GETTING ACTIVE - DIABETES CANADA

Missed 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:

Biking
Walking
Light Calisthenics
Yoga

Moderate Intensity Sports:

Shooting Baskets
Ballroom/Line/Square Dancing
Golf
Volleyball
Juggling
Curling
Fencing
Archery

Moderate Intensity Playing:

Throwing a frisbee
Swimming recreationally at the pool
Dancing around
Jumping on a trampoline
Climbing on playground
Tetherball

Moderate Intensity Outdoor Activities:

Hiking downhill
Downhill Skiing
Sailing
Kayaking/canoeing leisurely
Whitewater Rafting
Waterskiing
Paddle boating

Moderate Intensity Housework:

Vacuuming
Shovelling light snow
Raking the leaves
Carrying grocery bags
Weeding the garden
Scrubbing the floor or bathtub

Moderate Intensity Work:

Cleaning
Carrying boxes
Extended periods of walking
Cleaning

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)
Running/Jogging
Circuit Weight Training
Swimming Lengths
Rowing Machine

Vigorous Intensity Sports:

Basketball/Wheelchair basketball
Football
Soccer
Kickball
Handball
Beach Volleyball
Hockey
Karate, Tae kwon do, Judo, Jujitsu

Vigorous Intensity Playing:

Jumping Rope
Sledding/ Tobogganing
Wrestling
Skipping
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
Yoga
Heavy Gardening or Moving heavy boxes
Dancing
Lifting Weights
Resistance Bands
Biking
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

Hypoglycemia

(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:

Shakiness
Weakness
Abnormal sweating
Nervousness
Anxiety
Tingling of mouth and fingers
Hunger

Hyperglycemia

(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
Fatigue
Weakness
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

Weight Shifting

Quarter Squats

Seated Marching

Knee Extensions

Wall Push Ups

Wall Push Ups

Putting things into the trunk

Counter Walks

Putting things away on the shelves

Rows

Banded Rows

Pull Aparts

Picking up laundry basket

Bicep Curls

Lunge / Split Squat

Lowering yourself to the ground

Single Leg Deadlift

Golfer’s Pick Up

Deadlifts

Bending down to tie shoelaces

Log Rolls

Getting in/out of bed

Glute Bridge

Glute Bridge

Hip extensions

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.