Certified Diabetes Educator
Overcoming your barriers to exercise
By Daniel Stone,
Certified Diabetes Educator, Doctor of Physical Therapy, CEAS
When I worked as a fitness professional, I regularly saw people with both Type I and II diabetes to begin an exercise program. What I often found in performing a health screen was an underlying barrier or injury that kept that person from fully engaging in a fitness regimen.
I was surprised at how many people would just deal with aches and pains, which were downright injuries that significantly impacted their quality of life.
I guess I shouldn’t be so surprised as I remember the days of trying to be a stoic athlete with diabetes and just dealing with aches and pains (however, as I’m getting older, I’m hopefully wising up a bit.)
The challenges of diabetes and exercise
As an athlete with diabetes, I had very little direction in managing my diabetes during sports. As many of you can relate, I was my own experimental lab rat on how to try to perform with this new disease. “You shouldn’t eat that”, “Make sure you test your blood sugar 6 x a day”, “exercise is good for you.” Sometimes it just feels impossible to do all the good things we are supposed to do to keep our diabetes in check. Exercise is one of those complicated monsters.
In fact, the difficulties encountered during exercise can easily cause people with diabetes to stay away from this challenging treasure.
Do you ever find your blood sugar drastically dropping and then the next day rapidly rising with the same activity? Diabetes can often create a metabolic storm that can make blood sugar control difficult. Diabetes can’t always be placed in a convenient carb to insulin ratio box when it comes to physical activity.
In spite of the many challenges, exercise is well worth the time and effort and can greatly improve many of the diabetes complications related to poor circulation and blood flow. In one particular study from the Journal of Diabetes and Its Complications, regular aerobic exercise was shown to reduce the prevalence of neuropathy when comparing populations of similar criteria such as age, hemoglobin A1C, and weight.
Be aware of diabetes-related barriers to exercise
Diabetes increases the risk of developing certain musculoskeletal problems. For instance, persons with diabetes are four times more likely to develop “frozen shoulder” (or the scientific name of adhesive capsulitis). This is due to a process called, “glycosylation” which causes connective tissue in the joints of your body to become stiff and rigid. This can happen at multiple locations throughout the body limiting motion and contributing to pain.
One critical location that this occurs is in the foot and ankle. This process can contribute to peripheral neuropathy.
Take the time and effort to identify your barriers to exercise and, with the help of your diabetes team, overcome them on your road to success.
Get the right support from your Diabetes Team to get the full benefits of exercise
Many of you already know how excellent exercise can be for you. However, the important question is; if you’re not an active person, why? What barriers prevent you from being active?
If it is poor blood sugar control, I highly recommend talking to your diabetes team and utilizing professional resources to assist you.
If the answer is pain, then it’s time to see a professional to address the problem. Physical Therapists are a good start as they specialize in movement-related disorders and can help with injuries or balance. They take a thorough look at how you move.
If is a motivational barrier preventing you from being active, try to figure out why. Are you depressed? Do you need the services of a mental health professional?
If it is a lack of self-motivation, then remind yourself of the ways exercise can greatly improve your diabetes management: it can help to lower your blood pressure and blood glucose levels, it can help you to lose weight, it can help you to reduce and prevent diabetes-related risks, and, most of all, exercise can help to give you an overall sense of well-being, energy, and optimism.
About Daniel Stone, CDE, DPT, CEAS Dan was diagnosed with type I diabetes in 1993 at the age of 13. His process of wrestling with and overcoming the disease has directed him into the fitness profession. Dan worked 8 years as a Certified Strength and Conditioning Specialist and Clinical Exercise Specialist for an outpatient physical therapy practice educating clients in self diabetes management. During this time, he obtained his Doctor of Physical Therapy through a weekend course of study at Neumann University. He has 7 years of experience as a physical therapist in the outpatient and home health settings. He earned his Certified Diabetes Educator credentialing in 2015. His favorite line of work is fine tuning diabetes management strategies for athletes. One of Dan’s short-term visions is to launch a pilot study looking into the effects of foot and ankle mobility in relation to neuropathy and to introduce mechanical intervention as an effective neuropathy treatment to the medical community.