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Life Can Still Be Enjoyable!
Even in modern societies today there are many diabetics who are never taught that life can be normal with diabetes. They never learn how to live with their diabetes. And so they suffer with poorly controlled diabetes for years before anyone ever tells them the benefits of exercise.
At 19, Jeanette has only begun to learn how valuable exercise can really be. She has been an insulin-dependent diabetic since she was five—poorly controlled through all of her teenage years. It was only a year ago that someone finally told her about the importance of exercise.
Although every day has been a challenge in her efforts to learn to manage her diabetes, Jeanette feels that the progress has been tremendous. With regular exercise, she has been able to
greatly reduce the amount of insulin she needs. When asked if she had any advice for other diabetics, Jeanette’s answer was brief but emphatic, “Exercise. Be sure to exercise!”
Unfortunately, many insulin-dependent diabetics are afraid to exercise. They fear it will throw their diabetes out of control. But, as one young diabetic advises, “Don’t be afraid to try!” Even though she still struggles with her limitations, she says, “Remember that other people have limits, too, and other people get tired too. It’s not just because you’re diabetic.”
Don’t think of diabetes as a handicap, suggests a 17-year-old girl who has been taking insulin since she was nine. Just accept diabetes as a part of you—as something that is as much a part of you as your knees!
My friend Steven Lee takes his diabetes as a routine part of his life. “It’s probably made me a lot healthier than I’ve ever been. You realize, like anyone would in a tragic situation, that there’s more to life. I see life beautifully—I just love every day. At the same time, it makes you eat healthfully; it makes you exercise. I don’t see diabetes as a hindrance in any way at all anymore. Neither does my brother, even though he has the extremes,” “But he’s just such an extreme person, that’s why it happens,” Steven says in explaining why Roger frequently has hypoglycemic reactions.
Unlike his brother, Steven leads a relatively calm, quiet life, sitting at a desk every day and drawing building plans. But exercise is an important part of his life, too. Every evening—without fail—Steven does 75 push-ups. “But that’s not the type of exercise you need,” he comments. “You need to keep your circulatory system moving. Especially in your extremities, you need to keep you blood flowing. You need to keep those veins and capillaries open so that you don’t lose your feet.” And so, three times a week, he does go out for more vigorous exercise.
But Steven’s favorite exercise comes on those weekends when he goes out backpacking in the hills and mountains. His first backpacking trip was when he was 23—only four months after he was diagnosed as having insulin-dependent diabetes. “I definitely learned a few things on that trip!” Steven exclaims.
Although he cannot go hiking now as often as he once did, Steven used to hike between 800 and 1,300 kilometers each year. Many of those hikes were to isolated locations 80 kilometers from the nearest town! But never once did he have a serious problem.
Maybe part of the fun of hiking is that Steven gets to do things he cannot normally do…”like drinking real soft drinks instead of diet drinks, eating those energy bars and stuff like that. Usually that would send my sugar right through the roof, but when you’re doing something that extreme you are allowed to eat things you definitely could not eat at home.”
To Steven, the most important thing is “You have to understand your own body.” Extremely valuable advice that is—for any diabetic. If you know your own body and how it responds to foods, medicines and exercise, you can make the necessary adjustments. And then life can be beautiful and you can love every day like Steven does.
Something that Steven and many other diabetics like him have realized is that for safe exercise, the diabetic especially needs an extra amount of good nutritious food for fuel.
Steven’s brother, Roger, could have better control of his diabetes if he would always remember to “refuel” at the right times. So far, Roger has never had a hypoglycemic reaction on the soccer field, but he does have a mild hypoglycemic reaction at home after a game almost once in every two weeks. And he has gone to the hospital a few times.
As Steven describes it, “He’ll have a 110 blood sugar and he’ll drop down to 20 because he has used up everything. And his system is running so fast that it just runs out—whoooosh!—just like a car dies when it runs out of gas!”
That’s exactly what happens. Just as a car quits running if it runs out of gasoline the body also slows down to a halt if it runs out of its fuel—glucose.
A hypoglycemic reaction sometimes occurs during the actual exercise time. Or it may occur several hours later—or even the next day.
Preventing Hypoglycemia
To avoid a hypoglycemic reaction during exercise, most diabetics need to have a snack before the exercise begins. Anyone who is prone to hypoglycemia should take a snack about 15 to 30 minutes before exercise.
Every person’s need is different, and each individual needs to become acquainted with his own body and how it reacts to exercise. There are some general guidelines, however, which may be useful in deciding whether or not to snack, what to eat, and how much to eat before exercise:
*If your blood glucose level is less than 100 mg/dl before exercise, you should take a snack.
*If your blood glucose level is between 100 and 150 mg/dl, go ahead and exercise, then snack afterwards if you need.
*If your blood glucose level is 250-300 above, you should test your urine for ketones. If there are ketones in the urine, you shouldn’t exercise until your urine no longer shows ketones in it.
*If you need a snack before exercise, snacks can contain 10-15 grams of carbohydrate should be adequate for the first hour of moderate exercise such as swimming, tennis, jogging or cycling. For each additional hour of planned exercise, a person should add an extra 10-15 grams of carbohydrate snack. For intense physical exercise, you may need to snack every 30 minutes.
