It's amazing how much time and effort we put into buying and remodeling the homes we live in and how little energy we devote to the care and maintenance of the "homes" of our spirits: namely, our physical bodies.
Since our bodies are indeed our temples, making major changes for a healthier lifestyle is well worth the time, planning and commitment. People with diabetes can attain their health potential with regular exercise, healthy eating, stress management and drug therapy. Keep in mind, permanent changes do not happen overnight; planning, hard work and regular maintenance are the key components to success.
The value of exercise
The message is clear: exercise should be as much a part of your day as taking your medicine. Confused? Not sure what type of exercise is best? How long and how hard to exercise? Much of the confusion can be eliminated by following this recommendation: Accumulate about 30 minutes of moderate physical activity every day. For some of us, "moderate" may be vacuuming the carpet, for others it may be gardening, or jogging a few miles. Accumulating means we do not have to do the entire 30 minutes of exercise at one time. Splitting up activity minutes throughout the day may be ideal for those who are out of shape or are extremely busy, while others may need to do it all at once.
Should you jump into an exercise program as soon as you read this article? Maybe; maybe not. For most, starting a low to moderate intensity exercise program carries few risks; for others the risks are high. The American College of Sports Medicine recommends that people who have (or are at risk of developing) coronary artery disease, should receive a medical examination and possibly a clinical exercise test before beginning an exercise program. Those at high risk include people over 30 with juvenile diabetes who have had the disease for more than 15 years and people who contracted diabetes over age 35. Before you start an exercise program, inform your healthcare team of your plans. Your doctor may recommend an exam and exercise test before you begin your exercise regimen.
If you have to wait for a scheduled exam before beginning your exercise program, use the time to learn more about exercise and diabetes. Like all other things you do, blood sugars will factor in the equation. Author Neil Gordon has written a practical, easy-to-read guidebook for the Cooper Clinic and Research Institute Fitness Series titled Diabetes: Your Complete Exercise Guide. Many journals and newsletters devoted to diabetes care have regular features on exercise, while on-line searches can provide information on the topics of exercise and diabetes (http://www.diabetes.org). Your healthcare team is another wonderful source of information concerning exercise. Your practitioner may recommend that you contact a physical therapist or exercise physiologist to help you get started on a safe program.
Physical benefits of exercise
The reason so much information is available on exercise lies in the numerous physiological benefits. Exercise decreases blood pressure, LDL-cholesterol (bad) and plasma triglycerides, while increasing HDL-cholesterol (good). Exercise also improves glucose metabolism and insulin resistance, helps with fat loss efforts and helps maintain normal weight, improves circulation (which helps with wound healing), improves functional capacity (increases endurance for everyday tasks), and increases bone density and muscle mass.
Mental benefits of exercise
Most people are aware of some of the physical benefits of exercise; however, they may not be as familiar with the mental benefits. For those who exercise regularly, it is probably the "mental" benefits that keep them committed to their routine. Ask people who exercise regularly why they get up early in the morning to exercise, or come home after a long day at work to hit the pavement for a daily run. Most likely they will tell you that exercise gives them renewed energy, makes them more alert and provides them with time to think over their problems and find solutions. They may even tell you that their well-being depends on exercise. But don't just take their word for it. Next time you have a nagging problem or you're in a blue mood, try a few minutes of easy exercise.
Exercise professionals have begun to tout the powerful benefits of exercise. The problems of the 90s are mostly stress-related: low energy, fatigue, deadlines. Exercise is a key solution to these problems because it elevates the mood, gets the creative juices flowing, increases alertness and vigor, and reduces tension in the body. Researchers have started to look at what types of exercise maximize the emotional benefits. Most agree that mild to moderate intensity activities such as cycling, swimming, walking and weight training provide the most benefits. It appears that the rhythmic nature of these activities helps induce a meditative state that brings about relaxation. Other exercises such as T'ai Chi and Yoga are becoming popular with people in search of the exercise mind-body connection.
