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Take a whack at diabetes

If you have it, then a cornerstone of your care should be regular exercise.

Most of us have seen the alarming statistics about the rise of diabetes in our society. Type 2 diabetes is, by far, the most common form of the problem. The upside is that this type of diabetes usually responds well to changes in lifestyle, including diet and exercise.

Most of the recommendations from diabetic educators have focused on the dietary aspect of controlling blood sugar. While extremely important, let's not forget the effect of physical activity on controlling diabetes. In fact, research suggests that hitting the gym while avoiding the fridge can help to stabilize blood sugar in the short- and long-term.

A study of postmenopausal women published in 2005 reviewed the effect of diet and exercise on visceral fat, which is the fat that collects around our internal organs and causes our bellies to bulge. There were three groups of women in this study: The first dieted, the second exercised, and the third dieted and exercised. Although all of the women in the study lost some fat, over the 14-week period those who only dieted did not lose any visceral fat, which is the most important weight to lose. These conclusions are confirmed by similar research findings, including those of my Cooper Clinic.

The bottom line: If you suffer from diabetes, then regular exercise should be a cornerstone of your care regimen.

Diabetes and exercise tips
You need to take certain precautions. That's the bad news. The good news is that by remembering a few key points, those who have diabetes should be able to use physical activity to help manage the illness. Just remember the word "SWEETS" for guidance on diet and exercise.

Sugar. Diabetics who are just beginning an exercise program should be sure to check their blood sugar before exercising. If it's too high (greater than 250mg/dl) or too low (less than 100mg/dl), you may need to make adjustments in medications or foods before starting your activity program. Remember, exercising when your blood sugar already is low can trigger hypoglycemia, and exercising when your blood sugar is too high can create a paradoxical effect of abnormally elevating sugar after working out.

Water. Diabetics tend to be more dehydrated than other folks when their sugar is elevated, so consuming water before, during and after a workout will help you avoid that.

Eat. Appropriate nutrition is a must for active diabetics. With the help of a nutritionist, you can develop an appropriate regimen, which typically involves eating from the "carbohydrate exchanges" group 30 to 45 minutes before you exercise. Or check out diabetes.org, which has lots of nutrition and exercise information, as well as recipes.

Experiment. Different forms of exercise will have different effects on your blood sugar. Try out various types of activities (walking, golfing, swimming, etc.); your doctor can give you guidelines on the most appropriate type of exercise for your needs. After exercising, check your blood-sugar levels to see which form of activity works best for you and for your blood sugar. As a general rule, avoid intense bouts of exercise and instead perform a consistent program that's moderately intense.

Time of day. Our bodies love routine. Diabetics, in particular, need to have a routine to help regulate blood sugar. Exercising at the same time each day helps to establish a more consistent response, kind of like taking medicine at the same time every day.

Safety first. Exercise is extremely important for diabetics, but it's not without risks. Significant shifts in blood glucose can occur, especially when starting a program or changing an existing one. Try to embark upon your program with an exercise partner who has an idea of what to do if you have a problem during activity (or at least let someone know when and where you're exercising). Also, wearing a medical alert bracelet is a good idea whenever you're exercising, but it's especially important if you must exercise alone. If you're in trouble, this will alert anyone who encounters you that you have diabetes and can help to make sure you get appropriate care.

Those who have diabetes need to understand the importance of a physically active lifestyle in combating their illness. Exercise can be a wonderful tool for improving both blood-sugar control and quality of life. And although the benefits of physical activity are significant, remember that there are risks associated with exercise and diabetes. But by developing an exercise program in conjunction with your doctors and a qualified nutritionist, these risks are easily surmountable.

Contributing editor Tedd Mitchell, M.D.,is president and medical director of the renowned Cooper Clinic in Dallas.