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Exercise

By David Mendosa

Last Update: December 29, 2003

My friend Gretchen Becker recently proposed the "Becker Color Diet" on a diabetes mailing list.

"You'd give up all white foods (rice, white bread, milk, potatoes)," she wrote. "You'd eat two orange and six green foods every day. You could have red foods on Monday and Friday, blue foods on Tuesday and Thursday, yellow foods on Wednesday and Saturday, and purple foods on Sunday."

Exercise, eating less, and taking pills are the three keys…

She was joking. But some people took her seriously. It would make food choices easier, one person replied. Another wrote, "This diet seems more interesting the more I think about it."

Her message prompted lots of discussion, until someone wrote that the idea had already been used. It seems there's a book called The Tri-Color Diet.

This episode illustrates the huge interest we have in diet. Books and Web sites on diets abound.

Among adults, 64 percent follow a diet for their diabetes, according to the most recent data cited in Diabetes in America (second edition, 1993), a 733-page compilation and assessment of data on published by the government's National Institute of Diabetes and Digestive and Kidney Diseases. But it doesn't say how many have an exercise program.

Likewise, you will find few books and Web sites on exercise for people with diabetes. Amazon.com lists eight books with the words "exercise" and "diabetes" in the title.

But I know of only one Web site devoted to exercise for people with diabetes. The International Diabetic Athletes Association, previously reviewed here, educates people with diabetes regarding exercise.

Yet, exercise, eating less, and taking pills are the three keys to increased insulin sensitivity, which is what most people with type 2 diabetes need. And for most folks exercise is probably easier than eating less and has fewer side effects than any pill.

"As little activity as walking for 40 minutes four times per week is enough to lower insulin resistance," according to the 1999 update of the American Association of Clinical Endocrinologists' Medical Guidelines for the Management of Diabetes Mellitus. "Exercise increases the affinity of the insulin receptor for insulin, increases the mobilization of glucose transporters, and increases the activity of tyrosine kinase, each of which will lead to decrease in insulin resistance in skeletal muscle."

Beyond this statement, you can find a few Web pages about exercise and diabetes.

Arnold J. Gold in Connecticut tells his personal success story about How Diet and Exercise Has Changed My Life Forever. He says that at first he could only exercise for two minutes without getting out of breath, but that he now regularly works out for 40 minutes.

Women who develop gestational diabetes and those with type 2 diabetes who become pregnant benefit too from exercise. Raul Artal, M.D., has a relevant article on-line about Exercise: An Alternative Therapy for Gestational Diabetes reprinted from The Physician and Sportsmedicine.

The Diabetes Network has several excellent articles on exercise and diabetes in its "Active Lives" section. One article recommends that you "aim for about 60 percent of your maximum aerobic capacity. For most people, 60 percent capacity means moderate exertion with deep breathing, but short of panting or becoming overheated." Heart rate monitors are a more scientific way of gauging the intensity of your exercise.

But of all the diabetes pages on the Web none has more information about exercise than right here at the American Diabetes Association's site. The most detailed presentation is Diabetes Mellitus and Exercise, the association's position statement that is a part of its Clinical Practice Recommendations 2001. One of the biggest points this statement makes is the importance of a detailed medical exam before starting an exercise program.

People with type 1 diabetes, the statement also says, should avoid exercise if their fasting glucose levels are more than 250 mg/dl and ketosis is present or if their glucose levels are over 300 in any case. It's also important to monitor your blood glucose before and after exercise and eat enough carbohydrates to avoid hypoglycemia.

Then, the ADA has a less technical page about exercise on-line at Frequently Asked Questions: Exercise and Diabetes. This page suggests exercising with a partner. Exercise helps in two ways, this page says. It uses some glucose in the blood for energy, lowering your blood glucose levels. It also delays or stops cardiovascular disease, the leading killer of people with diabetes.

That's enough for me. Now I've got to get a snack and go out for my walk. 


The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.


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