Showing posts with label exercise. Show all posts
Showing posts with label exercise. Show all posts

Saturday, November 27, 2010

Managing Diabetes With Exercise: 6 Tips for Nerve Pain

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Diabetes Symptoms Diabetic Diet Gestational Diabetes Diabetic Neuropathy Prediabetes Insulin Pump Diabetes Health Center webmd.m.share.init(); Font Size A A A webmd.m.fontSizer.init(); Managing Diabetes With Exercise: 6 Tips for Nerve Pain By Rebecca Buffum Taylor
WebMD Feature Reviewed by Brunilda Nazario, MD

What kind of exercise is safe -- and fun -- if you have nerve damage from diabetes, called diabetic neuropathy? And how can you stay motivated after that first flush of inspiration fades?

"It depends on where you're starting," says Dace L. Trence, MD, an endocrinologist and director of the Diabetes Care Center at the University of Washington Medical Center in Seattle. "For the person who has been doing nothing, you would certainly want to start doing something that's comfortable and enjoyable and can be maintained."

Recommended Related to Diabetes 6 Diet Tips to Help Manage Diabetes Nerve Pain

If you have diabetes, you already know the drill. What you eat, when you eat, and how much you eat can send your blood sugar skyrocketing -- or make it plummet. For better or worse, "diet and diabetes" go together like salt and pepper.So if you need a little motivation to eat better - and who doesn't? - consider this: with diabetes, you're at high risk of the nerve pain and damage called diabetic neuropathy. What can start as a little tingling or numbness in your feet can turn into major problems...

Read the 6 Diet Tips to Help Manage Diabetes Nerve Pain article > >

If you have diabetic nerve pain in your feet, legs, arms, or hands, consider this: research published in The Journal of Diabetes Complications in 2006 showed significant benefits of exercise in controlling peripheral neuropathy. The study showed that for people who took a brisk, one-hour walk on a treadmill four times a week, exercise slowed how quickly their nerve damage worsened. There's no quick fix here, though; the study lasted four years.

Let's face it: when it comes to managing a lifelong condition like diabetes, it makes sense to think long-term. It's all about lifestyle changes to protect yourself from diabetic nerve damage. Becoming more active can help you control blood sugar levels, feel good, and lighten the load on painful feet and legs, especially if you're overweight. These tips can help you start and stick with an exercise plan for more than the first few days.

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Sunday, November 21, 2010

Is Correcting Low Blood Sugars Caused by Exercise Making You Fat?

Over the years, I have had many exercisers with diabetes ask me why they're gaining weight instead of losing it. There are two possible answers to that question. One answer is that muscle is heavier than fat, so if you are gaining muscle while losing fat-especially in the early stages of a new exercise program-your scale weight probably doesn't reflect your positive changes in body composition (i.e., less fat, more muscle).

The second possible answer is more applicable to people who are not new to exercise, but who may have recently changed the amount or intensity of their training. I always ask them, "Have you been treating a lot of low blood sugars recently?" When they invariably reply, "Yes," then I know to tell them that they have simply been taking in too many extra calories while treating hypoglycemia.

Of course, you have to treat a low if you have one! However, every calorie counts, even those? that boost your blood sugar back to normal (and beyond). People with diabetes often reach for candy, cola, juice, or other high calorie, high fat, and high sodium foods to correct lows, which can lead rebound high blood sugars, unhealthy eating, and weight gain. What you use to correct a low is usually just extra calories not accounted for in your daily meal plan.

What can you do to avoid gaining weight when you have to treat lows, especially if you have them fairly often?? The best advice is to treat them with something low in calories that has enough glucose to bring your sugars back to normal. When you have a hypoglycemic reaction, do not binge on candy, cookies, and other high calorie, high fat foods. These "treats" take longer to raise your blood sugar than pure glucose and usually contain calories (like those from fat) that do not raise blood sugar levels effectively. You are almost certain to eat too much of them while waiting for your blood sugar to rise, and you end up consuming unnecessary calories that cause weight gain. Excess weight gain can lower the ability of your insulin to keep blood sugars in check. You can also end up with rebound hyperglycemia, which may increase your insulin needs and promote fat storage.

I'm going to sound like a walking advertisement for glucose products from here on out, but both professional and personal experience has taught me how critical it is to make smart choices when you want to exercise regularly and avoid weight gain. Using fast-acting glucose to raise your blood sugars is likely to contribute the fewest extra calories. Why? Pure glucose tablets contain only four calories per gram, so a 15-to-20 gram treatment has 60 to 80 calories, and every single calorie goes directly to rapidly correcting your blood sugar levels.

Hypothetically speaking, if you're correcting just two lows per week with 15 grams of carbs, you will take in an extra 6,240 calories a year, or the equivalent of almost two pounds of body fat (one pound of fat is 3,500 calories). By way of comparison, getting 15 grams of carbs from other foods usually results in the consumption of far more calories, especially if any of the foods contain fat (nine calories per gram) or protein (four calories per gram), neither of which will rapidly correct a low blood sugar.

