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Sunday, February 16, 2014

Diabetes Positive Approach Newsletter #1402 on Exercise

Hey you guys, how's our self-image coming along? Great, I suppose because we are all here for each other. How can it be otherwise? But you know what? The best and most effective way to improve our self-image is to join a club or an organization that has worthwhile purposes. And we have that in our own little club, don't we, The Diabetes Positive Group. There's a ring to it, isn't there?

This is great for our next topic which is Exercise. Some of us will not want to do that but we will push each other. We might experience some difficulty getting people up but know that it is not necessary to become an exercise pro. We can just start somewhere and pretty soon as our confidence develops, I bet we will have a hard time getting you to stop. Exercise and Diabetes

Exercise is one of the three fundamentals in treating diabetes. The other two are food and medications but among these, exercise is cheap, easy, convenient and results in better blood sugar control. On top of this one cannot deny the fact that after the exercise, one usually feels well and healthy. How does this come about?

You see, whenever we use our muscles and that’s a given when we exercise, we burn both the glucose and the fatty acids. The beta cells in our pancreas can feel this so they relax the production of insulin giving them a much needed break. The lower insulin level alerts the liver to release its glucose reserves into the blood because the muscles need the energy for the exercise.

As the exercise continues, the liver turns the fats, lactic acid and amino acids into glucose to give the muscles what they need. This tells us that exercise is the best diabetes treatment because not only does it lower the blood sugar and fatty acid levels but also it gives the pancreas some time off from its work. You won’t suffer from hypoglycemia because exercise won’t lower the blood glucose to way below, the way some treatments may. But there are some risks, so listen up!

Heart Disease Risk

Before going into an exercise plan, consult with your doctor as it is imperative to know if heart disease is present as this is common, as much as 50%, among the PWD (people with diabetes). The doctor will consider your age, how long you have had diabetes, the family history, the blood fats and blood pressure and the presence of protein in the urine.

Undergo an exercise tolerance test if needed where they will make you walk on a treadmill and measure your heart’s response to stress. Don’t lose hope though if you find yourself in the positive territory because you can still exercise following some guidelines your diabetes care team will provide you. Besides, there may be medications that can lower this risk.


This is a concern for those who take insulin or some form of medication. If you’re in this category, you will have to do glucose testing to monitor how your body responds to exercise or any type of activity so you will be prepared for the low blood sugar that might come for a visit.

What some people do in such a case is drink orange juice or some other thing to treat the low making their blood sugar go high. This leads them to take extra medication or insulin only to continue the roller coaster ride with another low. It is very frustrating, isn’t it? What is worse is that they may stay away from exercise thinking it is not worth it when it leads to such confusion and scary scenario.

They are missing the point that testing the blood sugar more often will help them understand better the body’s reaction to exercise. With this more frequent blood glucose testing, they will be able to make better adjustment to the other two cornerstones of diabetes treatment: medication and food.

Diabetes Complications

Believe it or not, there are complications that may make it unwise to increase the physical activity. For example, any activity that requires one to strain and lift weights may just do more harm than good for those who have high blood pressure. In fact the aforementioned activities will just exacerbate hypertension. So make sure the blood pressure is under control before increasing the activity level.

Another medical condition that can be harmed by increased exercise is retinopathy. Exercise that includes straining will increase the pressure on the eyes’ blood vessels which may already be weak to begin with. So before starting an exercise program, get your eyes checked for the presence of retinopathy and do this annually.

With nerve problems in your feet, you may not be able to feel injuries in the form of blisters and sores. Get to the doctor to have this checked before embarking on a rigorous exercise program. You should also examine your feet every day and wear appropriate shoes for exercise. It does not mean you cannot exercise. Just build your own program to suit your needs and follow the guidelines for your specific situation.

Guidelines for Exercise

Guidelines can help you ease into increased level more safely. Monitor your body’s response and request your health care to help you with this. After you have been screened through treadmill stress test, eyes and foot examination and protein in the urine, you are ready to choose appropriate activities or exercise.

Type of Activities

Choose activities that you enjoy so you don’t get bored to the point you will make excuses to stop. Indulge in a variety of exercises, some by yourself, others with a group. Some can be outside in the open air like tai chi and others inside the house. You could have more moderate ones when you have time and lighter type of exercise when you are pressed for time.

Best Time to Exercise

The best time to exercise? Anytime at all. It is hard enough for some people to find time to exercise. It will even make it harder if we dictate the best time to do it. For one thing it is an individual thing. We have different schedules for work and play so only each person can work out a plan to suit his own time frame.

The more important question is on what to remember when you start an exercise plan. Test the blood sugar before and after the exercise. It is because when you do this, you will know how exercise affects your blood sugar level. It is a balancing act but we have to tract how the body responds to exercise, food, medication and even stress. This is the way we can make the necessary adjustment for optimal health.

Intensity of Exercise

Do warm up first by mild stretching and marching around the room. This will help the heart get ready for the exercise. Since most PWD have brittle tendons due to years of high blood sugar level, it is good to do some gentle stretching to warm up in order to avoid trouble with muscle and tendons.

