Helping someone with diabetes get started exercising
It isn't always easy to convince someone with Type 2 diabetes that exercise plays a key role in controlling this chronic condition and keeping serious complications at bay. In fact, exercise is the most underused way to keep the disease in check, say many diabetes educators. And maybe the person you're concerned about has never exercised a day in her adult life or scoffs at the notion that being active could make a difference. What's the best way to help her get moving?
First, get the doctor's green light.
If the person you're caring for is new to exercise, make sure she gets the OK from her primary healthcare provider. Suggest that you both meet with her doctor to discuss any health concerns she may have. If she has diabetes-related complications, such as a heart condition or foot problems, her physician will take that into account when considering an exercise program. Ask the doctor about safety issues, such as whether she should wear a medical I.D. tag when exercising.
Seek expert advice.
Once the doctor has given the OK, if the person you're caring for has diabetes-related mobility issues, you may want to begin by getting professional help. A licensed exercise physiologist can help her plan a safe, effective exercise program. Her certified diabetes educator may have advice about exercise-related issues. A licensed physical therapist is also trained to help people prevent injuries, stay fit, and deal with any disabilities from chronic diseases such as diabetes. Look for a physical therapist who has experience working with older adults. To locate one in the area, visit the American Physical Therapy Association’s database .
If the person you're caring for hasn't been active in the past, she needs to start slowly, to prevent injury from overdoing it. Doing a modest amount of activity, say 10 to 15 minutes at one time, a few times a week, will allow her body to get used to moving more. Encourage her to warm up first and stretch afterward to avoid stiffness and injury. Ideally, she should be active for about 30 minutes a day, but she'll need to work up to it -- and she doesn't have to do all the exercise at once. It's just as beneficial to fit in 10-minute spurts of activity three times a day as it is to do it all in one 30-minute session. If she's already active, she can work up from, say, walking on a flat surface for 20 minutes a day to tackling inclines and picking up the pace for a longer period of time.
Accentuate the positive.
Remind her that being active offers benefits beyond keeping diabetes under control. It can lift spirits, relieve stress and anxiety, increase energy, and help her sleep better.
In addition, exercise has specific benefits for people with diabetes. It helps with weight control and improves circulation and glucose, blood pressure, and cholesterol levels. For some people, regular exercise may reduce the need for certain medications or lower the dosage needed.
Help her play safe.
Suggest that she wear loose, comfortable clothing when exercising. People with diabetes need to pay particular attention to their feet to avoid infection from sores and cuts, so remind her to check her feet for any damage, such as blisters, after she's worked out. Take her shopping for well-fitting, sturdy athletic shoes and socks that cushion the foot.
She should also learn her blood glucose response to exercise, which differs for every person. It's wise for her to check her blood glucose before exercise, immediately following it, and a few hours later if she's engaged in more vigorous activity than normal.
During exercise, symptoms such as nervousness, shakiness, sweating, or hunger could indicate low blood sugar. She should keep glucose tablets or a fruit juice box on hand in case her blood sugar drops significantly. She should also discuss any concerns about blood glucose, activity, and medication dosages with her doctor.
How to keep someone with diabetes motivated to exercise
Call it activity rather than exercise.
Help her find a physical activity she likes to do -- and that gets her moving -- as she's more likely to stick with one she enjoys than one that feels like a chore. Walking is an excellent activity for beginners as well as folks who are already active. It's also a good choice if excess weight rules out some other forms of exercise. Look for ways for her to work her chosen activities into her life so they become a routine. That may mean walking in the morning, taking a sociable aqua-aerobic class at the local pool in the afternoon, or even scheduling a treadmill workout around a favorite TV show.
Mix it up.
It's wise for the person you're caring for to get a mix of exercise during the course of a week. Ideally, she should do an activity that helps burn calories and glucose, works muscles, and increases heart rate, such as walking, tennis, or dancing, at least a few times a week. She could also try a low-impact workout such as swimming or stationary biking. Whichever kind of workout she chooses, she should also do strength-building exercises that help build muscle and maintain bone density, like weight training, either using machines or light weights at a local gym or lifting, for example, canned foods at home a couple of times a week. She should include some flexibility exercises, such as gentle stretching or yoga, in her routine as well. If mobility is an issue, resistance and flexibility exercises can be done from a chair.
Find a partner or a program.
It's more fun and motivating to work out with a friend. So encourage the person you're caring for to find a friend who'll play golf or tennis, go for a walk, or take a low-impact exercise class. Look in her community for activities geared toward older adults, such as a mall-walking club, a senior center yoga class, or a group exercise program at local fitness centers like Silver Sneakers .
Take it indoors when the weather is bad.
If her exercise revolves around getting out in good weather, help her come up with an indoor backup plan when bad weather prevails. Such alternatives include stationary bikes or treadmills, dance or yoga class, or mall walking. Home exercise videos or DVDs are another option. Popular workouts for homebound older adults include: Stronger Seniors , Yoga for the Young at Heart , and the Sit and Be Fit public television series .
Be a role model.
You can help model ways to be more active on a day-to-day basis. When taking her to a doctor's appointment, park a few blocks from the office to get a short walk in before the visit. She may burn even more calories from unstructured activities than from any formal exercise regimen, so when you're with her suggest taking the stairs instead of an elevator. Take a hike, go bowling, or garden together. Your own children can be great playmates, so encourage her to play with them.
It's motivating for someone with diabetes to actually notice her own progress. A novel way for her to keep track of her activity: Invest in an inexpensive pedometer (under $20), a simple gadget that counts how many steps a person takes. The American Diabetes Association is one online source for such a tool . The National Institutes of Health offers other low-tech ways for people to gauge improvements in their physical conditioning .