*For prolonged heavy exercise, such as a marathon or a long hike, it may also be necessary to reduce the amount of insulin you take.
*Good snacks are not sugary sweets but rather foods which are nutritious and have complex carbohydrates. Some examples of good, healthful pre-exercise snack foods are crackers (biscuits), dried fruit, granola bars, or fresh fruits such as apples, peaches, plums, pears.
*After exercise, you should take some carbohydrate within two hours—preferablY within 20 minutes. Continue to monitor your blood glucose level for several hours after exercise.
Heavy exercise in the evening may make it necessary to eat a full meal late at night to prevent a reaction during the hours of sleep. Exercise increases the body’s metabolism for as much as 12 hours, so it is important to monitor carefully.
Exercise Precautions
Although exercise is almost always beneficial, there are times when it may not be wise, so just a few words of caution are in order here.
*If you are over 35 or have some health problem and have not been exercising, you should see your doctor for a good physical checkup before starting on a new exercise program. It is important to know that your heart is in good condition before subjecting it to the stress and strain of vigorous exercise.
If you have problems such as high blood pressure, the doctor will probably advise starting out more slowly. If you are on insulin or other medications, the doctor will also need to work with you on regulating and adjusting the amount of medicine you need to take.
*If you have not been exercising for a long time, begin slowly then gradually build up to your ideal amount of exercise.
*Exercise at the same time every day. Diabetes control is much easier if you are in a routine, with your meals, injections, and exercise all scheduled and carried out at nearly the same time each day.
*Inject insulin into areas which you don’t use when you exercise. If the insulin is injected into the thighs before you go out jogging, that insulin will be absorbed into the bloodstream more quickly because the legs are active. It is better to inject the insulin into the abdomen before exercise sessions.
*Avid exercising at the time when your insulin should be having its maximum effect. Different types of insulin have different peak-action times. Exercise should be done well before the peak time of your particular type of insulin. Otherwise, both the insulin and the exercise will be bringing down the blood glucose level at the same time, more likely resulting in a hypoglycemic reaction.
*Know your body, and know your early warning signals of hypoglycemia. Although there are many common signs and symptoms of oncoming hypoglycemia, every person has his own “usual” danger signals. One may feel a tingling sensation in his forehead; another gets a headache. Others simply begin to feel very hungry. Never ignore those warning signs!
*Always carry along an emergency source of energy—candies, raisins or other dried fruits, glucose tablets, or other quick sugar supply. And teach others how to care for you in case you have a more serious reaction and are unable to care for yourself.
*Be safe. Never swim alone—good advice for anyone, but especially for the diabetic. Exercise with someone else if you are prone to hypoglycemic reactions.
*Test your blood sugar level before beginning your exercise session. As mentioned earlier, a person should not exercise when the blood sugar is out of control. If the blood glucose is more than 300 mg/dl (1.6 mmol/l), exercise may actually cause the blood sugar to go even higher.
*Check your feet before, during and after exercise to be sure that there are no injuries. Be sure to use proper shoes which give good support but do not rub and cause pressure or blisters.
Keep Fit and Enjoy Life!
A newspaper said that British scientists predict that the average life expectancy could become 115 years—if people would adapt a healthy lifestyle. That healthy lifestyle naturally must include good exercise.
Well, maybe you and I won’t quite make it to 115. But we can extend our lives and improve the quality of life if we exercise some each day. So choose something you enjoy, and get out there today for the first day of your longer, healthier life!
THE DIABETIC’S ABCs OF EXERCISE
Exercise Should Be….
Aerobic—causing you to breathe in more oxygen
Balanced with good diet and adequate insulin
Continuous—keep moving during your whole exercise time unless you must stop to rest to intermittent claudication cramps to go away
Doctor-approved if you’re over 40 or have a health problem
Enjoyable—do something you like!
Friendly to your feet—wear good-fitting shoes and check your feet regularly
Gradual and progressive—start with a little, then push yourself to do a little more each time until you have reached your ideal endurance level
Habitual and frequent—at least three to five times a week
Intense enough for you to reach your target heart rate
Judiciously and sensibly planned for your own body’s needs
Kept safe—go with someone, or at least let someone know where you’re going and when you expect to return; have a snack handy, and eat it if you begin to need it
Left off temporarily if your blood glucose level is too high or if you are sick
Maintained for at least 20-40 minutes each time
Nonlife-threatening in case of a hypoglycemic reaction during exercise.
Outdoors in the fresh air if possible
Persistently and regularly done—don’t let the pressures of work stop you from exercising
Quality and quantity to improve your general fitness
Rhythmical—so that your muscles contract and relax in a rhythmic pattern, as in walking jogging, swimming, cycling, etc.
Stress—relieving and relaxing
Timed to coincide with a rising blood sugar level, not during peak insulin action time
Unspoiled by hypoglycemic reactions—know your body
Vigorous and energetic
Written into your log book, along with other important information on your food and insulin
eXhilarating, refreshing and stimulating as your body releases endorphins—the happy hormones
Your own pace—not someone else’s speed
Zealously done each day, giving you zest and enthusiasm for life!