Injury free exercising – 12 tips

Here are a few simple things you can do to help prevent injuries, dehydration, and hypoglycemia when exercising:

Talk to your doctor about which activities are safest for you. Your doctor’s advice will depend on the condition of your heart, blood vessels, eyes, kidneys, feet, and nervous system. Still, many people with diabetes can do the same activities as someone without diabetes.
Warm up for 5 minutes before starting to exercise and cool down for 5 minutes after. Your warm up or cool down should be a lower intensity than the rest of your time exercising. This helps get your blood flowing and warms up your joints.
Avoid doing activity in extremely hot or cold temperatures. Choose indoor options when the weather is extreme.
Drink plenty of water before, during, and after activity to stay hydrated.
If you feel a low coming on, be ready to test for it and treat it. Always carry a source of carbohydrate with you so you’ll be ready to treat low blood glucose. This is especially important if you are on insulin and have type 1 diabetes.
If exercising for an extended period (more than an hour or two), you may want to have a sports drink that provides carbohydrates. Be careful to check the nutrition facts though, you may need to water down the drink so that you don’t have too much, which can cause your blood glucose to spike.
Wear a medical identification bracelet, necklace, or a medical ID tag that identifies you as someone with diabetes in case of emergency, and carry a cell phone with you in case you need to call someone for assistance.
Activities should be energizing but not overly difficult. Use the “talk test” to make sure you are not pushing yourself too hard. If you become short of breath and you can’t talk, then slow down. This is most important when you are just starting to increase the activity in your routine. As you become fit, you’ll be able to exercise at a higher intensity and chat with others while you do it.
Take care of your feet by wearing shoes and clean socks that fit you well.
You should also check inside your shoes before wearing them. Socks that are made out of a material that reduces friction and pulls moisture away from your skin can also help protect your feet.
Carefully inspect your feet before and after activity for blisters, redness, or other signs of irritation. Talk to your doctor if you have a foot injury or a non-healing blister, cut, or sore.
Stop doing an activity if you feel any pain, shortness of breath, or light-headedness. Talk to your doctor about any unusual symptoms that you experience.

Exercising with complications

If you want to know more about exercising safely with specific diabetes complications, take a look at the list below.

This can serve as a guide to what types of activity might work for you.

Heart Disease

Be careful with: Very strenuous activity, heavy lifting or straining, isometric exercises, exercise in extreme heat or cold.

Beneficial Activities: Moderate activity such as walking, daily chores, gardening, fishing. Moderate dynamic lifting, stretching. Activity in moderate climate.

High Blood Pressure

Be careful with: Very strenuous activity, heavy lifting or straining and isometric exercise.

Beneficial Activities: Most moderate activity such as walking, moderate lifting, weight lifting with light weights and high repetitions, stretching.

Nephropathy

Be careful with: Strenuous activity.

Beneficial Activities: Light to moderate daily activities such as walking, light household chores, gardening, and water exercise.

Peripheral Neuropathy

Be careful with: High-impact, strenuous, or prolonged weight-bearing activities such as walking a long distance, running on a treadmill, jumping/hopping, exercise in heat or cold, weight-bearing exercise when you have a foot injury, open sore, or ulcer.

Beneficial Activities: Light to moderate daily activities, exercise in a moderate climate, moderate weight-bearing activities that are low-impact (e.g. walking, cycling, swimming, chair exercises). Moderate weight-bearing exercises like walking are okay once foot ulcers have healed.

Those with peripheral neuropathy need to have appropriate footwear and should check their feet every day.

Autonomic Neuropathy

Be careful with: Exercise in extreme heat where dehydration can occur, activities requiring rapid changes in movement that may result in fainting. Talk to your doctor before starting an exercise program – you may need an exercise stress test.

Beneficial Activities: Mild to moderate aerobic activities and resistance training, but increase the length of time you exercise slowly. Follow your doctor’s recommendations.

Retinopathy

Be careful with: Strenuous exercise, activities that require heavy lifting and straining, breath holding while lifting or pushing, isometric exercise, high-impact activities that cause jarring, head-down activities.

Beneficial Activities: Moderate activities that are low impact (e.g. walking, cycling, water exercise), moderate daily chores that do not involve heavy lifting, straining, or the head to be lower than the waist.

Peripheral Vascular Disease

Be careful with: High-Impact activities.

Beneficial Activities: Moderate walking (may do intermittent exercise with periods of walking followed by periods of rest), non-weight-bearing exercise: swimming cycling, chair exercises.

