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DIABETES and EXERCISE Presentation Overview

D disease I insulin A annoying B blood sugars E exercise T types (pre-diabetes, 1,2 gestational) E eating S sedentary. DIABETES and EXERCISE Presentation Overview. Why Exercise is important in good diabetes management Exercise guidelines How much, how often, how intense?

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DIABETES and EXERCISE Presentation Overview

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  1. D diseaseIinsulinA annoyingBblood sugarsEexerciseTtypes (pre-diabetes, 1,2 gestational)EeatingSsedentary

  2. DIABETES and EXERCISEPresentation Overview • Why Exercise is important in good diabetes management • Exercise guidelines • How much, how often, how intense? • Resistance training • Case Study 1 • Patient Considerations/Precautions • GRx Healthy Lifestyle Support • Case Study 2 • Recap

  3. Why Exercise? Physical Activity Nearly everyone with diabetes can derive some benefit from an appropriate physical activity programme. Physical activity (PA) is a cornerstone of patient’s diabetes self-management. • Aerobic exercise increases insulin sensitivity and, together with proper nutrition, helps restore normal glucose metabolism, by decreasing body fat. • Strength training (resistance or weight training) also decreases body fat by raising metabolism. • Its MAIN BENEFIT is increasing glucose uptake by muscles and enhancing ability to store glucose.

  4. How does exercise affect BSLs? When exercising, the body needs extra energy/fuel (glucose) for the exercising muscles. For short bursts (jogging to the car) muscles and the liver can release stores of glucose for fuel. With continued moderate exercising however, muscles uptake glucose at almost 20 times normal rate.This lowers blood sugar levels. But intense exercise can have the opposite effect and actually decrease BSL. The body recognises intense exercise as a stress and releases hormones that tell your body to increase available BSL to fuel the muscles. For a variety of reasons, after exercise, people with diabetes may have an increase or decrease in BSL.

  5. Specific health benefits for diabetics • Helps control blood glucose • Lowers triglycerides • Assists with weight loss • Lowers blood pressure • Helps raise HDL • Helps lower total cholesterol and LDL (if there is weight loss) • Increases cardiovascular fitness • Increases muscle strength and balance

  6. PA – yes, there’s more ..2 • Builds/maintains healthy bones / reduce risk of osteoporosis • Promotes psychological wellbeing • Reduces risk of colon cancer • Improves sleep patterns • Increases cardiovascular fitness • Decreases pain • Helps rehab after medical/surgical events • Helps maintain independent living / reduce risk of fractures • Exercise can mean the difference between ‘medical management’ and ‘lifestyle management’ of Type 2 Diabetes

  7. PA / Exercise GuidelinesHow much? How often? How intense? • Reduce sedentary (sitting) time From the Latin: sedere – to sit • Latest findings show that a combination of AEROBIC and STRENGTH traininghas a profound impact on helping people manage diabetes. • 30 minutes per day on at least 5 days a week (Pedometers 10,000 steps per day) • 10 minutes x 3 during the day preferable to 0 • Moderate intensity (Borg Scale Perceived Exertion of 6-7) (Talk Test) • Examples include brisk walking, cycling, swimming, dancing, rowing, lawn mowing- Preferred options include local pools, community classes, walking groups, gyms

  8. PA / Exercise GuidelinesHow much? How often? How intense? Cont.. • Weights/resistance training • Twice a week • 8 – 12 repetitions per set of 8 – 10 exercises targeting major muscle groups • Build up to 3 sets • Light hand weights, Dyna bands (Fit Strips), resistance balls cheap and effective • Qualified Trainer can set personalised, reviewable programme • Community options available i.e. ‘Shape-Up’

  9. Case Study 1 • 58 yrs old • 113 kg • Working full time • BP high, energy/mood low • Non-restorative, broken sleep • Diagnosed Type 2 early 2010 • Took nutritional advice to heart • Green Prescription issued March • Began walking 10 minutes to/from work 3 x week • Persevered to 5 x week, walking faster • Added weekend walks • Began to ‘just feel better’ • Now lost 17kgs and still feels fantastic!

  10. Patient Considerationsfor PA • Any additional risk factors for CVD • Peripheral arterial disease • Thermo regulation • Diabetic neuropathy • Retinopathy • Regular glucose monitoring(self observation) • Routine of exercise, eating and medication • Foot care / eye care • Medically stable for exercise (GRx)

  11. GRx Healthy Lifestyle SupportYour first port of call when prescribing exercise for diabetes 12 or 24 weeks patient support Use the 5 “A”s to assist patient to succeed (A=Assess, A=Advise, A=Assist, A=Agree, A=Arrange) Employ the 3 “E”s to achieve sustainability(E = Enjoyment E = Exercise E = empowerment) Monthly Face to face consultations Monthly telephone top-ups Smart Goal Setting Hit The Target steps to the Smart Goal Behaviour Change identification

  12. GRx Healthy Lifestyle Support cont.. Motivational text messages Effective Encouraging Emails Physical activity options – the right choice at the right time Exercise Induction Process at venues Personalised Physical Activity Plans Nutritional advice Using a Food Diary Short-term pedometer hire Links to other community support groups Transport assistance (St. Johns bus) Specific focus meetings Volunteer opportunities

  13. Case Study 2 • 65+ years old • Type 2 Diabetes • Overweight • No energy, too many medications • High BP • Mild Depression • Painful arthritis / reduced mobility • Nurse referred to GRx • Planned to look at Sit and be Fit and ‘Water-Worx’ • Attended seated exercises with a friend • Achieved success, no negative side-effects, lots of fun • Warm water at pool fabulous, moving more freely • No longer needs ‘nana naps’ • Lost 7 kgs • Regularly active and feeling so much happier!

  14. To Recap • PA crucial to good diabetes management • Refer to GRx team for Healthy Lifestyle Support(patient doing less than 2.5hrs/exercise per week and 18+ yrs) • Every little bit of exercise helps – 10mins x 3 x 5 • Contact GRx team anytime for extra motivational tips / phrases / helpful conversation guides

  15. Referrals Forms • GRx desk pad or • Your own MedTech electronic practice referral • No electronic referral onyour computer? Arrangefor installation.

  16. Please Contact Us • Leigh Dalzell, GRx Co-ordinatorNelson Bays Primary HealthP.O. Box 177620 New Street, NelsonTel: 539 1772DD 539 1662Cell 021 547811

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