Regular Exercise: The Most Important Lifestyle Decision We Can Make

By David Kiernan, B.Sc.Hons. Kin, MBA (C) posted in Healthy Living Physical Activity

Mature older people lifting weightsRegular exercise is the most important lifestyle decision we can make – everyone benefits. For people with diabetes it is especially important.  Regular physical activity plays an important role in taking care of your diabetes by keeping your heart and lungs healthy. It’s a low-cost, low-risk way to fight vascular disease, regulate blood sugars, reduce the risk of high blood pressure and boost your well-being.

Exercise helps to keep cholesterol levels in check and bowels in top shape and you may even lose a few pounds in the process. Our increasingly sedentary lifestyles – driving to work, to school, to the grocery store, spending more time at the computer and watching TV – have made it even more important to include daily physical activity in our lives.

If you are currently active, congratulations!  You are taking the right steps to minimize the impact of diabetes on your quality of your life.  If you are not presently active, the tips that follow will help and encourage you to get started.

Let’s help you get started today!

What Does It Take to Be Active?

Being active does not mean trudging off to the gym at 5 am every morning.

The benefits of exercise come from all sorts of activities…walking, swimming, cycling, dancing – movement is the key. Working some physical activity into your week is simply about getting and keeping you healthy and happy.

Having diabetes is definitely not an excuse not to exercise.  Think of exercise as part of a balanced lifestyle.  Combined with proper nutrition and taking your medications, it will give you the quality of life you deserve.   Taking some precautions will help ensure that you stay safe and on the right track.  So let’s take some time to give you some starter points and precautions to take.

First Things First

Before beginning any exercise program speak to either (or both) your family doctor or diabetes education team.  These health care professionals will assess your risk of adverse symptoms, and may be able to refer you to a diabetes exercise professional, or will have one as part of their team.  This will not only increase the safety aspect, but also the effectiveness of your program.

Having a stress test before starting is another necessary first step, especially if you fall into any of the following categories.  Information from this test will be helpful in assessing you heart health and establishing a safe training heart rate.

Recommended to get a stress test if:
You have or are at risk of having coronary artery diseaseYou are over 35 years oldYou are over 25 years old and have had diabetes for more than 10 years

The next step is to go and do some shopping.  Foot care is very important, so having the proper shoes and socks will help avoid issues such as shin splints, but also ulcers that can be difficult to treat.  An ounce of prevention is worth a pound of cure!

Learn how your blood sugars respond

Learning how your blood sugars respond is important when you exercise.  By taking your blood glucose reading immediately before and after exercising, you will know whether it is safe to begin exercise for that day, and how many points your reading drops due to exercise.

Before exercise, use your blood glucose meter to check that your blood glucose reading is at 5.5 mmols or higher, as it is most likely that you will get a lower number after you exercise.  If it’s lower, take 15 grams of a fast-acting sugar, such as a dextrose tablet or a hard candy (not sugar free), and re-check your blood sugar reading in 15 minutes.  After exercise it is recommended that you eat a light snack if your reading is less than 5 mmols, especially if you must drive.  Remember “5 to Drive”.

Another reading to be aware of is 14 mmols or greater before breakfast as this is too high to begin exercise.  While a slow walk may help burn extra sugars, moderate to vigorous exercise may cause problems, so postpone exercise until your sugars are back under control.

How Do I Get Started?

Take time to think about what activities you enjoy. If you don’t like riding stationary bicycles, then don’t.  Find what you do like.  The only consideration is to keep impact exercises to a minimum if you have any foot complications, such as neuropathy.  Look for opportunities to increase your activity throughout the day.  Aim for 150 minutes of moderate aerobic activity such as brisk walking, dancing or biking per week.  Spread it out over at least 3 non-consecutive days of the week with no more than 2 consecutive days in between.

Set a realistic goal.  Start with just 10 minutes of an activity like walking 4 days of the week. As you become fit you can increase to 30 minutes 5 days of the week.  You will find a Sample Walking Program below.

Enrol in a group exercise class. It‘s a good way of not only getting your body in shape but also getting out and meeting people.

Add some resistance training.  Research has shown that moving a weight with your muscles, known commonly as resistance training, is beneficial when you have diabetes.

How Hard Should I Be Working?

A very simple yet effective way to tell if you’re overexhausting yourself is the Talk Test.  Quite simply, if during exercise you are breathing so heavily that you can’t talk you are pushing your body too much.

Another 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. (We adjust for age by subtracting your age from the maximum heart rate of 220 and applying the 65% and 85% ranges) The following chart shows the approximate target heart rate (THR) for various age groups.


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

To help you keep within your target heart range, 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.


img_couplejogCOVERSetting a realistic goal is a really good way to get you on the active lifestyle bandwagon.  It’s also a good idea to set new goals from time to time to keep progressing along the way! Here is a walking program that starts slowly and gradually increases.

