Exercise

Diabetic-friendly energy drinks?

Are you a sportsperson with diabetes? Do you have any advice to share with Mike about energy drinks?

Good day,

I am a Type 2 diabetic who enjoys cycling. I’m looking for advice on energy drinks or sports drinks etc that are diabetic-friendly.

Just drinking water doesn’t help when the energy dips…

Thank you!

– Mike

Dance moves

Tired of the same old exercise routine? If the thought of putting on your running shoes makes you want to curl up on the couch, it’s time to find something new. Here’s what Nicole McCreedy suggests.

Dance is a great form of exercise, but most importantly it’s fun. So if motivation is an issue for you, then it may be time to try a dance class.

Dancing is a workout for the whole body. A half hour of vigorous dancing burns as many calories as jogging! But not only is it good for the heart, it’s also a weight-bearing activity. This makes for strong bones that, in turn, may reduce the risk of falling and osteoporosis. Depending on the dance form, it can also help to strengthen muscles in the stomach and thighs, and improve balance, posture, and coordination. Plus, the mental work to remember dance steps and sequences actually boosts brainpower and develops memory.  For those with diabetes, dancing – like other forms of physical activity  – promotes weight loss and lowers blood sugar.

And there are so many options to choose from! Whether your style is stomping your feet in gumboots or to ‘sokkie’ on the dance floor with your partner, you can still enjoy the health benefits.

African dance

Gumboot dancing has its roots in South Africa among black mine workers, but is now world-famous. Rhythmic body movements using all parts of the body accompanied by a forward bending motion are characteristic of African dance, and dance steps are performed with the feet and knees facing forward. Percussion often dominates the music – some dance studios hire drummers to accompany classes and rehearsals.

Zumba

You don’t need to be a great dancer, or be born with rhythm, to have a good time in Zumba classes. The upbeat Latin American rhythms of salsa, flamenco, and merengue music make Zumba classes feel more like a dance party than a workout. But Zumba classes are more than just a good time. Regular weekly attendance at Zumba improves health and fitness levels, and can lead to weight loss.

Indian classical dance

The origin of Indian classical dance stems from sacred Hindu musical theatre styles. The umbrella term, Indian classical dance, includes seven major styles: Kathak, Bharatnatyam, Manipuri, Kathakali, Odissi, Kuchipudi and Mohiniyattam. Indian classical music is played with the dance, and percussion forms part of this musical backdrop. It is common for dancers to wear bells around their ankles to complement the percussion. This form of dance is known to improve physical fitness, tone the body and increase stamina. The concentration required strengthens mental abilities, self-esteem and helps the body-mind relationship.

Ballroom

Styles of ballroom dance include waltz, foxtrot, tango, cha-cha, swing, and others. With very few exceptions, all of these are danced with a partner. People with diabetes attending ballroom or Latin American dance classes are also more likely to keep participating in the activity over time, compared with an exercise programme at home or at the gym. “Studies have also found that compared with traditional cardiac workouts, people with heart conditions who danced for just 20 minutes 3 times a week saw significant improvements in their heart health,” explains Kate Bristow, a Diabetes Specialist Nurse in Pietermaritzburg and the Midlands.

Did you know?

According to a study in “The Arts in Psychotherapy”, the activity of dance releases mood-improving chemicals into our bodies that literally help alleviate depression. Social bonds are also increased in group dance sessions and this helps reduce stress in the long-term.

Ask the expert: Ilona Padayachee, Biokineticist

Tips to stay motivated

Staying motivated isn’t hard if you stay flexible and have fun. Eventually, you’ll realize that you’re actually enjoying the workout – and before you know it, you’ll be looking forward to exercising.

  1. Participate in group exercises

Having a friend that holds you accountable is a way of keeping motivated to exercise. Group exercise classes are usually fun, especially if it’s with a group of friends.

  1. Play music

When you feel discouraged or experience a slump in motivation, put on some fun tunes and your mood will soon change.

  1. Don’t make exercise seem like hard work

When you start treating exercise like hard work, that’s exactly what it will become. Your exercise routine should be light, fun and exciting rather than something you have to do. Don’t let yourself get a bad attitude towards exercise: if this happens you’ll be more likely to give up than press on to reach your exercise goals.

