Exercise Prescription For Diabetes Robert Goldstein, MS;

Exercise Prescription For DiabetesRobert Goldstein, MS; • Health Educator • Fitness Therapist • Disease Management For Diabetes Health Fitness Instructor American College of Sports Medicine

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

Disclaimer • Today’s 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

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.

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

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!!!

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

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!!

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!

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

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

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.

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 Men’s waist 40” Woman’s 35” • 8) Age 45 0r over.

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.

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.

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

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.

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 don’t think you can and if you never did before.

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,

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

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.

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

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.

How Can I Start Stages of Change • Pre-Contemplation • Contemplation • Action: The Fierce Urgency of Now!! • Maintenance • Relapse

SmartGoalsKISS • Specific • Measurable • Attainable • Realistic • Timely

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

Pre and Post Exercise Blood Sugar Averages 1 Year • Pre exercise 140 • Post Exercise 100

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

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

Thank You Very MuchReady eXercise Robert Goldstein MS Exercise Physiologist readyexercise.com 925-457-5346

Exercise Prescription For Diabetes Robert Goldstein, MS;