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May Newsletter

Exercise

By David Mendosa

Last Update: March 22, 2005

Exercise, eating less, and medication are the three keys to increasing insulin sensitivity, which is the problem for most people with diabetes. And for most folks, exercise is probably easier than eating less and has fewer side effects than any pill.

Risk factors are not something you want to collect.

But few of us have a regular exercise program. Diabetes is a risk factor for coronary heart disease, and being physically inactive is another. Others include being overweight, smoking, hypertension or high blood pressure, and high cholesterol. Risk factors are not something you want to collect.

Hot News in Diabetes
The good news is maybe we don't need to exercise as hard as we previously thought to stay heart healthy. The conventional wisdom, provided by the Surgeon General's Report on Physical Activity and Health and endorsed by the American Diabetes Association and others is that each of us need 30 minutes of moderate physical activity on most days of the week.

A major study in the March 21 issue of JAMA, the Journal of the American Medical Association, shows that a light to moderate activity is associated with a lower risk of coronary heart disease. That activity is walking.

You don't need to walk fast or for a long time to benefit. "Time spent walking was more important than walking pace," was one conclusion. "At least 1 hour of walking per week, regardless of pace, was associated with lower CHD rates among relatively sedentary women," was another.

The study followed almost 40,000 female health professionals for up to 6½ years. But what about men? There's nothing in the study about them. But men aren't that different, are they?

Lifestyle Improvement Tip
A famous curmudgeon once said that he avoided any exercise that required buying a new pair of shoes. He was probably the same guy who said that anyone who hates children and animals couldn't be all bad.

At least he was consistently wrong. Any exercise, even something as easy as light walking, requires new shoes.

Walking shoes differ from other sports shoes. Walking shoes provide more lateral support and are more flexible, but are not made to absorb as much impact. Top-of-the-line cross-training shoes from one of the leading manufacturers of sports shoes should be excellent. Try on different brands at a well-stocked shoe store. Flex your feet, wiggle your toes, and walk around until you find a pair that feels comfortable to you.

Related Web Site Reviews
You can read the on-line abstract of the study of 39,372 female health professionals, "Physical Activity and Coronary Heart Disease in Women: Is 'No Pain, No Gain' Passť?" in JAMA, the Journal of the American Medical Association, March 2001, pages 1447-1454, at http://jama.ama-assn.org/cgi/content/abstract/285/11/1447.

"Diabetes Mellitus and Exercise" is the position statement of the American Diabetes Association. 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. The statement is on-line at http://care.diabetesjournals.org/cgi/content/full/25/suppl_1/s64.

The ADA also has a less technical Web section about exercise. This section suggests exercising with a partner. Exercise helps in two ways, this section 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. The URL is http://www.diabetes.org/weightloss-and-exercise.jsp


This article was originally written for the LXN Corp. Web site.


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