GETTING ACTIVE - DIABETES CANADAMissed our presentation? Find all the information you need about exercising with diabetes and how to get started below!
How much exercise do we need?
To achieve optimal health benefits current guidelines recommend 150-300 minutes of moderate intensity physical activity or about half that amount if it’s more vigorous per week. This is in addition to strengthening activities 2 or more days per week. We know most of you are just getting started with exercising, this can be an excellent long term goal for healthy individuals, those with diabetes type 1, type 2 and even gestational diabetes.
To achieve optimal health benefits, an ideal goal will be to reach 150 mins. per week. So that’s going to be:
– 30 min., 5 days per week or a little over 20 mins. per day each week
– 2+ days per week of muscle strengthening
Remember, it’s the total amount of activity that counts. Activities that meet the definition of moderate to vigorous intensity can include structured exercise if that is what you enjoy. However, your 150 minutes of activity can also be accomplished by doing what we like to call “NEAT” things.
NEAT is non-exercise activity thermogenesis. This encompasses all the little movements you do in the day that are not meant as exercise such as grocery shopping, dishes, taking transit to work, tidying up.
Even accumulation of low intensity NEAT physical activity can increase benefits. While these movements may not make as big a difference as moderate to vigorous physical activity (MVPA), it has been shown that increases in NEAT and decreased sedentary time can still benefit our health. So, if you are nervous about getting started with more activity or trying out more structured physical activity, start by increasing your NEAT. Accumulate 10 minutes at a time for more health benefits.
Aerobic Physical Activity
Aerobic activity indicates training cardiovascular fitness, AKA “Cardio”. Cardio has been found to be beneficial in bouts of 10 minutes at a time. Cardio includes repetitive movement of large muscle groups.
Aerobic Training Benefits:
– Reductions in Cardiovascular disease (CVD) and overall mortality.
– Slows development of peripheral neuropathy (numbness in the limbs)
– Cardio training such as walking, running, biking or dancing can improve your blood sugar efficiency
– Perhaps one of the most common benefits, is that it can help you lose weight
– Interesting fact, going from completely inactive to achieving 150 minutes of moderate to vigorous aerobic exercise per week is associated with decreased incidence of Type 2 diabetes by 26%
What is Moderate to Vigorous Physical Activity?
In most physical activity guidelines, you will find the term moderate to vigorous physical activity. These indicate specific levels of intensity for movement to allow people to achieve health benefits. Here is what these activity levels may look like:
Examples of Moderate Intensity Physical Activity
Moderate physical activity is an activity where you would feel a faster heartbeat and a warmer body temperature. However, breathing and talking would still be comfortable.
Moderate Intensity Exercise:
- Light Calisthenics
Moderate Intensity Sports:
- Shooting Baskets
- Ballroom/Line/Square Dancing
Moderate Intensity Playing:
- Throwing a frisbee
- Swimming recreationally at the pool
- Dancing around
- Jumping on a trampoline
- Climbing on playground
Moderate Intensity Outdoor Activities:
- Hiking downhill
- Downhill Skiing
- Kayaking/canoeing leisurely
- Whitewater Rafting
- Paddle boating
Moderate Intensity Housework:
- Shovelling light snow
- Raking the leaves
- Carrying grocery bags
- Weeding the garden
- Scrubbing the floor or bathtub
Moderate Intensity Work:
- Carrying boxes
- Extended periods of walking
Examples of Vigorous Intensity Physical Activity
Vigorous physical activity is an activity where you would feel a substantial increase in heart beat, breathing and body temperature. It would be difficult to maintain conversation during these movements. *NOTE that people with diabetes who have not previously done vigorous intensity activity should consult a medical professional before starting.
Vigorous Intensity Exercise:
- Jumping Jacks
- Walking > 5 mph
- Biking >10 mph
- Calisthenics (eg. Push ups, pull ups)
- Circuit Weight Training
- Swimming Lengths
- Rowing Machine
Vigorous Intensity Sports:
- Basketball/Wheelchair basketball
- Beach Volleyball
- Karate, Tae kwon do, Judo, Jujitsu
Vigorous Intensity Playing:
- Jumping Rope
- Sledding/ Tobogganing
- Playing a heavy musical instrument while in marching band
Vigorous Intensity Outdoor Activities:
- Canoeing or Rowing > 4mph
- Cross-country Skiing
- Hiking Uphill/Backpacking
- Rock Climbing
- Scuba Diving
Vigorous Intensity Housework:
- Carrying grocery bags or children while traveling up stairs
- Shovelling heavy snow
- Pushing non-motorized lawn mower
- Moving Furniture
Muscle Strengthening Activities
Muscle strengthening involves exercising your major muscle groups such as your legs, trunk and arms. This means applying enough load to your muscles and bones to improve strength. In order to increase strength, we must apply something called progressive overload. This means to progressively increase the difficulty of the exercise. To make this less overwhelming, try starting with movements that incorporate several body parts. For example, a squat would be standing up from a chair. This movement includes the torso, thigh, bottocks and calves. Remember, to get the most health benefits, strength exercises need to be done 2 or more days per week.