Here are a few other food comparisons:

●?? A two-ounce bag of Skittles candy contains almost 60 grams of carbohydrate and four times the calories of a 15-gram glucose dose. Likewise, just one ounce of Smarties contain 25 grams, which would probably raise your blood sugar too much and cause you to take in extra calories.

●?? A candy bar like Snickers contains about 100 extra calories for every 15 grams of carbs. Correcting lows with Snickers or other candy bars adds another three-pound weight gain a year.

●?? A regular soda that contains high-fructose corn syrup may take longer to correct a low (fructose has to be converted into glucose first),? and it's easy to consume more than 15 grams-which is the amount in only four ounces of a soda (one-third of a 12-ounce can).

●?? Even choosing orange juice or a banana to correct a low is less effective because the fructose (fruit sugar) is much more slowly converted into glucose. You probably won't be able to stick to only four ounces of juice or half of a medium banana (15 grams of carbs) while you wait for your low to be corrected, and you may end up consuming more calories than necessary.

Check out some calorie intake comparisons using Dex4's new Hypo Smart Choice Calculator at http://dex4.com/smartchoice/. You'll probably be surprised by how many extra calories you may be consuming just by treating low blood sugars with the usual treatments like orange juice and soda!

There is nothing worse than exercising and trying hard to lose weight, but ending up gaining instead due to all the extra calories you consume when correcting low blood sugars. If you can prevent exercise-related low blood sugars with diet and medication changes and thereby avoid taking in those extra calories in the first place, certainly do that!? But when you do have to treat an occasional low, keep in mind that using food rather than pure glucose can add a lot of calories to your total yearly intake, and your lows may take longer to correct.

In short, pure glucose is always best for rapid treatment of lows. For prevention of lows during longer bouts of exercise or overnight, however, consider taking in a low-calorie bedtime snack with a balance of carbs, protein, and fat, which will keep your blood sugars stable for longer. Some examples are Balance bars, low-fat and reduced sugar yogurt, or low-calorie ice cream. An ounce of prevention is always worth a pound of cure, especially if a hypoglycemic episode leads you to eat everything in sight!

***

Sign up for five free healthy living reports via e-mail or receive very low-cost weekly "Fit Brain, Fit Body!" fitness/lifestyle programs at www.lifelongexercise.com. Access more articles and information at www.shericolberg.com. If you need tips for getting safely started on an exercise program, check out The 7 Step Diabetes Fitness Plan.? For people with any type of diabetes who are already active, consult the Diabetic Athlete's Handbook.


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Thursday, November 11, 2010

Diabetes profile: Nancy Kaneshiro tried weight loss and exercise, then lap-band surgery

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EmailE-mail printPrint increase text sizedecrease text sizeText Size la-he-diabetes-control-kaneshiro-20101101 Nancy Kaneshiro tried practically every popular weight-loss program in the 1990s, including Weight Watchers and Jenny Craig. But the fortysomething book publicist remained 100 pounds overweight.

When diagnosed with diabetes in 1998, "I flipped my wig," she said. Her internist started her on the diabetes drugs metformin, glipizide and Actos. The Woodland Hills resident became a zealous calorie-counter and gym-goer, doing 30 to 60 minutes of cardio and resistance training at her 24 Hour Fitness every morning for 10 years.

"As you get older, the changes that Mother Nature visits upon women are very mean," Kaneshiro says. "No matter what I tried, the [ weight loss] was minimal." Her doctor explained that her age ? by then she was in her late 50s ? and her diabetes were conspiring to keep the weight on. Lab tests had him worried that irreversible kidney damage was around the corner. She decided it was time for more drastic measures.

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Fourteen months ago, Kaneshiro had lap-band surgery at Cedars-Sinai Medical Center. Doctors placed an adjustable band around the top of her stomach, which restricts the amount it can hold and digest to about half a cup of food (a normal stomach can hold 6 cups of food). It is a less-invasive type of bariatric surgery, which is recommended for diabetics who are severely obese.

"If you are not ready to take control and be responsible for what goes in your mouth, don't do it," advises Kaneshiro, who is still learning to take smaller bites and eat slowly. "The surgery is a complete change of lifestyle in one day ?you don't have a choice."

At her one-year post-surgery appointment, Kaneshiro was initially dismayed that she had dropped only 45 pounds. But her internist cheered her up by focusing on how much her health had improved. He reduced her metformin dose, eliminated Actos and is no longer worried about kidney damage.

Kaneshiro now reports less chronic back pain, fewer knee aches and better stamina than she's had in years. "I'm a big fan of this intervention for people who just can't swing" the weight loss, she says.

?Kendall Powell Copyright ⓒ 2010, Los Angeles Times

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