The Importance of Physical Activity

By Shannon Seeley MSPT

Type 2 Diabetes

The Importance of Physical Activity

DPP reports that changes in diet and physical activity resulted in a larger reduction in incidence of type 2 diabetes then medications alone.

Despite these results these behaviors have not been widely adopted.

Therefore the prevalence of diabetes and associated risk factors has continued to increase. Between 1999 and 2010 prevalence of hyperglycemia increased from 12.9 to 19.9%

Waist size above recommended level increased to 56.1%

Diabetes among the elderly increased by 1.69% 86 million americans now have pre-diabetes.

The importance of physical activity

Functional mobility issues for the diabetic patient Peripheral Neuropathy 1. Balance issues 2. Increased risk of falls. Gait deviations 1. lower extremity deformities and decreased

flexibility ex. Charcot foot, or equinovarus deformities. 2. Musculoskeletal pain syndromes or

degenerative joint disease. Sedentary lifestyles 1. Deconditioning 2. Muscle Weakness

Addressing Musculoskeletal issuesAddress neuropathy and balance issues with

proper foot wear, desensitization, and balance training.

Improve gait and minimize gait deviationsAddress musculoskeletal pain issues such as

DJD, Arthritis, and back pain prior to beginning an exercise program.

These issues can be addressed by medication and Physical Therapy

Contact your physician prior to starting exercise program.

The importance of physical activityExercise has large impact on the body’s

metabolism-can complicate the management of blood sugar levels most important influence on fuel utilization = glycemic balance are intensity and duration of physical activity.

Findings show that even very short bouts of exercise(2-15 minutes) of physical activity are associated with improvements in glycemic control. This would allow people who are not candidates or not compliant with traditional exercise programs to implement this into their daily life.

; Marni j. Armstrong, Sheri Colberg, and Ronald J. SigalMoving Beyond Cardio: The value of Resistance Training, Balance training, and other forms of exercise for Diabetic management

The Importance of Physical ActivityOf particular importance is the positive effect

that almost any type of exercise appears to have on both postprandial peaks(post meal) in blood glucose and amt of time during 24 hour period spent in hyperglycemic state.

The importance of physical ActivityCurrent recommendations include consuming a

balanced diet rich in fruits, vegetables, and fiber and low in sugars, saturated fats, processed meats, and low-nutrient foods – engaging in regular moderate to vigorous physical activity, limiting alcohol, and avoiding harmful substances such as tobaco and other drugs.

Risk factors for physical inactivity include sedentary employment, sedentary entertainment, and absence of marketing , programs, events, and reminders to encourage physical activity.

Things to remember when starting an exercise program

1. There are many options to consider when starting an exercise program.

2. Understand to differences to manage blood levels with the addition of exercise.

3. What are the causes of exercise induced hyperglycemia vs. hypoglycemia.

4. Incorporating an exercise program needs to be a lifestyle change and there are many strategies to help you to achieve that including utilization of technology, social media, and other resources.

5. Understanding the interactions between medications and exercise.

Things to consider when beginning and exercise program

What are your interests? Make a list of fun activities What do you like to do? What are you passionate about? What resources to you have available? What resources to you have available?Find ways to work physical activity into your normal daily

routine. Do little exercises while sitting at stop lights or standing

in line. Take stairs rather then elevator Park farther away. Do exercises doing commercials during your favorite TV

program.

Things to remember when starting an exercise program

Do you prefer to do activities on an individual/one on one basis or in a class. What will assist you to be accountable?

Utilize support groups if that is something that is of interested to you.

Social media can be a good resource utilizing apps or face book that keep track of steps or log exercises performed.

Utilizing Fit bit or jawbone if that is some thing that interests or have access to.

The importance of managing your diabetes with physical activity

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Ease into it. If you're not active now, start with 10 minutes of exercise at a time. Gradually work up to 30 minutes a day.

Carry Carbs always keep a small carb snack like fruit in case your blood sugar gets low.

Strength train at least twice a week. You can lift weights or work with resistance bands. Or you can do moves like push-ups, lunges, and squats, which use your own body

Importance of managing your diabetes with physical activity Be good to your feet. Wear athletic shoes that are in

good shape and are the right type for your activity. For instance, don't jog in tennis shoes, because your foot needs a different type of support when you run. Check and clean your feet daily. Let your doctor know if you notice any new foot problems.

Hydrate. Drink water before, during, and after exercise.

Stop if something suddenly hurts. If your muscles are mildly sore, that's normal. Sudden pain isn't. You're not likely to get injured unless you do too much, too soon.

Getting Started Get your doctor's OK. Let them know what

you want to do. They can make sure you're ready for it. They'll also check to see if you need to change your meals, insulin, or diabetes medicines. Your doctor can also let you know if the time of day you exercise matters.

Exercise as Medicine for Diabtetes: Prescribing Appropriate Activities and Avoiding Potential pitfalls; Sheri R. Colberg. Diabetes Spectrum Winter 2015

Education on monitoring blood sugars with exerciseContinuous glucose monitoring (24-hour

period) vs A1C = measure of overall glycemic control and glucose tolerance.

Exercise by insulin users require balancing insulin and food intake to remain in as close to a euglycemic state as possible.

Getting Started Check your blood sugar. Ask your doctor if you should

check it before exercise. If you plan to work out for more than an hour, check your blood sugar levels regularly during your workout, so you’ll know if you need a snack. Check your blood sugar after every workout, so that you can adjust if needed.

Goal SettingStart small with simple attainable goals that

allow for early success and build from their. If things are to hard or overwhelming people tend to get frustrated or give up. Most likely if they have failed in past it is secondary to trying to do to much too fast.

Avoid taking one step forward two steps back syndrome.

Life style ChangeActivity and exercise need to be a life style

along with eating healthy and taking your medication appropriately.

It needs to be incorporated into your daily life just like brushing their teeth or taking a shower.

It needs to be made a priority that is incorporated into what you do so that it becomes a habit and improves your quality of life.

Benefits of exercise Aerobic Enhance insulin sensitivity Lowers blood glucose and improves AIC Improved cardiovascular risk factors including

Visceral adipostity, lipid profile, arterial stiffness, and endothelial function

Lowers blood pressure and improves blood circulation.

Improve lipids profile by reducing level of triglycerides and free fatty acids as well as enhancing high density lipoproteins.

Improve cardiovascular endurance.

Resistance training Enhance insulin sensitivity Enhance daily energy expenditure and quality of

life Decreased AIC due to improvements in lean body

mass Lowered LDL cholesterol and reduced fasting

triglycerides Increased in muscle glycogen storage Increased lean tissue mm mass Decrease systolic blood pressure Reductions in the diabetes medications

Benefits of Exercise

Activity PossibilitiesAerobic and High force Resistance

Body weight resisted exercise

Core Strengthening and Yoga

High intensity interval training

Moderate Intensity Weight bearing

Combined Resistance and Aerobic Exercise

Resistance Exercise Training

ConclusionExercise is important for management of diabetes.

Consistency is the key. It is not only important for managing you diabetes but for improving and maintaining your quality of life.

It’s important to manage your blood sugars and diet while being involved in an exercise program.

There are many options and a variety of activities that are considered helpful so pick an activity that you enjoy so that you will stick to it.

Utilize support groups, classes, and social media to assist and increase your likelihood of success.