Osteoporosis or arthritis

Be careful with: High-Impact activities.

Beneficial Activities: Moderate daily activities, walking, water exercises, resistance exercise (e.g. light lifting activities), stretching

Worst Case Scenario: Diabetic Coma

Diabetic coma is an emergency. You cannot be prepared in advance. If you have the feeling of an extreme high or low blood sugar you should call your local emergency number. You need to ensure help before you pass out.

If there is a person with you instruct him/her about it. If this person is familiar with diabetes care he/she should:

Test your blood sugar.
If the blood sugar level is lower than 70 mg/dL (3.9 mmol/L), administer an injection of glucagon. If glucagon isn’t available, rub glucose gel, honey or non-sugar-free syrup on the inside of the unconscious person’s cheek. No insulin should be given!
If the blood sugar level is above 70 mg/dL, wait for medical help to arrive. Don’t give sugar to someone whose blood sugar isn’t low.

Let the emergency care team know about the diabetes and what steps have been taken, if any.

Eating out at a restaurant

If you have an eating plan for your diabetes this does not mean that you cannot go out to eat. Your meal at a restaurant can be part of your eating plan if you are well aware of what you need. Here you find some suggestions about how to ease the process of going to a restaurant and to stay committed to your eating plan:

Research restaurant menus

When available online check a restaurant’s menu, and ethe nutrition facts if available.

Keep portion sizes in check

Generally speaking you should eat moderately. So try to avoid big portions:Choose the smallest meal size if the restaurant offers options, for example a lunch-sized entree. Share meals with a dining partner. Request a take-home container

Consider avoiding “all you can eat” buffets. They make it difficult to resist and moderate your meal.

Make substitutions

Don’t settle for what comes with your sandwich or meal but customize it according to your needs. For example avoid French fries in favor of grilled vegetables. Do not be afraid to ask.

Watch the extras

Keep in mind that extras, bacon bits, croutons and fried chips, can sabotage diabetes nutrition goals by quickly increasing a meal’s calorie and carbohydrate count.

Even healthier additions — including fat-free salad dressing, barbecue sauce and fat-free mayonnaise — have calories. But you can enjoy small servings of these without adjusting your meal plan. Ask for them on the side to further control how much of them you eat.

Speak with the chef

Food preparation is also something to consider. Avoid breaded and fried food. Instead request that your food be:

Broiled
Roasted
Grilled

Don’t feel like you’re stepping out of line if you request healthier options or substitutions. You’re simply doing what it takes to stay committed to your meal plan.

Watch what you drink

Remember that calories come from drinks as well. So avoid high-calorie drinks. Instead of soda try following: diet soda, water, unsweetened iced tea, sparkling water or mineral water. Remember also that alcohol may be highly problematic. If your diabetes is under control and your doctor agrees, an occasional alcoholic drink with a meal is fine. But alcohol is rich in empty calories and can lead to diabetes complications. When choosing alcohol, choose options with fewer calories and carbohydrates such as:

Light beer
Dry wines

Limit alcohol to no more than two drinks a day if you’re a man and one drink a day if you’re a woman.

Eat on time

Your meal schedule is important to maintain steady blood sugar levels — especially if you are taking medications or insulin.

If you’re eating out with others, follow these tips: Schedule the gathering at your usual mealtime.To avoid waiting for a table, make a reservation or try to avoid times when the restaurant is busiest.If you can’t avoid eating later than usual, snack on a fruit or starch serving at your usual mealtime.

Save room for dessert

Remember that dessert isn’t necessarily off-limits. Sweets count as carbohydrates in your meal plan. If you’d like dessert, compensate by reducing the amount of other carbohydrates — such as bread, tortillas, rice, milk or potatoes — in your meal.

Remember the ground rules

Whether you’re eating at home or eating out, remember the principles of diabetes nutrition. Eat a variety of healthy foods. Limit the amount of fat and salt in your diet. Keep portion sizes in check. And above all, follow the nutrition guidelines established by your doctor or registered dietitian.

I found a blister on my foot, what should I do?

Diabetes complications include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly and are difficult to treat. Proper diabetes management and careful foot care can help prevent foot ulcers.

When foot ulcers do develop, it’s important to get prompt care. An ulcer that won’t heal causes severe damage to tissues and bone and may require surgical removal (amputation) of a toe, foot or part of a leg.

Here’s what you need to know to keep your feet healthy, and what happens if amputation is necessary. (Hyperlink)

Vaccinations

Keep your vaccines up to date.