  1. Keep an exercise log

Having a visual reminder of the days you work out will keep you motivated to keep going. Also make a note any time you reach your exercise goals: if your clothing fits you better, if you’re feeling and looking healthier, or if your blood sugar levels have stabilised.

  1. Hire a personal trainer

When you start paying for services, you’re more likely to stick to the exercise programme. Most personal trainers will charge you the full rate if you cancel at the last minute, so you’re less likely to do that!

  1. Keep positive

Always try to have a positive attitude towards exercise. A positive mind can help you to achieve all of your exercise goals and remain focused and motivated.

Embrace the chill

We’ve got a dose of winter workout motivation that will ensure the only layers you’ll be adding this chilly season are layers of clothing! Lee-Anne Spurdens gives us the ideas.

While it’s tempting to stay under a blanket all winter long, hibernating isn’t good for your body or mind. Exercise is essential to manage your diabetes well, keep away the winter blues and build a healthy body – which also means you’ll be able to battle the winter germs better. Need some ideas to get you started? Here are seven of our favourites.

  1. Skipping Mobile, inexpensive and effective, this might be the most winter-friendly workout around. If it’s too cold or wet to skip outdoors, any indoor non-slippery surface will do (even in front of the TV). Skipping ups the heart rate, burns calories and strengthens muscles and bones. Start with five to 10 minutes a day.
  2. Boot camp If a little authority is what you need to get moving, you could be a winter warrior in the making! Boot Camp Academy SA (bcasa.co.za) offers “military” style boot camp classes across the country for all fitness levels.
  3. Exercise videos If you prefer to be drilled from the comfort (and warmth) of your living room, an exercise DVD is a good option. And who better to whip you into shape than martial arts guru, Billy Blanks? His legendary Tae Bo workouts are a mix of taekwondo and boxing, and available from takealot.com.
  4. Fit radio Sometimes all you need to get you moving is the right music. The Fit Radio app delivers a fresh new workout soundtrack whenever you need it and is guaranteed to get you off the couch, even if all you do is dance around your living room. Which brings us to…
  5. Dancing A tonic for body and soul, the ultimate stress buster and a fun way to warm up a cold body! From ballet and ballroom to hip hop and salsa, there are adult classes available for just about every type of dance. Check out dancedirectory.co.za to find a class in your area – soon you’ll be walking taller, sitting straighter and bending down more easily.
  6. Walking A brisk, daily 30-minute walk can help maintain a healthy weight, strengthen bones and muscles, manage high blood pressure and heart disease, improve balance and lift your spirits.
  7. Running If you’re ready (and willing) to take your walking up a notch, why not try a local park run? These free, timed 5km runs take place every week all over the world, are open to all levels and are a great way to get the whole family moving and make new workout buddies. Visit parkrun.com to find a run near you.

Morning movers and shakers

Generate some heat on chilly winter mornings with this 3-minute blood-pumping routine:

  • Jumping Jacks: Jump your feet out and sweep your arms up over your head, then jump feet together and bring arms to your side. Repeat for 60 seconds.
  • Side squats: Squat as low as you can, stand up and take a step to the side. Squat down again. Repeat on the other side. Keep going for 60 seconds.
  • Plank: Get into a push-up position. Bend your arms to the floor, and rest your body weight on your forearms. Your elbows should be directly beneath your shoulders, your body in a straight line from head to feet. Hold for 60 seconds.

How to motivate yourself to get off the couch

Ask the expert: Ilona Padayachee, Biokineticist

Enjoyment: This is the key to staying motivated, so make sure you enjoy whatever exercise you choose.

Goal setting: This reaffirms a sense of mission, purpose and direction. Set goals during winter to keep you motivated, and reward yourself for sticking to your exercise routine.

Variety: Change up your workout routine to prevent it from becoming boring – try different activities, train outdoors as well as in, and work out with a partner to keep things interesting.

Happy feet

Your toes might be in hiding over winter, but that doesn’t mean you should neglect them. Podiatrist Anette Thompson has this advice for healthy winter feet:

  • Treat dry, flaky skin with an exfoliating foot scrub and a good foot and heel balm.
  • Warm feet up by soaking them in warm (not hot) water for five to 10 minutes. Follow with foot balm and thick socks for extra snugness.
  • Shoes with inflexible soles prevent natural bending at the ball of the foot, which can cause circulation problems. Tight shoes and a toe shape that does not match your foot shape can also limit circulation. Wear low-heeled shoes with flexible soles that don’t squeeze the front of your foot (this can cause inflammation of the big toes or ingrown toenails). Buy a larger size if you wear thick socks, and choose shoes with built-in cushioning – this promotes circulation under the ball of the foot.

