Thursday, November 3, 2011

Exercise & Diabetes.... yep I used the "E" word

When you are a diabetic, you hear about exercise as much or more than you hear about checking your blood sugar!  It seems to be the number one focus of everyone from health care providers to your favorite (or un-favorite) family member.  When you hear diabetes or exercise what do you think?  Be honest.... you think.. usually it is something along the lines of "it's about time Alice lost weight".... believe it or not while that is one of possible benefits it is not the main reason a diabetic should exercise.... yep... I said it, it is not about the weight - weight is not necessarily health but its what the high blood sugar is doing to a diabetics body that maters.

On my quest to become healthy, I have made a lot of changes....a ton of changes but with my check-up and med adjustment tomorrow, exercise was the last thing on my list to "Start".  I had to sell myself on why losing a few pounds would matter to the overall scene.  If you know much about me, you know that I need data to back up anything.  I need to sell myself on stuff with books, reports, white papers, clinical studies...etc etc etc.... it is great to hear from people but the data talks to me.

About a week ago,  I started the data dive as to why to exercise.  Expecting it to be about weight, after-all isn't it always?

That is NOT what I found!  I learned that exercise makes your insulin receptors active and more willing to accept/process the glucose in the body!  Yep, it acts as a insulin booster pack.  OK, the data had me interested... so I dug in deeper.

A post hoc meta-analysis, published in JAMA on September 12,2001 (vol 286 no 10), looked at 13 studies that compared exercise groups and non-exercise groups based on A1C (A1c is the tattle tale for Diabetics, it is a blood test that shows the averaged based blood sugar level for the last 3 months).  This meta-analysis showed there was a "clinically significant" change in A1c levels between the groups while there was not a significant lose of body mass.... yep, people did not lose weight but they made a nice dent in their blood sugar results.  (Lets face it we are probably talking about typical diabetic patients that do not enjoy "exercise" - as one and related to a few, I pull the I can say it because I represent it card!!)

OK, how did this information help me decide to exercise.... it didn't!  But this next part did.....

There was not a significant difference between the people who worked out via aerobic and the people who did the resistance training.... yep, I can lift a few weights.  Perhaps a lap or 2 in the pool.  Get in some funky Yoga stances or maybe even play with the elastic broken rubber bands (resistance bands) and get a "clinically significant" advantage to my blood sugar.  Lets face it, even the laziest diabetic can lift a weight while they are watching television or if they are playing wow (..... not pointing fingers at anyone specific...) perhaps they can lift a weight while you wait for the game to load.....

When they say "clinically significant" what does that mean?  Well it is different for different studies and etc... but the basis is two things.  A. it can be repeated with a reasonable degree of faith and b. it is enough to make a difference in the symptom/disease state.  For this study, it found a averaged decrease in A1c of .66%.... Does not look like much but lets look at the numbers...It drops your daily average by approx 12 points, at 300 not a big deal (After all you are seriously out-of-whack, you need medical help) but if you are pre-diabetic or if you trying to make sure you do your part to keep your..... eyes, arms, legs, kidneys... blah blah blah.... those points matter! If I had to guess, I would put my A1c between 10 &11 right now.  But not for long!  I bet if they spent less time trying to get diabetics to lose weight and more time educating why exercise mattered (aka made their bodies happier to accept the insulin) it would matter.  Even framing up what "exercise" would do the trick.  After all when I think of exercise I am thinking sweating, huffing, puffing, pain, should I go on??  nah.  I know I would have done more, if I understood more the reason.

In about 30 min, I meet with my new personal trainer (poor girl!).  Next week I have a fun new toy coming (expect a blog on it!!) that will help track every movement I make towards a healthier lifestyle + Exercise.  IF my arms still work, I will post a blog about the workout tomorrow.

Well off to change into a workout outfit and get ready for my next expensive adventure in this process I call "living healthier."

Get more active... that is the basic gest of all the articles I read on the subject (which was about 20).  If your not someone who likes to "exercise" in the tradition way, find something that gets you moving.  Every motion matters when it comes to your blood sugar.  (If your blood sugar is about 250 and all that other, I am not a doc cant give advise  blah blah blah coverage stuff - Talk to your doc!)

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