Getting Started
The first order of business with any exercise plan, especially if you're a dyed-in-the-wool couch potato, is to consult with your health care provider. If you have cardiac risk factors, she may want to perform a stress test to establish a safe level of exercise for you.
Certain diabetic complications will also dictate what type of exercise program you can take on. For people with diabetic retinopathy, activities like weightlifting, jogging, or high-impact aerobics can pose a risk for further blood vessel damage and possible retinal detachment. And the ADA recommends that patients with severe peripheral neuropathy (PN) avoid foot-intensive weight-bearing exercises such as long-distance walking, jogging, or step aerobics and opt instead for low-impact activities like swimming, biking, and rowing. If you have conditions that make exercise a challenge, your provider may refer you to an exercise physiologist who can design a fitness program for your specific needs.
If you're already active in sports or work out regularly, it will still benefit you to discuss your regular routine with your doctor. If you're taking insulin, you may need to take special precautions to prevent hypoglycemia during or after your workout.
Start Slowly
Your exercise routine can be as simple as a brisk nightly neighborhood walk. If you haven't been very active before now, start slowly and work your way up. Walk the dog or get out in the yard and rake. Take the stairs instead of the elevator. Park in the back of the lot and walk. Every little bit does, in fact, help.
Alert
Leg pain during exercise, especially aching in the calves, buttocks, or thighs, could be a sign of intermittent claudication and peripheral vascular disease (a potential complication of diabetes). Physician-supervised exercise, particularly walking, can actually help ease the pain over time. Medication may also be required.
As little as thirty minutes of daily, heart-pumping exercise can make a big difference in your blood glucose control and your risk of developing diabetic complications. One of the easiest and least expensive ways of getting moving is to start a walking program. All you need is a good pair of well-fitting, supportive shoes and a direction to head in.
Do pay particular attention to your feet both before and after you walk or run. Because of the risk for foot ulcers and other diabetic foot problems, you should examine them carefully for blisters and abrasions and treat them promptly if they do occur. Seamless, waterproof socks that wick moisture away from your feet can help to prevent friction while walking. For more on diabetic foot care, see Chapter 16.
Making Time
Everyone is busy. But considering what's at stake, making time for exercise needs to be a priority right now. Thirty minutes a day isn't much when you get right down to it. Cut one prime-time show out of your evening television-viewing schedule. Get up a half-hour earlier each morning. Use half of your lunch hour for a brisk walk. You can find the time if you look hard enough for it.
Essential
You don't have to spend a lot of money to get moving. However, some people find that if they make a monetary investment, they're more likely to follow through on fitness. If you're on a budget, investigate a basic membership at your local YMCA or community center.
You can also try combining exercise with something else already on your schedule. If you normally spend an hour on Saturday morning playing video games with your kids, take it out of virtual reality and play a real game of touch football or Frisbee outside. Get off the riding mower and cut the grass the old-fashioned way — with a manual push mower. Wake up early and walk your kids to school. Look for opportunities rather than excuses.
