By Carol Stathers & Bob Pope
The Challenge: How do we encourage our clients with diabetes to throw on their runners and get mov’in?
Diabetes educators are well aware of the benefits of exercise to those with diabetes. In the past, assessing the client’s readiness for change was often overlooked in education centres. Clients were given the long list of reasons why they should start exercising with the expectation that if they were interested in preventing complications they would comply. That list often included improved glycemic control, decreased insulin resistance, improved lipid profile, improved cardiorespiratory fitness, maintenance of weight loss and ultimately decreased risk for diabetes and cardiovascular complications.
Following those lectures on why the client should exercise, came the discussion about the reality of how long they will be wearing their running shoes. Between the Canadian Diabetes Association and Health Canada the recommendations range from 150 minutes of moderate-intensity aerobic exercise per week, plus additional resistance exercise or up to 60 minutes per day. For many, these recommendations were daunting and needless to say, many clients chose to ignore them leaving their new runners in the box.
So how do we engage these clients in activities that interest them and ultimately benefit them with their diabetes management? We need to realize that diabetes educators are not alone; we need to look elsewhere and find partners in the community who will work with us for the long-term benefit of the client.
For the past four years in our community, health and municipal recreation have been partnering to promote and encourage physical activities and healthy lifestyle choices. With over 1,500 people in our “Get Active” Program, our role has been to embrace the province of B.C.’s challenge to get our residents 20% more physically fit by 2010 (in time for the Olympic Games). With this goal, we will be positioning ourselves further upstream to assist in reducing the incidence of chronic diseases and related complications. Our program not only includes offering physical fitness opportunities, but also seminars related to prevention, goal setting and promoting a healthy mind, body and spirit.
We are working with people who have had a health incident such as diabetes or cardiovascular disease in their lives and are now trying to prevent another occurrence and get healthy in spite of their medical condition. The benefits of physical activity and the obvious outcomes were evident and very encouraging early in the program. There is another outcome that we see again and again with all types of participants; that is the immeasurable benefit of positive attitude and hope.
A study at Trent University in Nottingham, England, published in the British Journal of Sports Medicine (2001), has shown that physical activity boosts people’s moods due to a naturally occurring amphetamine, which improves mood and decreases fatigue. This can be the most important building block in a person’s recovery because of what it does for patient’s overall outcome.
It is the effect on the mental attitude and the belief that you have some control over your health that is so encouraging. Bouncing back from a life crisis can be overwhelming and the pursuit of a successful physical lifestyle can be an invaluable tool on the road to recovery.
So many of the participants have seen life-changing improvements … here are 8 tips on what helped make it possible:
1. Proactive Goal – setting with S.M.A.R.T. objectives:
- Small steps – setting smaller, more specific goals keeps them motivated. “The journey of a thousand miles begins with a single step” (Lao Tse 604 BC)
- Measurable – write down measurable goals and display them.
- Attitude – Positive self-talk – enjoy the call to action, consider starting with a walking program: smell the roses, listen to the birds, feel good about being proactive and a positive attitude can’t be far behind.
- Realistic – Set realistic goals – be realistic about change – no doctor or pill can do it for you.
- Timely – set timelines to short term goals “Good resolutions are like babies crying in a church or at a concert; they should be carried out immediately.” (Charles M. Sheldon)
2. Support and mentoring. Don’t underestimate the power of people. Working with a buddy, trainer, with another patient or even just alongside other recreation participants can have huge benefits.
3. Effort equals endorphins. No pain (not too much anyways), but lots of gain. Oprah Winfrey says “I’m not one of those people who claim that she loves to exercise. I simply love all it does for me.” This can be such a switch from feeling like a victim to feeling those endorphins!
4. Forgiveness, loss and grief. When a life crisis happens, it can be like experiencing a death and all that goes along with it. Positive success through physical activity can move this process along.
5. Life is a highway. Recharging life’s batteries is so important. How we feed and maintain our body effects the distance it will go and the quality of performance. Once people get success in improving fitness, they also begin to look at other lifestyle choices. “Genetics loads the gun, but lifestyle fires it off.” (author unknown)
6. Walking away from stress. “If you are stressed on a daily basis and do nothing to resolve the stress, it begins to take residence in your body. Blood pressure creeps up, digestion begins to falter, blood sugar becomes more unstable and muscles start to contract and ache. Often doing something as simple as a walk can improve your situation”. (Martin Collis)
7. Celebrate successes. Don’t wait too long to celebrate. After a health incident, it is critical to “win a few” to feel that there is a life again after the event.
8. It’s never too late! Help clients explore how important and confident they are in making changes; listen when they need you; be empathetic as change is not easy! Work with them to help them develop their action plan and provide the resources and assistance they need, when they need it.
So, look outside your clinic when it comes to providing resources for your clients. Look for partners in your community, whether they are leaders in recreation, private business, coaches, trainers or lay-leaders. Expand your team for the benefit of the client. Put yourself in the “coach” position to provide assistance to the client making healthy lifestyle changes.
The doctor of the future will give no medicine, but instead will interest his or her patients in the care of the human frame, in diet and in the cause and prevention of disease.” (Thomas Eddison)
About the Authors
Carol Stathers is a certified diabetes nurse educator for Interior Health and the Program Coordinator for the new hearts@school program with the Healthy Heart Society of B.C. Over the past couple of years she has worked extensively with the City of Penticton, recreation program on its “Active Communities” initiative and school walking program.
Bob Pope has a recreation Diploma and numerous certificates in field of Leisure Education. He has been working for the City of Penticton; Recreation Department for the past 20+ years and currently, is the Active Living Recreation Coordinator for the Community Centre. He has won provincial and national awards for his pedometer walking initiative and active living programs which have been replicated throughout B.C. He is respected as a leader in active living and healthy lifestyle promotion and has lectured throughout BC, Canada and Washington State.
- Building Competency in Diabetes Education: The Essentials 2001
- Canadian Journal of Diabetes: Canadian Diabetes Association 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada