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Diabetes, Exercise and Caregiving

The benefits of exercise for people with diabetes can be quite substantial. With both forms of diabetes, type 1 and type 2 (insulin dependent and non-insulin dependent respectively), exercise can play a vital role in the prevention of costly, uncomfortable and sometimes fatal complications.

First, exercise can help control blood glucose and insulin sensitivity. In type 2 patients, consistent exercise can completely control glucose and carbohydrate metabolism. Many people are concerned that since type 2 runs in their family, they will inevitably get it as well. Regular exercise can protect you from ever developing this common metabolic disease by helping to fight insulin resistance and obesity. While complete glycemic control in Type 1 patients is not possible, and insulin must still be utilized, they can often decrease the amount used.
A second reason for exercise is the prevention of coronary problems.

Cardiovascular disease is the leading cause of death for people with diabetes. Regular exercise can improve heart and lung function, cholesterol, blood pressure, and help improve circulation, especially vital in diabetic trainees. (KATE what is a diabetic trainee?)

Special care needs to be taken when designing an exercise program for the person with diabetes. First and foremost, consult your clients’ physician for an examination. Special attention will be given to heart, blood vessels, eyes, kidneys and nervous system. A foot examination will also be needed as many patients experience loss of the protective sensations in the feet. Often times, the primary caregiver will be asked to perform regular foot exams for sores and blisters. If your loved one does not have a problem with mobility, you may be asked to help make selections in quality athletic shoes and socks as well. Comfort and fit, not style is what matters. Foot care is of paramount concern in active diabetics.

Cardiovascular training should be the foundation of the exercise program. Aim for at least 20 minutes of sustained activity three to five days per week. If one suffers from loss of sensitivity in the feet, avoid exercises such as prolonged walking, jogging or step exercises. Better choices for cardiovascular exercise would be swimming, bicycling, rowing, chair exercises and other non-weight bearing activities. Fluid intake is important during exercise, and especially so with cardiovascular activity and the diabetic exerciser. Consider a high-glucose sports drink like Gatorade or fruit juices over water, which can help keep blood sugar from going too low. Drink fluid before, during and after exercise.

Resistance training has been shown an effective way to help promote circulation and control obesity in people with diabetes. Care should be taken to avoid strenuous, heavy lifting; especially in individuals who suffer from diabetic retinopathy complications. Find a comfortable weight with which one can perform two to three sets of 10-12 repetitions with good form. If the exercise form on lifts gets “sloppy”, go down in weight. Stress the fact to your client that form is always more important than how much weight one can lift.

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