Nobody welcomes a disease. However, in our lives, it is not what happens but rather how we react to it. I was diagnosed with juvenile diabetes at the age of 13. What I have realized since then is that juvenile diabetes is a very manageable disease. Just understanding this alone and really focusing on it should help the child and their parents. There are a few fundamental concepts trainers must embrace in order to understand diabetes properly.
Engaging in a consistent program of cardiovascular exercise and resistance training will greatly support the body’s ability to properly utilize the insulin and balance internally the hormonal balances that help to keep glucose levels stable. It is imperative that you make exercise a lifestyle. That is, make it something that is a part of your daily life that becomes a life long habit. I like to think of this as a ritual. It is not something that I decide or ponder over, but it becomes a part of my day, an important, essential, mandatory part of my day. The positive effects of exercise are unlimited. It supports the circulation of the body and builds collateral vessels. Do you think this may be important later on in life when your vessels have already collapsed?
Exercise has a profound impact on our mood. This is due to the effect exercise has on our hormones in the brain. Beta endorphins are very potent mood elevators. Exercise causes an influx of 02 uptake. More oxygen to the cells of the body provides a positive impact in every system of the body. Exercise has also been shown to elevate the HDL (good cholesterol). Exercise strengthens the heart and makes it a more efficient pump. It will ultimately reduce the heart rate and increase stroke volume. Exercise builds collateral circulation. This is like having a built-in life support system if one of the arteries gets blocked.
The following five reasons help to illustrate why exercise is important for diabetics:
- While thousands of patients go to clinics around the world for help with their diabetes, it is exceedingly rare to find one who already has an exercise prescription in hand.
- Cells of exercising muscles can extract glucose from the blood much more efficiently than those of resting muscles.
- Scientists cannot explain exactly why, but we see with consistency that there is a glucose reducing action of exercise in the diabetic patient. Regardless of the why, just comply! Exercise is a powerful tool to lower blood sugar levels and reduce the amount of insulin.
- Sometimes, endocrinologists have their insulin dependant diabetic patients just increase their dosages of insulin if the diet choices (poor choices) warrant it.
Exercise increases the cell sensitivity to insulin. Therefore, as sensitivity increases, the insulin requirements begin to decrease. Exercise increases the fluidity of the blood. This reduces “stickiness” of blood, which could lead to a clot. Ultimately, this could lead to a stroke or a heart attack. Therefore, consistent exercise can help prevent damage to the eyes and kidneys in the insulin dependant diabetic.
Personal and family lifestyle issues play a major role in the control of diabetes. My goal in training the diabetic is to have the entire family participate collectively. It is much easier for diabetics to maintain their exercise program when an entire family is actively engaged in wellness. In conjunction with exercise, a family unit who consciously maintains proper eating habits acts as a huge support system.
How often you exercise and the type of exercises is important for diabetics. In my experience, I have maintained a daily exercise program consisting of an hour of strength training along with 15 to 20 minutes of cardiovascular exercise on the Stairmaster, treadmill, elliptical machine or the recumbent bike. Depending upon how you are receiving your insulin via pump or injections, the timing of meals and exercise can be extremely significant. As a current pump user, I advocate its use because of the flexibility of your eating schedule. It enables you to have a constant feed of insulin throughout 24 hours while pumping additional insulin prior to major meals. If your client is taking insulin through injections, you should have him eat and exercise regularly at the same times each day. It helps regulate the insulin uptake and creates more of a homeostatic state in the body.
Stress is a major contributor to high blood sugar in a diabetic patient. Stress comes about in many forms. Emotional, physical and structural stressors all play havoc in the juvenile diabetic. As a trainer, you should be aware that a simple cold or flu would often dramatically alter the blood glucose level in your diabetic client. It is advisable to have your client avoid excess exercise until any health crisis is handled. All personal trainers should be aware of the emotional challenges inherent with most young diabetics clients. Many young clients who have been diagnosed with diabetes are in denial of their problem or feel depressed because of their diagnosis. Therefore, any positive support you can provide will be greatly appreciated by your client, even if he does not verbalize it.
When training someone with diabetes, it is important to know the feelings and signs of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) and how to treat each situation appropriately. Watch to make sure your client isn’t "zoning out," or acting lethargic and fatigued. If you have clients who are diabetic, it's a good idea to carry Lifesavers or sugar packets with you in case of a hypoglycemic emergency. What I have found works best for me through trial and error is the combination of a carbohydrate (four to six whole wheat Ritz crackers) and about eight ounces of all natural fruit juice. The science behind this recommendation is that the carbohydrate will cause the simple sugars of the fruit juice to be absorbed more slowly and prevent any spiking of high blood sugar. With regards to hyperglycemia, the best thing to do is to fully hydrate and hold off from exercising until your client’s glucose levels stabilize.
The biggest challenge to a diabetic is having someone who is skilled and knowledgeable to guide a client correctly. This is where I come in. With years of personal and practical experience, I can create an exercise regimen that will aid in controlling blood sugar. From there, the only other challenge is finding the motivation to start and follow through.