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Accessible Exercise and Recreation

by Andrew Leibs

Getting regular physical activity can be a difficult part of managing diabetes, especially if you are more used to being sedentary. Making the effort to be active is worth it, however, because exercise can improve the body’s sensitivity to insulin in people with either Type 1 or Type 2 diabetes. This can translate into better blood glucose control and possibly into a need for less insulin or oral diabetes drugs.

If you have a physical disability or limited mobility because of your diabetes (or any other reason), however, starting and maintaining a physical activity routine can seem daunting. Fortunately, a boom in accessible recreation has provided opportunities for exercise and enjoying the outdoors that can make living an active life easier and more fun for people with limited physical abilities.

A few factors have led to this growth. First, the Americans With Disabilities Act, passed in 1990, implemented specific rules that have made places like pools, parks, and gyms (both public and private) more accessible. It has also undoubtedly sparked a wider “inclusion-consciousness.” As a result, programs like Wounded Warriors — which teaches disabled US veterans adaptive skiing, cycling, and other forms of recreation —have been created in the wakes of the conflicts in Afghanistan and Iraq. Growth of the Paralympics (“para” for parallel), which brought 4,000 disabled athletes to Beijing in 2008, has created an expanding industry of adaptive products, athletic programs, and opportunities for recreation and competition that can accommodate any number of physical limitations.

This article profiles 10 types of recreation that are either accessible to or adaptable for people with a variety of mobility impairments.

Getting started
When starting a new activity program, your first stop should be your health-care provider’s office. The American Diabetes Association recommends that most people with diabetes have a medical exam that screens for the presence of uncontrolled high blood pressure as well as any diabetes-related complications such as diabetic retinopathy (eye disease) and neuropathy (nerve damage) before beginning an exercise program. This is especially important if you are over 35, have Type 2 diabetes, or have had Type 1 diabetes for more than 15 years. If you have any complications, your health-care provider may advise against certain types of activities.

While you’re having your exam, ask your doctor about preventing and treating hypoglycemia (low blood glucose) while being active. If you take insulin or oral pills that cause your pancreas to release more insulin, you will most likely be advised to eat or drink some carbohydrate before exercising if your blood glucose is lower than 100 mg/dl. You should also anticipate the need to consume at least 15 grams of carbohydrate for each 20–30 minutes of moderate-intensity activity to avoid hypoglycemia during exercise.

Once you know what forms of exercise are safe for you and how to maintain blood glucose control during physical activity, it’s time to pick an activity. Think about which activities you enjoy, what would fit easily into your life, what you are able to do, and what kind of help you can get if you need it.

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