Diabetes Pharmacist : Diabetes Pharmacist Blog : Focus Express Mail Pharmacy : Insulin Pumps, Diabetes Supplies and Information

The Mercy Wound Healing and Hyperbaric Medicine Center, a National Healing Corporation Wound Healing Center, offers these exercise tips:

• Before starting an exercise program, talk with your health care professional regarding the presence of vascular complications that could worsen with exercise and orthopedic or musculoskeletal conditions that may exempt certain exercises.

• Check your blood glucose before and after exercise to learn how your body responds. Those at risk for low blood glucose should have a source of carbohydrates nearby while exercising.

• Since dehydration is often an issue with diabetes, it is important to drink water early and frequently when exercising.

• For diabetics with reduced sensation, prolonged walking, jogging, using a treadmill and step exercises are not recommended. Instead, try swimming, bicycling, rowing, chair and arm exercises and other non-weight bearing activities.

• Proper footwear is essential. The use of silica gel or air midsoles as well as polyester or cotton/polyester socks will help prevent blisters and keep feet dry.

• The American College of Sports Medicine has demonstrated that resistance training can improve insulin sensitivity to about the same extent as aerobic exercise. The American Diabetes Association recommends that exercising with weights is acceptable for younger individuals but not recommended for older people with long-standing diabetes.

• There are many ways to increase physical activity besides formal exercise, such as: gardening, housecleaning and even marching in place or walking around the house during TV commercial breaks.

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In a new study, Dr. C. Ronald Kahn of the Joslin Diabetes Center and Harvard Medical School in Boston says,"If you are exercising, in part, to reduce diabetes risk, you shouldn't take anti-oxidant vitamins C and E."

Kahn says that part of the reason that exercise improves insulin sensitivity is that it causes oxidative stress on the muscles but when you block the oxidative stress response (with Vitamins C and E), you also block the beneficial effects of exercise on insulin sensitivity.

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People with type 2 diabetes developed better blood sugar control if they combined aerobic exercise with lifting weights, according to a recent Canadian study. Researchers split participants into four groups:

• Aerobic exercise only
• Resistance training only
• Aerobic exercise and resistance training
• No assigned excercise

After 22 weeks, hemoglobin A1c levels improved for all three exercise groups but those who got aerobic exercise and also lifted weights had the biggest improvement. There was no improvement in the non-exercise group. An editorial published with the study in the Annals of Internal Medicine says "Doctors should prescribe exercise to all type 2 diabetes patients who are healthy enough to work out".

 Photo courtesy of New York Times 

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My dad (Big Irv or Itzi),who will be a healthy 84 this summer, has always said that " a brisk walk is the best exercise for everyone and anyone." After a "heart scare" in his late 30's, he began to walk every night, usually with my brother and me, and it was amazing how much weight we lost and how much better we all felt. We walked in the heat and in the cold. We talked about our beloved Phillies and listened to their games on a transistor radio in the Summer and we threw snowballs at STOP signs and fire hydrants in the Winter. And we walked the same route almost every night-once or twice around the cemetery up the street- which was 1 to 2 miles. And we always felt GREAT when we arrived home.

Now researchers at Stanford University have discovered why. They say that walking, probably the safest form of exercise, has a positive impact on weight, blood pressure, risk of stroke, muscle mass, and flexibility. Additionally. the study’s lead author, Dena Bravata, M.D., stated that participants who wore pedometers-a small device that clips on to your waistband or a pocket and measures how far you walk in steps or miles- increased their overall physical activity by 27 percent!  When used properly, pedometers can have significant health benefits," states Michael See, Exercise Physiologist at the Joslin Diabetes Center, clinical partner of Beth Israel Deaconess Medical Center.

Exercise has been shown to lower blood glucose in people with diabetes, but make sure that you consume fifteen grams of carbohydrate  for every 35 minutes of activity to avoid low blood glucose episodes. This means that it’s crucial to carry at least one snack with the appropriate carbohydrate content.

My dad, who still likes to walk when his knee isn't bothering him, also says that all diets are about one thing: "Burn up more calories than you take in." We'll discuss that at another time.

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Focus Express Mail Pharmacy Inc. of Horsham,PA  donated more than $25,000 in pedometers, educational materials, programs, and grant money to the Haverford School District elementary schools to kick off Peds for Prevention, a program to increase children's physical activity and healthy food choices. Each elementary school participated in a walking program sponsored by the company and raised money for the district's Education Foundation. Focus Express also donated $3,000 for health and wellness initiatives to the three top performing schools.

Pictured above, walking the final 2000 Steps on April 26, 2008 in foreground are Greg Vitali (PA State Representative), Nick Braccia (Focus President), Ellen Fisher (President of The Haverford Township School District Education Foundation) and Joel Shpigel R.Ph.  (Focus CEO)   along with the hundreds of children and parents who participated.

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 It seems like everyone I know goes to a gym or participates in some type of regular exercise program. For most of us, that just means doing a little stretching and then off you go to the weight room,  treadmill,  elliptical etc. But for those people with diabetes, a lot of thought and preparation should be done before exercising. Exercise will lower blood sugar, and since insulin is more effective during exercise, a dangerous drop in blood sugar can occur.

The University of Michigan Health System offers these tips for people with diabetes to maintain healthy blood sugar levels when exercising:

1. Check your blood sugar before and after exercise -- and during if you can -- and record your results.
2. If you are going to exercise strenuously, make sure you eat a meal first.
3. Keep snacks -- especially some with sugar -- on hand when you exercise.
4. Talk to your doctor about possibly adjusting your insulin dose for exercise.
5. Don't inject insulin into a part of the body that will be strenuously used during exercise, as it will absorb more quickly. For example, if you will run, inject your abdomen instead of your leg.

And here's a tip from me: if you're just starting to exercise, don't overdo it. Gradually increase your time on cardio equipment and gradually increase your weights for weight training. Good Luck!

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According to Dr. Gabe Mirkin, exercise helps to prevent and treat diabetes by increasing the number of enzymes that transport fat from fat cells to muscle cells where it can be used for energy by the muscles. Before insulin can do its job of removing sugar from the bloodstream and putting it into cells where it can be burned for energy, it must first,,MORE

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