Diabetes Self-Management Blog

I’m taking a liberty this week with the ever-popular quote from a World War II British safety poster: Keep Calm and Carry On. If you’re wondering what the context is here, it’s exercise. Yes, I know you’ve heard and read numerous times that exercise is important, and that you should aim for at least 30 minutes, five times a week. The question, though, is are you doing it?

Grim statistics
Researchers at the Centers for Disease Control (CDC) looked at survey data from 450,000 American adults across all 50 states. Folks were asked about how much aerobic activity they got outside of work, and for how long. The findings probably won’t surprise you: Only about 20% of people got the recommended amount of exercise (at least 2.5 hours of moderate-intensity activity per week, according to the US government). That means 80% don’t get enough. People most likely to exercise were between the ages of 18 and 24; least likely to exercise were adults ages 65 and older.

Perhaps not surprisingly, people who were overweight or obese were less likely to exercise. Also, Hispanic Americans were found to be not as active as whites.

Why don’t we exercise?
Unless you’ve been living in a cave for the past 10 to 20 years, it’s pretty hard to ignore the messages everywhere that a) exercise is good for us and b) we need to do more. But the reality is that, for the most part, we don’t. We’ve gotten the message, but somehow, that message hasn’t taken hold. “I know I should exercise more but…” or “I really don’t have enough time” are not uncommon. The fact is that we all have 24 hours in our day. Some of the busiest people around find time to exercise. Yet barriers crop up everywhere, whether they be lack of time, feeling fatigued, having sore knees/back/hips. What’s really behind our reasons for not being active?

Some experts think that it’s not because we’re not getting the message (we are, loud and clear) but rather, that maybe the key is to focus on how good (or bad) exercise makes us feel. Researchers at Iowa State University found that as exercise intensity increased to the point of the person barely being able to talk (because of breathing so hard), called the ventilatory threshold, some, but not all, people felt more pleasure. Beyond the ventilatory threshold, most felt bad.

The complicated part is that everyone has a point where their ventilatory threshold kicks in. For some, it might be walking a few yards. For an extreme athlete, it might not occur until they’ve reached their maximum threshold. And some people feel better (great, actually), when they push past their ventilatory threshold. So what does all this mean? Maybe, rather than bombarding us with messages to walk 30 minutes, five times a week, the message should focus on finding an activity that truly makes us feel good. Researchers think that being able to find an activity that consistently makes us feel better is the key to motivating us to keep at it.

How do we get started…and stay with it?
The hardest part of exercise for many people is getting started. Maybe you haven’t been active for a long time. Maybe you have neuropathy or arthritis, or you can’t stand up. These are legitimate concerns, but they don’t have to be barriers. And sometimes, it can seem discouraging to look at super-fit people or watch people running a marathon, for example. You might be thinking, “I could never do that” or “I’m too embarrassed to be seen exercising in front of these people.” Here are some tips to think about. Hopefully some will resonate with you.

Seek guidance. If you’re serious and ready to start an activity program, get some advice. An exercise physiologist or a physical therapist can help you get started and be safe. Certainly, if you have any diabetes complications like neuropathy, retinopathy, kidney disease, or heart disease, check with your health-care provider first and, if necessary, ask for a referral to a physical therapist or exercise physiologist who can tailor a program around your needs.

Consider hiring a personal trainer. Prices vary — a typical session will cost about $50. You don’t need a trainer indefinitely, but knowing that you have to be accountable (you’re paying for it and maybe he is even going to show up at your house) can help keep you going. If money is truly tight, as it is for many, consider signing up for just a few sessions. Or look into partner or small group training, or even online training sessions. Maybe your spouse or children will give you a few sessions for a holiday or birthday gift.

Schedule in time. Exercise is usually the first thing to go when you’re crazy busy. But you still probably find time to eat, brush your teeth, check your blood glucose, show up for work, and pick your kids up. You might argue, “But those are things I HAVE to do!” Why isn’t exercise on that list? Find time for it. Pencil it in your calendar. Put it into your Outlook calendar or in your smartphone. Make it important to you.

