.e. digestion
- 9. Risks- Retinopathy Damage to retinal blood vessels causing them to leak fluid/blood into retina Can lead to blindness Diabetics have risk of blindness 25 times greater than healthy persons
- 10. What are the benefits of EXERCISE?
- 11. Exercise Benefits Stimulates insulin function Easier to maintain optimal blood sugar Assists in weight management Decreased incidence and severity of complications Increased functional capacity Improved muscle tone Lower cholesterol and triglycerides Reduces stress Improved concentration Decreased appetite Exercise can not counter the effects of poor nutrition
- 12. Exercise and Proper Nutrition Enable Disease Management To Be Possible!
- 14. To Begin... Obtain medical clearance from your physician before beginning exercise. Wear medical alert identification on a bracelet or necklace Never exercise if you have high blood sugar High blood sugar = Greater than 300 mg/dl
- 15. Next Step… Get Moving! Choose an aerobic activity you enjoy Examples- walking, bicycling, swimming, running, jumping rope, tennis, aerobic dance,etc. Start at an easy pace Increase your pace and time spent gradually
- 16. Aerobic Example Warm up 10-15 min Light Pace Pick up pace 5 min Light-Moderate Maximum pace 15 min Moderate- Somewhat Hard Cool down 5-10 min Light 60-90% Max Heart Rate 20-40 minutes Perform 4-7 days/week
- 17. Time Of Day For Exercise Be consistent- improves timing of insulin action Avoid exercise at time of peak insulin action Evening- not recommended Delayed hypoglycemia when sleeping Morning- After a small snack and before the morning insulin injection may reduce risk of exercise-induced hypoglycemia Also, greatest influence on maintaining stable blood sugar throughout the day
- 18. Increase Overall Activity Daily activities have benefit Examples: Walk to the store instead of driving Walk your dog Take the stairs Push mow the lawn Wash the car
- 19. Signs of Hypoglycemia Thirst Excessive sweating Faintness Rapid heart rate Irritability Unusual drowsiness/fatigue Hunger Blurred/double vision Shakiness, Trembling
- 20. Signs of Hyperglycemia Confused Nauseous, Vomiting Headache Breath has sweet, fruity odor
- 21. Weight Training Also beneficial in disease management Improves insulin sensitivity Easier to maintain optimal blood sugar
- 22. Strength Training . . . Add after 2 weeks of regular aerobic activity Through trial and error, find a weight challenging for 10-15 repetitions If additional weight is not available, focus on increasing repetition Perform 2-3 sets/exercise 2-3 days/week
- 23. Strength Training Workout Warm up aerobically 5 min. One Arm Bent-Over Row 2 x 15 Wall Slide 2 x 15 Side-Lying Hip Abduction 2 x 15 Standing Heel Raise 2 x 15 Wall/Modified Push-Up 2 x 15 Abdominal Crunch 2 x 20 Cool Down aerobically 5 min. Stretch 1 x 30 sec.
- 24. Special Exercise Concerns Appropriate Exercising Blood Sugars Proper Footwear
- 25. Monitor blood sugar When? Before, during, and after exercise Why? Learn your body’s response to exercise Avoid hypoglycemia Determine an appropriate pre-exercise snack
- 26. Type of Exercise Blood Sugar Exchanges to Add Short Duration, Low- Moderate Intensity Walking (1/2 mile) or Leisurely cycling (less than 30 minutes) Under 80 mg/dl Over 80 mg/dl 2 fruit 1 fruit Moderate Intensity Tennis, swimming, jogging, golfing, or leisurely cycling (1 hour) Under 80 mg/dl 80-180 mg/dl 180-300 mg/dl Over 300 mg/dl ½ meat and 2 bread 1 fruit or 1 bread No extra food Do not exercise Strenuous Football, hockey, racquetball, basketball, strenuous cycling, swimming, or shoveling Under 80 mg/dl 80-180 mg/dl 180-300 mg/dl Over 300 mg/dl 1 meat,2 bread,1 fruit,1 milk 1 meat and 2 bread 1 meat and 1 bread Do not exercise Food Exchanges For Exercise
- 27. Proper Footwear Foot ulcers common Protection from ulcers and orthopedic problems crucial Running or walking shoes recommended New Balance, Asics, Mizuno, Adidas, etc.
- 28. Exercise is a MUST! Manage Diabetes Effectively Avoid Complications Avoid Foot Ulcers Feel & Look Better Enjoy Living Win battle against DIABETES