Glucose and Exercise

The next question is how much to exercise. The recommendation from the American Diabetes Association is not to exercise when the fasting blood glucose level is higher than 13.89 mmol/l (250 mg/dl) and ketone is present. We also have to be careful when the ketone is not present when the reading is16.67 mmol/l (300 mg/dl). ADA also recommends for us to eat a snack before exercise when the level is below 5.56 mmol/l (100 mg/dl ). Then test again after 15 minutes.

Do the activity or exercise after eating as this will help bring down the increased blood sugar after a meal. If you take insulin, know the peak times so you can plan your activities appropriately. Avoid the activities when the insulin is peaking to prevent hypoglycemia. Bring glucose tablets if you are at risk for hypoglycemia which if this occurs, stop the exercise right away and take the glucose tablet.

If you have repeated hypoglycemic episodes when you increase your activity, you should tell the doctor as he may have to change your medication. Monitor your blood glucose while exercising to see how the activity affects you. Check it before you start and every half hour during exercise.

2. Must-Reads from Around the Web

Optimize Your Diabetes Regimen for Physical Actvity

A Hassle for your Health

Tips for Beginner Joggers

Boost your Mood, Lower your Stress

Frugal Fitness: 7 Tips to Work Out on a Budget

3. “Alerts I Can’t Resist To Send You

Warning: Foods to Avoid to Prevent Complications Prevent Complications: Avoid These Foods

A Bad Habit That Makes Diabetes Worse Diabetes and Smoking

The Messed-up Healthcare Reimbursement System New Credo for Diabetes Health Insurance Coverage

Consumer Guide 2014 For Living With Diabetes Your Guide to 180 Tools for Living Well With Diabetes

Bayer Diabetes Care Would Stop Making the A1C A1C Lives On After All

4. A Success Quotation of the Month“

“You have brains in your head, You have feet in your shoes, you can steer yourself any direction you choose.” Dr Seuss

5. Dessert Recipe”

Warm Chocolate Souffles

6. Some Humour - Let's laugh together at the joke below even if it's not funny. It is really good to try having a good laugh. It’s the best medicine. Why not try laughter meditation? This consists of stretching, laughing, and silence. It can change your mood and energy.

Who Won The Best Joke Contest?

Roselyn: Why is Alabama a smart state? Because it has 4 A’s and one B

Peter: Which city cheats at exams? Peking.

Roselyn: How come birds fly south in winter? It‘s too far to walk.

Peter: How come the flamingo lifts just 1 leg? He’ll fall over if he raised 2.

Roselyn: What comes after the dinosaur? Its tail.

Peter: Why are some goldfish red? The water turns them rusty.

Roselyn: I’ll tell you a joke about a pencil but it has no point.

Peter: Why do idiots eat biscuits? Because they’re crackers.

Who won the contest? No one because the judge left the room disgusted, 7. Do you have a question or comment for the team?

Drop us a line at Put on the subject line “Diabetes Positive Approach” so no one can mistake it as spam. Write your questions or comment there.

You may see your question answered in an upcoming issue of Diabetes Positive Approach like this one below.

7. Q&A: I get too busy all day long. How can I fit in an exercise plan?“

Answer: Being busy all day long is good. You are probably burning all kinds of calories every day. In fact, the surgeon general said some activities will burn 150 calories a day or around 1000 calories a week. How do you like that? You may be wondering what those activities are. Here are some examples:

Shoveling snow for 15 minutes, climbing steps for 15 minutes, walking 2 miles in 30 minutes, gardening for half an hour to 45 minutes, bicycling 4 miles in 15 minutes, pushing a stroller for one a half miles for half an hour are some of the activities. They are heart-pumping ways and burn calories to help you get fit.

8. Got something to say? Please write down your questions and comments in Facebook.

Just go to the Just copy and paste that on your browser. Facebook will want you to join me first before you can send me a message. My! All that exercise tired me out. Truth be told though, I feel great after the end of an exercise session. It is only at the start that I feel, “Yikes, not again! Why do I have to do this? But then comes the end of the session and I feel like I can do anything. I can even look at Prime Minister Harper in the eye.

Don't you find sometimes it is hard to look at other people in the eye? There are some people who cannot look directly at someone they are having conversation with. Some have such self-image they feel they are not worthy to look at some people directly. Well, we are not like these people because we have been developing our self-image. Yay!

Warm Regards,

Roger and Evelyn Guzman Check out Defeat Diabetes Now It's a Natural Cure For Diabetes E-book, Doctor Recommended, Safe And Effective, Results Guaranteed! You will learn how to reliably control your diabetes through diet and exercise.

Did you like this newsletter? If so, please recommend it to your friends. If you have any questions or tips, please leave a comment at Just copy and paste that on your browser. Facebook will want you to join me first before you can send me a message. This newsletter is copyright 2014 Roger Guzman, M.D.

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