Ways to exercise at work

Long office hours and travelling to work by bus or car can make it hard to find the time to exercise. Nicole McCreedy gives us some fun ways to squeeze it in at work.

It’s no surprise that most people spend too much time each day sitting. These habits are having a negative effect on our long-term health and are increasingly linked to being overweight and obese, the development of Type 2 diabetes, some types of cancer, and even an early death. How’s that for inspiration to get moving!

Experts say that those of us who work desk-based jobs should aim to stand and do light activity throughout the day. In some countries, workers are encouraged to spend up to half of their eight-hour working day standing. This may not be possible for many of us, but we can all take at least ten minutes here and there at work to fit in some physical activity.

Being active is especially important when you have diabetes. There are many benefits to regular activity, but the biggest one for diabetics is that it makes it easier to control your blood sugar levels. Regular movement can also help you avoid sore wrists, stiffness and repetitive motion injuries.

Use the space available

Making simple adjustments to your routine can help to increase your daily activity. We’ve all been told to take the stairs instead of the lift, but there are many other things you can do to inject some movement into your day. Avoid sitting at your desk during your lunch break, and instead head outside or to the parking lot for a quick stroll. If you need to take a meeting, suggest that you “walk and talk” with your colleagues. Another option is to find an empty office or conference room where you can shadow box, run on the spot or do a few walk-lunges or some yoga poses.

If you have diabetes, it’s obviously important to be aware of your blood sugar levels. Depending on the type of activity you plan to do, carry a snack or eat a 15g portion of carbohydrate beforehand to prevent low blood sugar.

Exercises to do at your desk

We asked biokineticist Ilona Padayachee and podiatrist Anette Thompson for a few exercises you can do while seated at your desk to tone your muscles and lift your heart rate, without breaking a sweat.

Top tip! Remember to repeat the exercise on each side.

  • Seated toe raises: Seated upright at your desk with your core pulled in tightly, lift your toes while keeping your heels firmly on the ground. When you lower your toes, push them into the ground and pull them back. Alternate your feet. Complete 3 sets with 10 repetitions in each set.
  • Seated straight-leg raises: Keep your back straight, your chest out and your shoulders down. Straighten your right leg out in front of you and tighten the quadricep muscle. Raise the foot off the floor approximately one ruler height (20 to 30 cm). Repeat on the left side.
  • Leg extensions: Seated upright at your desk with your core pulled in tightly, sit on the edge of your chair and extend your right leg until it is level with your hip. Hold this position for 10 seconds and then lower your leg slowly. Alternate sides. Complete as many as you can and remember to increase your holding time slightly every week.
  • Calf raises: Stand in front of a desk or other piece of furniture you can hold on to for balance. Raise your heels of the floor and slowly lower them.
  • Heel raises: These can be done while standing or seated. Lift your heels up as high as possible. Keep the weight on the big toe side of your foot. Hold for two to three seconds at the top, then lower. Repeat 25 times. Heel raises improve circulation and tone the calves.

Ask the expert: Anette Thompson, Podiatrist

“Doing 300 heel raises a day is the same as going for a long walk. People who haven’t done them before should aim for 50 heel raises in a day, then gradually build up the repetitions until you can do them all in your lunchtime.”

FAQ: Exercising with diabetes

As a parent, you obviously want what’s best for your child – but what is really best when it comes to exercise and children with diabetes? Riekie Human tells us what you need to know (adults can learn a little something, too!).

Although experts agree that it’s crucial for kids with diabetes to exercise, you need to make sure they’re doing it safely. Thankfully, it’s easier than you think… We got all the answers from experts in the field.

What kind of exercise should my child do?

