Information on Physical Activity

Physical activity is very important for the whole population and of immense benefit to people with insulin resistance and/or Lipodystrophy. By increasing physical activity you can help to improve insulin resistance.

If you are not active your insulin resistance will get worse.

Physical activity can also:

• Improve muscle strength.
• Increase bone density and strength.
• Lower blood pressure.
• Help to protect against heart and blood vessel disease by increasing 'good' (HDL) cholesterol.
• Improve blood circulation and reduce your risk of heart disease.
• Increase energy level and enhance work capacity.
• Reduce stress, promote relaxation, and release tension and anxiety.
• Reduce your risk of developing some forms of cancer

Burning calories and losing weight!

Exercise is great for helping you to burn calories but it should not be a substitute for not following a low fat diet. As above exercise has huge health benefits even if you are not overweight. Try not to be tempted to treat yourself with food after exercising. Instead, try and reward yourself with a non-food treat, for example taking time to do something such as painting your nails or watching a film.

What are the recommendations?

It is recommended that everyone does a minimum of 150 minutes (2.5 hours) of moderate intensity physical activity every week. Moderate-intensity (aerobic) activity means you should feel warm, may break a sweat but should feel comfortable enough to maintain a conversation.

Examples of good aerobic activities include brisk walking, swimming and cycling.

Further to the above it is recommended that adults should do physical activities that strengthen muscles at least twice a week. This should involve using all the major muscle groups e.g. carrying and lifting, using weights or resistance bands.

Although 150 minutes may seem like a lot to many people, it may help to break this down into 30 minutes on five days a week. When starting out, this can be further broken down into three x ten minute sessions during a day. If you are managing to achieve 150 minutes a week then increasing the duration will give you further benefit.

Exercise does not need to take up hours of your time or mean that you have to buy lots of expensive equipment or clothing. If you don’t attend a gym already or play a sport then think about increasing your walking. Walking should not be underestimated as a way to improve fitness. It is a great all round exercise and can be completed at any time of the day.

One way of monitoring your activity levels could be to count your steps. You have likely heard that we should aim for a target of 10,000 steps a day. Some people find it beneficial to track their steps on their phones or a watch. This can help you track your progress and be very motivating. You could try and increase your target each week to get to the 10,000 steps.

Ways to increase your activity levels

• Walk while on the phone (most phones are mobile!). If you know the call will last more than 10 or 15 minutes then walk while you talk.
• Aim to walk locally e.g. to the shops or get off the bus a stop early or park a little further away.
• Build a walk into your lunch break.
• If you’re bored at home or feel down, a walk will give you fresh air and help keep you busy.
• Go for a walk with a friend – walk and talk rather than meeting in a pub or café.
• Walk/cycle to work.
• Join a gym or find an exercise buddy.
• Set yourself goals/targets.

Your ideas ……………………………………………………………………………………

How does exercise/activity affect blood sugar levels?

• Normally, insulin is released from the pancreas when the amount of glucose (sugar) in the blood increases. Insulin stimulates the liver and muscles to take in excess glucose. This results in a lowering of the blood glucose level.
• When exercising, the body needs extra energy or fuel (in the form of glucose) for the exercising muscles. For short bursts of exercise, such as a quick sprint to catch the bus, the muscles and the liver can release stores of glucose for fuel. With continued moderate exercising, the rate at which your muscles take up glucose can be as much as 20 times the normal rate. This lowers blood sugar levels in the long term.
• Intense resistance exercise can have the opposite effect and actually increase your blood glucose levels. This is especially true for many people with diabetes. The body recognises intense exercise as a stress and releases stress hormones that tell your body to increase available blood sugar to fuel your muscles. If this happens to you, you may need a little bit of insulin after intense workouts or finish your intense exercise with a longer cool down walk to reduce your blood glucose level again. If you notice this happening then please speak to your diabetes educator.

Risks of hypoglycaemia

If you are injecting insulin then you need to be aware that exercise can cause hypoglycaemia (low blood sugar).

This is where your blood glucose level falls below 4mmol/l. If you notice that you have to eat more to prevent your blood sugars dropping below the ideal range (4-7mmol/l) please speak to one of the team as we may be able to adjust your medications/insulin instead and enable you to exercise without risking hypos when you are exercising. This will further aid weight loss through exercise.

• Make sure you exercise with someone who knows you have diabetes and knows what to do if you have a low blood-glucose
• Wear a medical identification tag (for example, MedicAlert) or carry an identification card that states you have diabetes.
• Always carry hypo treatments and identification when exercising away from home e.g. four to five dextrose tablets or four jelly babies.
• It is advisable to avoid exercising following a hypo as you will be at greater risk of having another hypo.
• It is important to test your blood sugar to check you are hypo as sometimes the symptoms of being tired and sweating from exercise can be confused with a hypo.

If you do a lot of exercise then please speak to your diabetes educator for more specific and personalised advice.

General exercise guidelines and precautions

• Choose an activity that you enjoy. You'll be more likely to stick with it in the long run.
• Start slowly and gradually increase the intensity.
• If you have mobility or joint problems consider non-weight bearing activities e.g. cycling, swimming and/or water aerobics.
• Wear good shoes and practice good foot care. If you have any foot issues ask to be referred to a podiatrist.
• Drink water before, during, and after exercise to prevent dehydration.
• Do not ignore pain - discontinue any exercise that causes unexpected pain. If you continue to perform the activity while you are in pain, you may cause unnecessary stress or damage to your joints. It is not a case of ‘no pain, no gain’!

Burning calories and losing weight.

Exercise is great for helping you to burn calories but it should not be a substitute for not following a low fat diet. As above, exercise has huge health benefits even if you are not over weight.

Useful websites

NHS Choices Website – get fit for free

This website has excellent links to 12 week fitness plans. Good suggestions for individuals and family activities

Better Health Website - healthier families

This website provides excellent information for the whole family.

There are a number of national weight management group that incorporate exercise into the programme – A couple of examples are listed below:

Rosemary Conley website (opens in a new tab)

WeightWatchers website (opens in a new tab)

There are also a number of online activity classes available free of charge. Try searching for a free dance class, walking groups or yoga session in your area. There are also many free online pre-recorded classes if you do not feel confident to join a group.

If you do not have access to a computer and wish to have this information please ask one of the team to print this off for you. We will also be happy to discuss the information with you.

It is also worthwhile consulting your local GP surgery as many surgeries have a variety of exercise schemes set up in your local area.

If you have any questions, please ask the healthcare team.

Contacts/Further information

SIR dietitians Catherine Flanagan and Lisa Gaff on 01223 216655

SIR diabetes nurse – 01223 348790 or 01223 756455