Physical activity

If the benefit of daily physical activity could be put into a pill, it would be the most widely used medicine in the world! Did you know that regular physical activity is a key component in taking care of your diabetes? The benefits are too important to ignore.

Heart, lungs, blood pressure, blood glucose, cholesterol, bowels - you name it - all work better. Exercise can do all that? You bet - just give it a chance.

If physical activity is not a regular part of your world, ask yourself – why not? The benefits are clear – the risks of an inactive lifestyle are also clear!

How to get started

The rewards are great, but... what does it take to be active? Does the thought of becoming physically active send images of spandex through your mind? It shouldn’t! These wonderful benefits come from all sorts of activities …walking, swimming, cycling, dancing…you name it, movement is the key.

Take time to think about what activities you enjoy. Look for opportunities to increase your activity throughout the day. You don’t need special or costly equipment – a pair of shoes will do!

Aim for 150 minutes of moderate aerobic activity such as brisk walking, dancing or biking per week, spread over at least 3 nonconsecutive days of the week.

Start with just 10 minutes of an activity like walking, 4 days of the week. As you become more fit you can increase to 30 minutes, 5 days of the week.

Enrolling in group exercise is a good way of not only getting your body in shape but also getting out and meeting people.

Research has also shown that moving a weight with your muscles, or resistance training, is beneficial when you have diabetes.

“Resistance training” may sound a bit scary but it simply means using weight or weight machines to flex your muscles. To start a resistance program, it is best to speak with a qualified fitness instructor. They will review proper technique and help you avoid injury. Start slowly, with 1 set of 10 – 15 repetitions, gradually working up to 3 sets of 8 repetitions, 3 times a week. Your fitness instructor can ensure your technique is safe.

ARE THERE ANY RISKS TO BEING PHYSICALLY ACTIVE?
The biggest risk is inactivity! There are, however, some precautions to consider. If you are inactive, and you plan to do an activity that is more strenuous than brisk walking, first plan a visit to your physician. If you have any of the complications associated with diabetes, such as nerve damage, eye damage or heart problems, discuss your activity with your physician before starting it. Your doctor may order a stress test if you have been previously inactive and are at risk for heart disease.

HOW HARD SHOULD I BE WORKING?
A common way of measuring how hard you are working is to use your heart rate as an indicator. Everyone has a different maximum heart rate but a good overall average has been calculated at 220 beats per minute. There is a range where we do the most amount of good with the least amount of stress called the target heart range or (THR). This range changes as you get older. The desirable range has been estimated to be between 65% and 85% of the maximum heart rate. The following chart shows the approximate target heart rate (THR) for various age groups.

To help you keep within your (THR), just before your cool down walk, simply take your pulse for a 10 second period and multiply by 6 to find your beats per minute. For example, if you count 20 beats in 10 seconds your heart rate is 120 beats per minute. It’s important to keep moving while you are counting. If you are plus or minus two beats in a 10 second count don’t worry because there is always some inaccuracy built into taking your pulse, especially while still moving. Your pulse can be found on the inside of the wrist on the same side as the thumb.

TARGET HEART RATE
AGE	65%	85%
20	130	170
30	124	162
40	117	153
45	114	149
50	111	145
55	107	140
60	104	136
65	101	132
70	98	128

Setting a realistic goal can be helpful. Here is a walking program that starts slowly and gradually increases. If you need more time in this stage, delay increasing the pace for another week. Set your own pace. As a motivator you might want to consider using a pedometer. This is a small device worn at the waistband that tracks the number of steps you take.

A SAMPLE WALKING PROGRAM

Week 1
This program is based on walking 4 times per week. All sessions include a 5 minute warm-up period of stretching/flexibility exercises and walking slowly to start. Then pick up the pace so that for the next 5 minutes you are walking briskly. Cool down by walking slowly for the next 5 minutes. The total exercise time is 15 minutes.

Week 2
Continue walking 4 times per week. All sessions include a 5 minute warm-up period of stretching/flexibility and walking slowly to start. Then pick up the pace so that for the next 7 minutes you are walking briskly. Cool down by walking slowly for the next 5 minutes. The total exercise time is 17 minutes.

Weeks 3 to 12
Continue the program as indicated in week 2 but now increase to 9 minutes of brisk walking. Continue this basic pattern for 12 weeks, increasing the brisk walking by 2 minutes each week up to a maximum of 30 minutes of brisk walking by the twelfth week. By this time you might well be looking for a further challenge and in that case you may add some other forms of exercise that you can comfortably enjoy. It’s a good idea to check your pulse periodically to make sure that you are within your (THR) range.

THE POWER OF A PEDOMETER

A pedometer is a great way to track how active you really are. The average person takes anywhere from 2,000 to 5,000 steps in a day with a normal routine. Some researchers have suggested that taking 10,000 steps a day leads to a healthier you. 10,000 steps are roughly equal to 8 kilometers (5 miles).

To use a pedometer, wear it for a few days to see what your usual daily step total is. When you have this number, set a goal to increase it by 500 steps. When you achieve the new goal for several days in a row, set a new one… and you are on your way!

When each step is tracked – you will soon be looking for ways to collect more. Parking a little farther away from an entrance, taking an extra loop around the mall…or just walking with a friend, all contribute to more steps.

When choosing a pedometer, there are several points to consider. Check to see if the brand is accurate. A strap to secure the pedometer to your belt is helpful if your pedometer slips off your waistband. A cover will protect the button from accidentally being reset. A one button model is the easiest to use. Happy stepping!

THINGS TO REMEMBER
Physical activity can have an effect on your blood glucose for up to 12 hours. When getting started, check your blood glucose just before and right after your activity, as well as in several hours after your activity stops. It is a great way to see the benefit of physical activity. It also helps you watch for any potential low blood glucose levels if you are at risk.

If you take medication that increases insulin release, or you take insulin injections, take a snack along in case your blood glucose runs low. Discuss some healthy snack ideas with your diabetes educator. Review low blood glucose levels with your educator, and find out if you are at risk. If you are, always carry glucose tablets with you in case your blood glucose drops too low.

Begin gradually and work at your preplanned pace.
Try to be physically active on a regular basis to establish a comfortable routine.
Carry glucose tablets if they are required.
Drink plenty of water.
Your feet are important. Make sure your shoes fit well and that you replace them on a regular basis. Your athletic shoes wear out on the inside far sooner than the outside, so pay attention. Check your shoes on the inside for any rough areas or small objects.
Wear medical identification - it will speak for you when you can't.

TIME OUT
Occasionally, there are times when you should not continue your physical activity.

On your doctor ’s advice.
If you are nauseated or have abdominal pain.
If your blood glucose is less than 4 mmol/L, until you have a snack.
If your morning or pre-meal blood glucose is above 14 mmol/L and there are ketones in your urine.
If there are climate extremes and your activity is out of doors - too cold or too hot, excessive humidity or pollution alerts.

Make physical activity a regular part of your day - you are worth it.