High blood sugar can weaken your immune system, which makes routine vaccines more important than ever. Ask your doctor about:

Flu vaccine. An annual flu vaccine can help you stay healthy during flu season as well as prevent serious complications from the flu.
Pneumonia vaccine. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you’re age 65 or older, you may need a five-year booster shot.
Hepatitis B vaccine. The Centers for Disease Control and Prevention (CDC) currently recommends hepatitis B vaccination if you haven’t previously been vaccinated against hepatitis B and you’re an adult aged 19 to 59 with type 1 or type 2 diabetes. The most recent CDC guidelines advise vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you’re age 60 or older and have diabetes and haven’t previously received the vaccine, talk to your doctor about the whether it’s right for you.
Other vaccines. Stay up to date with your tetanus shot and its 10-year boosters. Depending on the circumstances, your doctor may recommend other vaccines as well.

Foot Treatment

Begin taking good care of your feet today. Set a time every day to check your feet.

Check your feet on a daily basis. Look at your bare feet for red spots, cuts, swelling, and blisters. If you can’t see the bottoms of your feet, use a mirror or ask someone to help.

Wash your feet daily. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. Use a pumice stone to gently rub the skin where calluses easily form. Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft.

Don’t remove calluses or other foot lesions yourself. To avoid injury to your skin, don’t use a nail file, nail clipper or scissors on calluses, corns, bunions or warts. Don’t use chemical wart removers. See your doctor or foot specialist (podiatrist) for removal of any of these lesions.

Keep your skin soft and smooth. Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes.

If you can see and reach your toenails, trim them when needed. Trim your toenails straight across and file the edges with an emery board or nail file.

Wear shoes and socks at all times. Never walk barefoot.

Wear clean, dry socks. Wear socks made of fibers that pull (wick) sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid socks with tight elastic bands that reduce circulation, as well as thick bulky socks that often fit poorly and irritate your skin.

Buy shoes that fit properly. Buy comfortable shoes that do not fit tightly and that provide support and cushioning for the heel, arch and ball of the foot. Avoid high heels or narrow shoes that crowd your toes. If one foot is bigger than the other, buy shoes in the larger size. Your doctor may recommend specially designed shoes (orthopedic shoes) that fit the exact shape of your feet, provide cushioning and evenly distribute weight on your feet.

Protect your feet from hot and cold. Wear shoes at the beach or on hot pavement. Don’t put your feet into hot water. Test water before putting your feet in it just as you would before bathing a baby. Never use hot water bottles, heating pads, or electric blankets. You can burn your feet without realizing it.

Keep the blood flowing to your feet. Put your feet up when sitting. Wiggle your toes and move your ankles up and down for five minutes, two or three times a day. Don’t cross your legs for long periods of time.

Don’t smoke. Smoking impairs circulation and reduces the amount of oxygen in the blood. These circulatory problems can result in more severe wounds and poor healing. Talk to your doctor if you need help to quit smoking.

Schedule regular foot checkups. Your doctor or podiatrist can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Schedule foot exams at least once a year or more often if recommended by your doctor.

Take foot injuries seriously. Contact your doctor if you have a foot sore that doesn’t begin to heal within a few days or other persistent problems with your feet. Your doctor will inspect your feet to make a diagnosis and prescribe the appropriate course of treatment

Preventing long-term conditions

Preventing long-term conditions – Your own help is needed

Don’t smoke

If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage, and kidney disease. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.

Keep your blood pressure and cholesterol under control.

Like diabetes, high blood pressure can damage your blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when you have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions.

Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Sometimes medication is needed, too.

Schedule yearly physicals and regular eye exams.

Your regular diabetes checkups aren’t meant to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications — including signs of kidney damage, nerve damage and heart disease — as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.

Insulin Safety

For many people with diabetes, injecting two types of insulin is a daily requirement. Giving yourself your injections can become so much a part of your routine that you can do it without thinking — which can lead to errors.

To increase insulin safety and avoid taking the wrong insulin:

Pause and double-check that you’re taking the correct insulin.
Label insulin vials or pens with different-colored tape, so that you can differentiate between them. For example, use red tape for short-acting insulin and yellow tape for long-acting insulin.

If you accidentally give yourself the wrong insulin:

Call your local emergency number.
Test your blood sugar frequently until help arrives. Eat or drink a fast-acting carbohydrate to maintain a blood sugar within your goal range.

In preparation for such issues, it’s a good idea to always carry a simple sugar source with you, such as glucose tablets, juice, regular soda or hard candy.