This program is based on walking 4 times per week to start. Begin with a 5 minute warm-up period of stretching/flexibility exercises and walking slowly to start. Then pick up the pace and walk briskly. Finish it off with a cool down by walking slowly for 5 minutes.


4 times per week

5 minute warm-up period – stretch & start walking at a slow pace

5 minutes – pick up the pace so you are walking at a brisk pace


5 minute cool down – walk at a slow pace

Total Exercise Time : 15 minutes


4 times per week

5 minute warm-up period – stretch & start walking at a slow pace

7 minutes – pick up the pace so you are walking at a brisk pace

5 minute cool down – walk at a slow pace

Total Exercise Time : 17 minutes

WEEKS 3 – 12

4 times per week

5 minute warm-up period – stretch & start walking at a slow pace

9 minutes – pick up the pace so you are walking at a brisk pace

5 minute cool down – walk at a slow pace

Total Exercise Time : 19 minutes

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 be looking for a further challenge – great! Feel free to add some other forms of exercise that you can comfortably enjoy – go for a swim or maybe try a group class. Remember, it’s a good idea to check your pulse periodically to make sure that you are within your target heart range.

Tip – Use a Pedometer for Motivation

Pedometer-300x300A pedometer is a small device worn at the waistband that tracks the number of steps you take.  It’s a great little tool to help  you track how active you really are, and motivate you to do more.  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 you see how many steps you’re taking a day you’ll soon be looking for ways to up the count! 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.

Shop around for a good pedometer. Make sure 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.

General Instructions for Resistance Training

“Resistance training” is nothing to be afraid of.  It simply means using weight or weight machines to work your muscles. A weight can be anything from a dumbbell to a can of soup from the pantry.  Another good tool to use is a resistance band.

Resistance training is important because it helps maintain or possibly build muscle strength which will help to improve your energy level and increase the effectiveness of the insulin your body makes or the insulin your doctor may prescribe.

Like aerobic exercise, there are some things to consider before beginning resistance training.   If you have any eye complications due to your diabetes (retinopathy) you should get clearance from your health care provider before beginning.  An aneurism or hernias (other than hiatus hernia) are other ailments that will likely preclude you from resistance training.  If in doubt, check it out.


If you’re interested in starting a resistance program, it is best to speak with a qualified fitness instructor. They will review proper techniques and help you avoid injury.

Generally it is advised to start slowly and gradually work up the amount of weight you can lift and the number of repetitions you can do.  Here’s an example of how you should progress:

Lift band/weight smoothly and under control.

A minimum of 60 seconds rest should be taken between sets.

DO NOT HOLD YOUR BREATH. Exhale when the band is being stretched or weight is being lifted against gravity (most difficult part of the exercise).

Progression Steps:

1 set of 10 repetitions per exercise

When you’re ready, slowly increase  to 1 set of 15 repetitions

Increase weight slightly & aim for 1 set of 10 repetitions

As you progress increase to 2-3 sets of 10-15 repetitions

Resistance training can be done 2 – 3 times a week.  Leave at least 48 hours between sessions. Your fitness instructor can ensure you are using the right amount of weight and completing a safe number of repetitions while assessing that your technique is safe.

Last Minute Reminders

Physical activity can affect 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 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 to find out if you are at risk and, if you are, always carry glucose tablets with you in case your blood glucose drops too low.

  • Drink plenty of water.
  • Set realistic goals – begin gradually and work at your own preplanned pace.
  • Try to be physically active on a regular basis to establish a comfortable routine.
  • Make sure your shoes fit well and that you replace them on a regular basis.
  • Wear medical identification – it will speak for you when you can’t.

Don’t Exercise If…

  • Your doctor advises against it.
  • You are nauseated or have abdominal pain.
  • Your blood glucose is less than 4 mmols, until you have a snack and your reading returns to normal.
  • Your morning or pre-meal blood glucose is above 14 mmols, and there are ketones in your urine.
  • There are extreme weather conditions.  This includes too hot or too cold temperatures, excessive humidity and pollution allerts. Take a look at the forecast and adjust and change your activity to something you can do indoors if possible.

The Ultimate Goal – An Optimal You

What you want to achieve is up to you, but getting and staying healthy is truly the ultimate goal.  Start by doing something you love and aim for at least 150 minutes of aerobic activity a week.  Add a little more time for being active whenever you feel ready.  And don’t forget about your muscles – add some resistance training to your plan as well.  When it comes to physical activity, the more you do, the better you feel, and the chances of keeping your own mobility as well as your independence are far greater than if you don‘t exercise.  Physical activity on a regular basis not only makes you look good and feel great but significantly decreases your risks of all sorts of health complications.

Make physical activity a part of your day – you are worth it!

David Kiernan is the Professional Resource Cardiac Rehabilitation Chair – Employee Wellness Committee (Action 360) Southlake Regional Health Centre