Question: I walk to school instead of taking the bus almost everyday. My doctor tells me I need to do more activity to get my weight down. Why do I need to do more activity if my blood sugar is at a normal level?
Keep up the good work with walking to school. Great Job! If you're blood sugars are under good control, that's even better news. "However, it is important for everyone to be physically active whether or not they have diabetes or are trying to lose weight. Being physically active has lots of health benefits including keeping your heart, muscles, and bones strong," says Dr. Erinn Rhodes, Director of the Type 2 Diabetes Program at Children's Hospital Boston. She says that children and adolescents should aim for at least 60 minutes of moderate to vigorous physical activity per day and should also include some physical activity that strengthens the muscles and bones at least three days a week. If you are looking for ideas for these physical activities, Dr. Rhodes recommends that you check out this website, http://www.cdc.gov/physicalactivity/everyone/guidelines/what_counts.html
Question: My doctor tells me that I should aim to be doing 60 minutes per day of moderate to vigorous physical activity. That seems like a lot for me to handle. Do I have to do it all at once?
Having a target goal is important, but equally important is being realistic about how quickly you can get there. Dr. Rhodes advises, "Be sure to start slow and with intermediate goals that you can definitely achieve. Keep advancing as you go. Your exercise does not need to be done all at one time." She reminds us that there are lots of activities that you might do every day, like walking or biking to school, which all count as exercise. Take things one day at a time. Before you know it, you'll be on your way to a regular exercise routine.
Question: Can I exercise if I'm taking insulin?
Exercising is key to managing your type 2 diabetes, and you can definitely still exercise if you're taking insulin. According to Dr. Rhodes, there are a few extra things that you should keep in mind. Always check your blood sugar before and after you exercise. Also check during exercise if you feel symptoms of a low blood sugar. Why? Because exercise tends to lower blood sugar levels--your muscles use more sugar for energy, and your body becomes more sensitive to insulin. To avoid low blood sugars, try to exercise after a healthy meal or snack and avoid exercising when your insulin is at its peak. Talk with your diabetes team about the best time for you to exercise or if you are having any problems with low blood sugars when exercising.
Question: I don't like exercise, and my doctor just told me I have to. How do I start?
If you've never really exercised before, it can seem overwhelming. You might find gym class boring (or maybe don't have gym at school) and anything beyond that feels too hard. "The main thing to remember is that there are lots of different ways to be active. Exercising does not necessarily mean going to a gym and running on a treadmill," says Dr. Rhodes.
She suggests that if you aren't currently active, start slow. Think about activities that you already do--like walking a dog or walking around the mall--and do them more often. Exercise is good for everyone, so get a friend to join you. Slowly, you can work toward a goal of 60 minutes per day. Remember that physical activity can affect your blood sugar, so be sure to check it before exercising, and always have your meter and something on hand to treat a low blood sugar. As you make small changes, you may surprise yourself and end up trying new activities like dancing, yoga, or biking.
Question: Are there specific types of exercises that are better than others for kids with type 2 diabetes?
In general, exercise is an important part of managing type 2 diabetes because it helps to manage blood sugars by improving the body's sensitivity to insulin. Exercise allows muscles to more effectively use sugar as energy while improving cardio respiratory fitness and lowering body fat. According to Dr. Rhodes, "Children and adolescents should aim for at least 60 minutes of physical activity per day and most of this time should be either moderate-intensity aerobic activity, like brisk walking, or vigorous-intensity aerobic activity, like running." Dr. Rhodes also notes that kids with type 2 diabetes, especially those on insulin, who are planning on starting a new exercise plan, should start/advance slowly. She recommends checking your blood sugar before exercise and during exercise if you experience any symptoms of a low blood sugar, making sure that you have a source of sugar, like glucose tabs, with you in case your blood sugar drops. Dr. Rhodes also recommends avoiding giving one's self an insulin shot in an area that will be used for exercise (e.g., avoid the thigh if you are about to go running). Finally, be sure to talk with your diabetes team if you are having repeated problems with low blood sugars during exercise.
Question: Does taking the stairs at school count as exercise? Does walking instead of taking the bus count too?
Absolutely!! According to Dr. Rhodes, you have to "give yourself the credit you deserve." Walking instead of the bus and taking the stairs instead of the elevator are great ways to be more active. Get support from your family too. Next time you go to the supermarket, park a little further away from the entrance. The extra walking will be good for everyone! Many household activities can be exercise too. Raking leaves and chasing your little brother or sister around the house are definitely exercise!
Question: It's getting too cold to walk outside, what are easy ways to exercise in winter?
Exercising in the winter can be a challenge. The important part is to try not to let it stop you from managing your health. If you enjoy walking, check with your school or a nearby college to see if they have an indoor track that you can use. When there aren't sporting events going on, tracks are often open. Going dancing with friends is exercise. So is walking laps around the mall. Dr. Rhodes wants you to remember that "being physically active does not mean that you have to be on a treadmill. If you have access to a community center, see if you can get a group together for a game of basketball. If you prefer to exercise on your own, dance at home to your favorite music. A cold winter is a time to be creative. Just keep moving!"
Question: I feel like I exercise a lot and yet I don't lose weight. Why? What can I do? Am I doing anything wrong?
Congratulations! You should feel proud of taking an important step in managing your diabetes. According to Dr. Rhodes, you should consider how much time you spend exercising and the intensity of your exercise. She adds, "It is important to start slow and with realistic goals." Regular exercise will help lower your percentage of body fat even without a change in weight. This is an important way to reduce your risk of future health problems. Ask your doctor about creating an exercise plan that's best for you.
Question: Sometimes I feel sore after I exercise, is that because I have diabetes?
"Exercise is an important part of a healthy lifestyle and key to successful diabetes management," says Dr. Rhodes. Dr. Rhodes reminds us that every exercise plan needs to include a warm up, stretching and cooling down. She adds, "These steps are key to avoiding muscle soreness." If you find that your muscles are still sore, be sure to consult your diabetes team. Also remember to talk with your diabetes team when starting a new kind of exercise to make sure it's right for you.
Question: I have played baseball and basketball since I was in middle school. I am in high school now. Do I have to do more exercise to manage my diabetes?
First, take a moment and congratulate yourself on a job well done. Finding sports that you enjoy plays a key role in managing your diabetes. According to Dr. Rhodes, you should think about how much time you spend exercising and the intensity of your exercise. You should aim for 60 minutes of moderate to vigorous physical activity per day. She notes that regular exercise can help lower your percentage of body fat even without a change in weight. Along with eating a healthy diet, exercise is an important way to reduce your risk of future health problems. Always be sure to ask your doctor about creating a nutrition and exercise plan that works best for you.