Monday, November 16, 2009

Get A Move On!

Exercise regimens are important for any individual, but are of increased importance in the diabetic population. It has been shown that exercise lowers blood sugar levels and improves the body’s ability to use glucose.

During exercise in the non-diabetic individual the muscles of the body demand increased fuel sources, thus they turn to glycogen stores in the muscles themselves. If additional fuel sources are needed, the muscles will use glucose from the blood stream and eventually the liver, where glycogen is converted to glucose or stored proteins and fats will be used to supply energy.

In the diabetic patient this process isn’t as efficient. This by no means gives you a ticket out of exercising, but must increase your awareness in selecting exercises that are most appropriate.

Your exercise regime should be focused on increasing flexibility and maintaining proprioception. Proprioception is the body’s ability to feel that the ground is beneath your feet. When proprioception is lost, which occurs often in the diabetic patient, the risk and incidence of falls increases. Below are several exercises that will both increase flexibility to decrease deformity as well as increase proprioceptive reflexes to decrease risk of injury.

  • Cardiovascular Exercise – this is exercise that makes you sweat and increases your heart rate, but should be low impact. Good options for “cardio” include walking, stationary bike, swimming or jumping rope. (20 minutes)
  • Sit to Stand – Sitting in a chair with your knees bent at a 90-degree angle raise yourself from the chair without using your hands. Lower yourself down and repeat. If you feel unsteady, try to use just one hand for support. (3 sets of 10 repetitions)
  • Seated Single Leg Raise – Sitting forward in a chair with your knees bent at a 90-degree angle, straighten the right leg at the knee elevating the foot off the floor, hold for 3 seconds and return to the start position. Repeat on the left leg. (3 sets of 10 repetitions)
  • Calf Stretching – Facing the wall, place your hands onto the wall in front of you, place one foot forward with knee bent and one foot back with the heel touching the ground. Lean into the wall keeping the back leg straight and the heel on the ground. Hold for 10 seconds, relax and repeat. After 10 repetitions switch legs. (3 sets of 10 repetitions on each leg)
  • Tandem Repeats – Standing close to a wall with feet shoulder width apart, place one foot in front of the other and hold for 5 seconds, return to start. Repeat on the other side to complete 1 repetition. For increased proprioception, close your eyes and try to complete this exercise. (3 sets of 10 repetitions)

The U.S. Government recommends a minimum of 5 days per week of appropriate exercise, but 3 days a week, or even 2 days a week are better than none. Remember to do as much as you can without overdoing yourself! If you experiencing calf pain, referred to as claudication pain, during exercise and you find yourself traveling shorter and shorter distances daily, you need to see your Podiatrist immediately. This could indicate decreased blood flow to your lower extremities and demands further vascular investigation.

So, get out there and get exercising!