Personal empowerment
Increasingly, exercise is being prescribed as part of a therapeutic approach to the treatment of mild to moderate anxiety disorders and depression. Patients experience an increased sense of self-worth and personal empowerment with regular exercise. This sense of empowerment helps diabetics take a more active role in the day-to-day management of their disease.
Physicians are getting into the act of promoting patient self-empowerment by initiating a new campaign called "Patient First." This is designed to help patients aim for intensive diabetes self-management. A contract is signed by both the patient and the physician, empowering the patient to better manage their condition with the help of their healthcare team. For more information, call 1-888/50-SUGAR or look up the web site: http://www.aace.com.
Conquering depression
How prevalent is depression in people with diabetes? Up to 40% of diabetics will have depression at some point in their lives, making depression more common in people with diabetes than in the general population. Why? Because diabetics deal daily with a problem that will not go away, often resulting in frustration, anger and depression. Diabetes requires the detailed and lifelong commitment of the patient for careful meal planning, daily insulin injections or oral medication, and making adjustments for exercise, stress or illness. Along with the daily worries of diabetes comes the real threat of devastating complications. Patients and families often feel overwhelmed and unable to adapt to the circumstances of their disease.
Mental health has taken its seat next to diet, exercise and drug therapy as a component of a healthy lifestyle for people with diabetes. Emotions not only affect blood sugars and blood pressures, they also play a vital role in the conscious and unconscious efforts to comply with a healthy regimen. The link between energy and mood is very tight, with blood sugar being at the forefront of mood control. Low blood sugars can make one irritable, moody and unable to concentrate, while high blood sugars can result in fatigue. Stress is related to high blood sugars because cortisol, a neurotransmitter produced during stress, prepares the body for "fight or flight" by turning stored energy into usable energy, resulting in higher blood sugar levels. Practicing stress management techniques, such as mindful exercise, is an integral part of a healthy lifestyle.
Social and family support
Social support is another key to living healthy with diabetes. Although other people cannot manage your diabetes for you, they can provide support for your efforts to manage your disease and change your lifestyle. Besides family members, healthcare providers, co-workers and friends, support can be found in the numerous diabetes groups springing up all over the nation. These support groups may offer emotional support and lectures on such themes as diet. Area groups can be found through your local American Diabetes Association (ADA) chapter or your healthcare providers. For those who do not have the time or inclination to join a local support group, try using the Internet for daily, up-to-date information on diabetes, tips and a database of people who want to exchange mail. Though permanent changes in lifestyle must come from within, we can all use a cheerleader now and then to keep us going.
Healthy Diet
We cannot forget healthy eating when we talk about healthy living. We are what we eat. An unhealthy diet of high fat and sugary foods, excessive consumption of caffeine and alcohol, and low intake of whole grains and vegetables will leave us unhealthy. A registered dietitian is the best person to talk to about your diabetic diet. Plus, you can easily follow the steps outlined below as a starting point for your new "healthy diet." Remember, like all major changes in life, eating healthy will take time to perfect. Making one change at a time may be the best way to begin. Build gradually on your successes, and reevaluate any problems you may be having. Many people view diets as isolated events with starting and stopping points. It's no wonder so many diets fail! If you choose to follow a healthy diet, make this choice for life. Everyone can follow these steps with little effort:
- Break your fast by eating in the morning.
- To keep alertness and energy levels high and blood sugar levels steady, eat several times throughout the day.
- Drink lots of water. Mild dehydration can result in fatigue.
- Avoid an erratic eating schedule and calories that may leave you feeling fatigued and unable to concentrate.
Making changes to last a lifetime will take time, planning and commitment. To be successful at change, we have to give value to the changes we are contemplating. These healthy changes will help you to take the reins of fear that stem from living with the complications of diabetes. The challenge we all face is to live healthy and to live well every day of our lives.