Take 10. Exercise and fitness aren’t “all or nothing.” Short, 10-minute bouts of exercise count, and the more you do of them, the more benefits you’ll reap. Lose the defeatist thinking that you have to do at least 30 or 60 minutes of exercise for it to count. That’s not the case. If you can run to Starbucks for your morning latte, watch the evening news, or chat with your neighbor, you can squeeze in 10 minutes of activity. And I’ll bet you can find 10 minutes in the morning, midday, and evening in your schedule, too. By the way, the latest thinking is that shorter bouts of higher intensity exercises are even better than longer, drawn-out exercise sessions.

Do something you like. Walking is easy because you can pretty much do it anywhere. But maybe you have some stairs you could climb to kick it up a notch. Try a new class. Pop in a DVD or comb YouTube for free exercise videos that you can easily do in your own home.

The point is to make exercise more of a priority in your life and to find time for it. If you have tips or suggestions for what works for you, please share!

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Comments
  1. Exercise is critical and crucial. I would not have got my numbers back down every day from 238 unless I walked 2 miles - 8 - 1/4 miles loops. That is what it took to wipe out the dawn effect dumps each and every day until with my Doctor’s help we figured out how to put on doses of metformin at night time.

    I still do 1.5 miles and 1200 calorie lower glycemic diet before and after met dose corrections.

    The skeletal muscles are used to park extra glucose from blood stream as part of regulating it. Exercise keeps the glucose burned off in muscles and room to store more glucose and regulate blood stream.

    Posted by jim snell |
  2. The biggest roadblock for me is that I suffer from chronic fatigue, for which my doctors have yet to find a cause or even attempt to treat. Some days are better than others, but I frequently barely have the energy to make it to work and back, and all I can focus on is a desire to sleep. The most obvious potential cause -medication- is a virtual non-starter, as all the meds that carry the drowsiness warning have been deemed essential to keeping me alive. And I’m not talking simple drowsiness or tiredness, but brain-numbing exhaustion much of the time.

    The bottom line is, I would love to exercise. I was once a professional athlete, and working out was like eating or sleeping. I still have strength, I can do almost anything on a good day. But on a bad day just standing up feels like trying to lift a car over my head. There is more to it than just “taking the time.” For me it also has to be the *right* time, and those times are getting more and more scarce.

    Posted by Joe |
  3. I am a bit like Joe in above comment. I am 65 and have always enjoyed walking a mile 4-6 times a week since I live near a walking trail. Last year I had stress fractures in my foot and had to wear a walking boot for 8 weeks. The bad part was it took 4 doctor visits and about 7 weeks to diagnose. Then when my stress fractures healed—my foot still swelled and hurt every day. Back to an orthopedic doctor who finally decided to do an MRI and found I had 3 partially torn tendons, a severe bunion, and tendonitis. They prescribed physical therapy and orthotics for shoes. They said I needed surgery but it might not heal correctly. After all it had been 5 months since the original injury. I opted for an ankle brace. Nothing has helped my foot. And now I have developed osteoarthritis in my knees and need the cocks-comb injections to build up cartilage. So I haven’t walked the track in about 1 1/2 years, my sugar is up and so’s my weight. I still work every day but I can’t seem to find much exercise to do in my chair. I, too, would love to walk but just can’t.

    Posted by Linda Martin |
  4. It really is discouraging when you can’t walk!! Been there and found it really depressing. I have seen some videos for chair exercise routines though that might be fun, especially with some motivating music you like. I hope you can find something Linda.

    Posted by BK CDE |

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Exercise
BMX Camp for Kids With Type 1 Diabetes (07/31/14)
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2013 Conference on Diabetes and Exercise Available Online (12/05/13)

 

 

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