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Health & Exercise Forum

Living With Diabetes: Definition, Causes, Treatment, and Exercise - Part 2

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May 7, 2009

Dr. Mackarey's Health & Exercise Forum(This is the second in a series of 2 articles related to diabetes:
Definition/Causes; Treatment/Exercise)

Exercise and Diabetes

Exercise is a critical component of diabetes management. Studies show that pre-diabetics and type 2 diabetics can prevent or reverse their condition through diet and exercise. However, it is important that you do not jump into an extreme diet or exercise program without proper professional medical advice. Your program will be based on the extent of your diabetes: the condition of your heart, lungs, blood vessels, eyes, kidneys, feet and nervous system. While some people who are very deconditoned and have advanced disease must exercise carefully, others may be capable of a more advanced and strenuous program.

10 Tips for Health & Exercise With Diabetes

(According to Prevention Magazine and ADA)

  • Keep Weight Under Control – why most people exercise
  • Control Blood Sugar – diabetics should exercise to reduce risk of complications such as nerve and eye damage by controlling blood sugar
  • Improve Heart Function & Bloodflow – critical to improve bloodflow to the distal extremities, especially the feet
  • Check Blood Sugar -
    • <100mg/dl = eat a carb (banana or whole wheat bagel)
    • between 250-300mg/dl = test for ketones, if + DO NOT EXERCISE
    • >300mg/dl = DO NOT EXERCISE
  • Inject in the Abdomen – better with exercise because it will prevent difficulty with absorption better than arms or legs
  • Recognize Warning Signs – If you get dizzy, faint, confused STOP – have OJ, nondiet soda or glucose tablets. It is possible to experience an insulin reaction during or up to 12 hours following exercise.
  • Drink Water – drink before, during and after exercise because dehydration can raise blood sugar
  • Identity Bracelet – ID with medical info is essential if you are exercising alone
  • Foot Check – diabetics often have poor sensation in their feet. You must check for areas of redness, soreness, blisters and skin breakdown after exercise. Wear properly fitted shoes.
  • Eye Check – if you have retinopathy avoid significant elevation of blood pressure such as heavy weight lifting, upside-down positions such as yoga or inverted traction.

Maintain Fitness Level

As little as 10 extra pounds is unhealthy if you are a diabetic. It also makes it more difficult to maintain a good fitness and activity level. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of complications associated with diabetes.

Aerobic exercise will help promote weight loss or prevent weight gain and cardiovascular disease. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. If you walk or stand most of the day, wear good shoes that fit well. Avoid high heels and shoes without adequate support like sandals.

Weight Training

Performed 2-3 times per week, 20-30 repetitions with light weights through full range of motion. Avoid spinal loading from overhead lifting such as military or overhead press.

Upper Body

  • Bicep Curls – 1 arm at a time with a dumbbell – bend elbow
  • Tricep Extention – lying on back and extend elbow
  • Chest Press – lying on back with dumbbell and extent arm up
  • Shrug – stand with dumbbell in each hand at side and shrug shoulders
  • Shoulder Fly – stand with dumbbell in each hand and raise arm up like a wing to 45 degrees.
  • Rows – stand with theraband in hands and pull like rowing a boat
  • Lats – stand with theraband in hands and pull like sawing wood
  • Shoulder External and Internal Rotation – stand with theraband in one hand and turn arm out against resistance. Repeat turning arm in.
  • Wrist Curls – elbow bent, dumbbell in hand bring wrist up and down and turn palm up and down
  • Grip exercises – squeeze ball or gripper

Lower Body

  • Leg Extension – sit in chair and extend leg up with sandbag weight on ankle
  • Leg Curl – stand and hold onto countertop and bend knee up with sandbag weight on ankle.
  • Calf Raise – stand and hold onto countertop and raise body up on toes
  • Step-Ups – step up  4 to 6 inch step and lower down
  • Wall-Slide – stand with back against wall and slide back up and down wall while bending and extending knees to a 45 degree angle

Aerobic Exercises

3-4 times per week for 30-45 minutes at moderate intensity. Treadmill, bike, recumbent bike, elliptical, walk, cross-country ski.

Core Lumbar Stabilization Exercises

Abdominal Strengthening sitting on balance ball while doing bicep curls, shrugs, rows, lats, and leg extension. Contract abdominal muscles and keep balance with using arms and legs.

**This column is based on information from local physicians Kenneth Rudolph, MD, Gregory Borowski, MD and the American Diabetes Association.

Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.