Exercise Prescription For Diabetes Robert Goldstein, MS;

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Exercise Prescription For DiabetesRobert
Goldstein, MS

• Health Educator
• Fitness Therapist
• Disease Management
• For Diabetes
• Health Fitness Instructor
• American College of Sports Medicine

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Exercise Prescription For DiabetesYour Moderate
Exercise ProgramRobert Goldstein MS

• Your Optimum Program Getting Started
• 7 Major Components of Fitness
• 1) Warm up
• 2) Cardiovascular Fitness
• 3) Muscular Strength
• 4) Flexibility Fitness
• 5) Cool Down
• 6) Body Composition

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Disclaimer

• Todays Lecture is for Educational Purposes and
  not Medical Advice. If you have certain medically
  related issues you should speak to your
  physician.
• Please Check with your physician about starting
  an exercise program

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Blood Glucose The Good The Bad and The Ugly

• Body Requires Glucose as Energy Source.
• Broken down from food breaks food down into
  sugar.
• Insulin is necessary to regulate glucose from
  blood into cells.
• High blood Sugar harms the body. May do eye,
  heart nerve and kidney damage.

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What are the Types Of Diabetes?What are the
Treatments?

• Type 1 Diabetes
• Pancreas has a total inability to produce any
  insulin
• Daily Insulin Injections
• 5 to 10 Of all diabetes
• Diet and Exercise

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Type 2 DiabetesThe Most Common

• Pancreas is able to produce insulin but not
  enough to register with cells.
• 90 of all Diabetes
• Treated with oral medication.
• People over 40. High BMI or family history.
• Diet and Exercise!!!

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Gestational DiabetesDevelops During Pregnancy

• Develops in up to 5 of all Pregnancies.
• May disappear after birth.
• Large risk in future to develop type 2.

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Juvenile DiabetesWalking Away From Disease And
Disability

• Childhood Diabetes
• May be first generation to not live longer than
  parents
• Often genetic
• 200,000 cases nationwide
• Large have type 1
• 10 to 15 children overweight
• Type 2 more prevalent
• Diet and Exercise Now!!

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Pre-DiabetesTime To make ChangeYour Wake Up
Call

• 1) Blood Glucose Higher than normal.
• Positive for metabolic syndrome risk factors.
• High risk to develop type 2 diabetes.
• Estimated 54,000,000 Americans many not
  diagnosed
• Diet and Exercise Now!

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Benefits Of Moderate ExerciseAnd Diabetes

• Benefits Of Exercise
• 1) Weight Loss
• 2) Lower Blood Pressure
• 3) Reduce Risk for Heart Disease
• 4) Improve Cholesterol Ratios
• 5) Control Blood Sugar
• 6) Reduce Back and Joint Pain
• 7) Improve Balance
• 8) Reduce Medications
• 9) Increase Self Confidence
• 10) Reduce Risk For Fall

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Warm Up

• 1) Reduce risk for injury
• 2) Gradual increase of pressure and heart rate.
• 3) Increases circulation in legs.
• 4) Warms Muscles.
• 5) Types of Warm up
• Light Walking
• Light Cycling
• Balance Exercise
• Movement and Light Stretching
• 5 to 10 minutes

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Cardiovascular Fitness

• 1) The heart, lungs and blood vessels deliver
  adequate supply of oxygen to large working
  muscles.
• 2) Also called aerobic fitness uses the oxygen
  pathway.
• 3) Examples- Walking, Cycling, Swimming, ,
  Recumbent Step Machine.
• 4) Perform 3 to 5 times a week. May be done in
  short bouts or duration.

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Risk Factors for Heart Disease

• 1)Family History of Heart Disease.
• 2) High Blood Pressure 140/90 0r above.
• 3) Sedentary Lifestyle.
• 4)High Cholesterol over 200
• Low HDL under 35.
• 5) Cigarette smoking or those who have quit
  within the past 6 months.
• 6) Impaired Fasting Glucose over 100.
• 7) Obesity BMI over 30 and Mens
• waist 40 Womans 35
• 8) Age 45 0r over.

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Muscular Strength and Endurance

• Strength Training
• 1) Helps to maintain lean body weight and muscle
  mass.
• 2) Perform 2 to 3 times a week with a day rest in
  between.
• 3) Light Dumbbells, Thera- Band, rubber tubing.
• 4) Exercise within range of motion without pain
  or excessive weight.
• 5) Start with one set of 10 until mastered and
  increase to two sets.
• 6 ) Extremely important and helpful in reducing
  blood sugar.

