DiabetesSource

by David Hite PhD

Last month I introduced the 5Ms, a diabetes self-care model designed to empower patients by introducing tools that support their efforts to better manage blood sugars. All five M’s in this plan are important and need to be learned and understood, but because it’s easy to become overwhelmed by trying to change too much too quickly, I encourage my patients to focus initially on a single modality. If they ask my opinion of which element they should emphasize first, I suggest they start with most underused element in this model: Motion.

For years patients have heard their doctors tell them, “you need to lose weight.” Losing weight does help diabetes control and is an important long-term goal, but dieting alone is not an adequate modality for losing and maintaining weight loss. Physical activity recruits active muscles to directly address the problem of overcoming insulin resistance, the hallmark of type-2 diabetes, and in turn supports weight loss. In addition, recent research indicates that fitness not fatness is the greatest predictor of all-cause mortality. Implementing a regimen of physical activity has far-reaching effects and addresses physical, social, spiritual, and emotional needs.

Surprisingly, I find that negotiating a plan for physical activity is often the path of least resistance. While patients may be defensive about discussing changes to meals or medications, they sheepishly admit that they know they should exercise, and it’s the one thing they haven’t tried. Because exercise overlaps and supports the other four Ms, I find that after their initial success getting active, other elements are more likely to fall into place.

I remind my patients that as we get older, fitness is less about looking good and more about being fit. We need to be strong enough to care for ourselves, to maintain our quality of life and our independence. Some patients have been sedentary for a long time and don’t know where to start. Often there are physical limitations such back or joint pain. Some have balance issues or safety issues that have to be considered. As we enter winter and the holiday season, opportunities and places to exercise become more problematic. To address this need, we started a seated exercise class at my health clinic. Patients feel much more comfortable beginning an exercise regimen in a safe and receptive environment. Another option may be at the local mall. Most shopping malls offer some sort of walking program during the cold winter months. Pool aerobics is another good choice. The buoyant force of water takes the pressure off of painful joints and allows for a great workout.

Holidays can be a challenging time for anyone trying to implement or maintain a healthy lifestyle, so follow the motto: “When you eat more, move more.” Employing an exercise regimen within the limitations of their ability can help a patient lose weight, lower blood sugars, and increase energy levels. Motion offers emotional and stress relief, combats depression, improves sleep, and lessens the pressure on meal planning and medication modalities. Help your patients find again the joy of motion - Fit is It.

Sources

1. Exercise: How Does It Promote Insulin Sensitivity?
http://www.medscape.org/viewarticle/438372

2. Long-Term Effects of Changes in Cardiorespiratory Fitness and Body Mass Index on All-Cause and Cardiovascular Disease Mortality in Men
http://circ.ahajournals.org/content/124/23/2483.abstract

3. Fit People Live Longer, Regardless of Weight Changes
http://www.webmd.com/fitness-exercise/news/20111205/want-to-live-longer-...

More Information on Seated Exercises

Daryl Madison: Chair-a-cise (Aerobics, Abs, Strength)
http://www.chairacise.com/videos.html

Jodi Stolove; Chair Dancing
http://www.chairdancing.com/

Mary Ann Wilson: Sit and Be Fit
http://www.sitandbefit.org/

Stretch Break Repetitive Stress Injury Prevention Software
http://ergonomics.about.com/od/buyingguide/gr/rvwstretchbreak.htm

About The Author
David Hite PhD, is a lifelong educator, spending 20 years teaching biology, chemistry, and health education at the high school and community college levels, two years teaching science at Cairo American College in Egypt, and two years at Shanghai American School in China. Dr. Hite developed the patient-friendly "Take Control - Diabetes Basics," a diabetes educational DVD used by clinicians to encourage their patients to implement and maintain effective self-care strategies, and has spent the past 11 years working daily with diabetes patients as a Clinical Health Educator in the Chronic Conditions Management Department for a large non-profit healthcare provider in Sacramento, California. Dr. Hite is a member of the American Association of Diabetes Educators, and the American Diabetes Association.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of DiabetesProductSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.