Resistance Training Benefits
- Improves blood sugar efficiency
- Increases your strength
- Increases your lean muscle mass
- Increased bone density
- Prevents osteoporosis
- Resistance training exercise is also very beneficial for prevention and management of Type 2 diabetes
- Combined programs of aerobic and resistance training showed the best improvements in blood glucose measures
Examples of Muscle Strengthening Activities
- Bodyweight exercises
- Heavy Gardening or Moving heavy boxes
- Lifting Weights
- Resistance Bands
- Climbing stairs or walking uphill
Help yourself feel safe
1. Check with your doctor before starting program – especially if you have other health conditions (eg. CVD, CHF, previously sedentary, COPD, CKD).
2. For most people, benefits of exercise far outweigh risks. In fact, exercise can also help manage symptoms of OA, RA, fibromyalgia and other conditions that may seem limiting for exercise. Think about starting small and building up slowly. If you have decreased sensation to legs or feet, then try floor exercises or focus on the upper body. If you are nervous, overwhelmed or just want some guidance on getting started, seek help from a clinical exercise professional such as a kinesiologist or physiotherapist. Be sure to check if they have experience helping people with diabetes start an exercise program
3. The risk is much higher to stay sedentary.
4. Seek supervision when starting out – this could be from an exercise professional or finding a friend to workout with
5. Start small/slow – gradually increase, baby steps
6. If you have reduced or poor bone health, like people with osteoporosis for example – try floor exercises, chair yoga/chair strength training or water based exercises
7. Continually monitor blood sugar around exercise – learn how your body responds to it
8. Know the signs of hyper/hypoglycaemia
(low blood sugar: <70mg/dL or < 3.9mmol/L) is the most common concern for those exercising with diabetes. This can occur if a person has not eaten carbs* recently enough or their medication activity peaks during or after exercise. Low blood sugar can occur during or post exercise (immediately or up to 12 hours after). The risk is decreased by monitoring blood sugar levels. With practice, a person can optimize carb* intake timing and insulin timing with exercise to ensure safety. It is best to consume carbs* (up to 15g) when blood sugar levels are <5.6mmol/L.
- Risk can be reduced by consuming carbs* before and after exercise
- Performing resistance training before aerobic exercise can also decrease risk
- During exercise, it is best to keep glucose tablets on hand in case.
- Exercising with a partner can also increase safety
* for more information, take a look at pre-exercise blood sugar guidelines
Be aware of:
- Abnormal sweating
- Tingling of mouth and fingers
(high blood sugar: >300mg/dL or >16.7 mmol/L) can occur in people who do not have adequate blood sugar control. People may exercise with high blood sugar as long as they feel well, but should not do vigorous intensity exercise until blood sugar comes back into normal range. Blood sugar can temporarily increase with exercise as your body needs to send sugar to muscles for energy.
- People who have high blood sugar should be aware of their water intake as they will likely need to urinate more frequently. This is even more important during exercise as the body tries to get rid of excess heat through sweat.
- Do not workout in extreme heat as there is a higher risk adverse events
Be aware of:
- Frequent urination
- Increased thirst
- Acetone breath (breath smells like nail polish remover)
Let’s get started!
Usually at the end of my sessions working with patients, I will give them a little homework to get started.
Start walking 10-15 min a day x5 per week -> increase to 30 min (WEEKLY TOTAL: 50-150 min)
Try to keep things in perspective. We suggest these 8 exercises below, if you spend 1 minute on each exercise, that would be 8 minutes total. If you were able to do these twice a day, that would take your total up to 16 minutes, giving you a (WEEKLY TOTAL: 100-112 min), that’s a great place to get started if you’ve never exercised before.
Sit to Stands
Sit to Stands
Wall Push Ups
Wall Push Ups
Putting things into the trunk
Putting things away on the shelves
Picking up laundry basket
Lunge / Split Squat
Lowering yourself to the ground
Single Leg Deadlift
Golfer’s Pick Up
Bending down to tie shoelaces
Getting in/out of bed
Butt taps on wall
If what we’ve shown you here isn’t meaningful, then really it comes down to trying something else. It really has to have a meaning to you. What our main point is: sit less and move more, just try to get active.
Need help with proper form and technique? Starting exercising for the first time can be intimidating. Working with our kinesiologists will help you learn proper exercise progressions, and educate you so that you can start exercising on your own. Click here to book an appointment.
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