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Flexibility

• 1) Flexibility Decreases after the age of 25.
  Increasing risk for injury.
• 2) The biggest reason for missing work after the
  common cold is low back pain.
• Stretching
• 1) Best when muscles are warm during and after
  workout.
• 2) Static Stretching. Holding Stretch for 30
  seconds on each side.
• 3) Only stretch to comfortable range of motion
  increasing as muscle allows.

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Cool Down

• 1) Brings Blood Pressure and Heart rates down
  gradually.
• 2) Aids in preventing muscle stiffness or
  soreness.
• 3) Prevents pooling of blood and promotes
  adequate flow to muscles and heart. Increases
  circulation.
• Slow Walking
• Stretching
• Slow Movement

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Blood Sugar Levels for Exercise

• Goal is to avoid hypoglycemia for people who
  exercise.
• Type I may have larger drops with exercise and
  risk for hypoglycemia
• Type II Lower risk of hypoglycemia but still
  possible
• Dizziness, Headaches, Weakness
• Headache, Pale Skin
• Initially check blood sugar before and after
  exercise
• Light snack as crackers, rice cakes, pretzels are
  of low caloric content and can help raise blood
  sugar.

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How Hard do I Need to Work

• A great question
• 1) Very individual prescription.
• 2)Heart rate method 220 minus age. Safety is
  number one concern.
• 3) Full evaluation of your medical history,
  medications, surgeries and orthopedic conditions.
• 4) Doctors approval and contraindications.
• 5) The good news, you can exercise even if you
  dont think you can and if you never did before.
  

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Intensity

• Exercise Prescription
• 1) Mode Type of exercise. Determined on an
  individual basis.
• 2) Intensity How hard do I work. Workload.
  Starting low and graduating when perfecting
  current intensity.
• 3) Duration How long. Also based on individual
  needs. Short bouts to start.
• 4) Frequency How many days per week,

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Rated Perception Of Exertion and Meds

• 1) Beta blockers, Alpha blockers, Calcium Channel
  and Diuretic Medications blunt heart rate and
  blood pressure.
• 2) With this in mind heart rate end blood
  pressure will not be the best indicator of how
  hard you work.
• RPE Borg Scale
• 6
• 7 very Very Light
• 8
• 9 very light
• 10
• 11fairly light
• 12 moderate
• 13 somewhat hard
• 14
• 15 hard
• 16
• 17 very hard
• 18
• 19 very very hard
• 20

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Other Methods of Rating Intensity

• 1) The talk test- You should be able to carry on
  a conversation while exercising.
• The Reggie test Get a 4 month old puppy and
  work until exhaustion
• 2) Evaluating Range of Motion. Stopping when
  feeling pain.
• 3) The no pain no gain mentality is not
  appropriate. You should not feel pain.
• 4) If you are feeling pain you are possible
  hurting yourself and preventing improvement.

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Body Composition

• Body Composition and Risk for Heart Disease.
• 1) Body Mass Index.
• 2) Body Fat Percentage.
• 3) Waist Hip Ratio.
• 4) Circumference Measurements

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Weight LossTaking it Slow

• How Weight Loss Works.
• 1) Negative caloric expenditure.
• 2) Negative expenditure thru diet
• and exercise.
• 3) 3500 calories one pound. 1 pound
• a week is a reasonable weight loss.
• 4) Eliminate about 250 calories per
• day thru diet
• 5) Another 250 calories through exercise.

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How Can I Start

• Stages of Change
• Pre-Contemplation
• Contemplation
• Action
• The Fierce Urgency of Now!!
• Maintenance
• Relapse

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Smart GoalsKISS

• Specific
• Measurable
• Attainable
• Realistic
• Timely

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Reduce Risk factors for Heart Disease

• Modifiable Risk factors
• Cigarette Smoking
• Hypertension
• Hypercholesterolemia
• Impaired Blood Glucose
• Obesity
• Sedentary Life Style
• Stress

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Pre and Post Exercise Blood Sugar Averages 1 Year

• Pre exercise 140
• Post Exercise 100

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Exercise Levels Start and 20 Sessions On
Treadmill

• Starting Session
• 1.4 MPH 0 Grade
• 20 Sessions
• 2.9 MPH 0 Grade
• 48 Increase in Workload

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First Session and 20th SessionAerobic Time
Minutes

• Session One
• 9 Minutes Total
• 3 Minutes Bike
• 3 Minutes Treadmill
• 3 Minutes Bike
• Session Twenty
• Total Time 29 Minutes
• 14 Minutes Bike
• 15 Minutes Treadmill
• 300 increase

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Thank You Very MuchReady eXercise

• Robert Goldstein MS
• Exercise Physiologist
• readyexercise.com
• 925-457-5346