“The most helpful exercises encourage muscle contraction and increase the effect of insulin.” What does that mean? The exercise helps more glucose to be transported out of the blood stream and into the cells to be used: body weight exercise and resistance training are particularly good at this. However, young children should take part in all kinds of exercise, particularly cardiovascular for the development and health of the heart, lungs and lipid profiles (cholesterol), and team sports to encourage skills and develop confidence. Sarah Hall, Biokineticist at Wellness in Motion, Morningside

Ball sports are especially good for children with diabetes. “They involve a combination of exercises like jogging and sprinting, and research has found that this is best for stability in blood sugar levels.” Contact sports like karate can be tricky, especially for children with insulin pumps, as the pump could get damaged – and the same applies to horse riding. Andrew Heilbrunn, Head Biokineticist at the Centre for Diabetes and Endocrinology (CDE) in Houghton

What time of day should my child exercise?

The best time for kids with diabetes to exercise is before breakfast and before supper. “They’re less likely to hit lows at those times. Before breakfast, they’ll be quite insulin-resistant and are unlikely to experience a drop in blood sugar.” The worst time to exercise? An hour or two after meals, when insulin in the system can cause more frequent lows.

Andrew Heilbrunn

How long should my child exercise for?

That depends on the child: what they’re capable of and how fit they are. “The general recommendation is 1 to 2 hours, but take into account the type of exercise, your child’s age and their fitness level. And remember to limit exercise to 30 to 45 minutes if it’s a new sport or type of exercise – and then closely monitor their blood sugar levels, before and after exercising.”

Sarah Hall

What else do I need to know about exercise and diabetes?

It’s important to give the coach a list of symptoms of high and low blood sugar, as well as detailed instructions of what to do if your child goes low. “A child with low blood sugar will be irritable, have a headache and blurry vision, and generally feel horrible.” If your child’s blood sugar is too high, they will feel tired and thirsty.

Dr Claudine Lee, GP

If your child exercises for more than one hour, any time of the day, they should have a protein snack, like full-cream yoghurt or small yoghurt-coated rice cakes, before going to bed. “Sustained energy overnight is crucial, as it prevents hypos between 2 and 4am. “Also, always have a quick-acting sugar snack on hand (fruit juice, sweets or honey) to treat low blood sugar, and make sure the coach knows how to use a glucagon pen in case of emergency.

Andrew Heilbrunn 

Ask the expert: Sarah Hall, Biokineticist Studies have shown that children with Type 1 or Type 2 diabetes are generally less physically active than those without: the exact opposite of what the situation should be!

Some advantages of increased physical activity for children with diabetes:

  • Better health
  • More confidence
  • An improved response to insulin and blood sugar control
  • A greater awareness of diabetes and their bodies
  • The prevention of conditions associated with diabetes, like obesity and heart disease
  • Improved weight management

Top Tips

  • Don’t let your child exercise if their blood sugar is too high: over 16mmol/l or too low: under 4mmol/l, or if ketones are present.
  • Make sure your child’s blood sugar is in the target range before exercise, in order to avoid low blood sugar.
  • Talk with your doctor about lowering your child’s insulin dose before exercise, if necessary.
  • Inject insulin before exercise in a site other than the body parts about to be used. For example, if your child will be running, don’t inject in the legs.
  • Watch for symptoms of low blood sugar for 12 hours after exercise, especially if it’s a new kind of exercise.
  • Make sure your child drinks water so they don’t get dehydrated.
  • Choose something fun for you and your child to do together and they’ll learn that getting active is just as enjoyable as relaxing. You could go to dance classes, swim, learn to surf, take up yoga, go on hikes, play tennis or even join a soccer team. There’s even something called laughter yoga if you really want to have a good time.

A fit pregnancy

Staying active during pregnancy is the best thing for you – and your baby, Cindy Tilney tells us.

While exercise may not be what you feel like doing when you’re expecting, experts agree that it has a host of benefits – besides being a natural mood-lifter, there’s no denying how good it is for you. “In pregnancy, it’s always better to exercise than not – even with a chronic disease such as diabetes,” says personal trainer Shelley Lewin, who offers specialised pre- and postnatal exercises in Cape Town. “Staying active is not only important for the physical and emotional health of the expecting mother – research has shown that unborn babies thrive if their moms are active. Unless you have a specific medical condition that puts you and your unborn child at high risk during pregnancy, it can only work to your advantage,” she says. “And in people with diabetes, it can help the body to process glucose more effectively.”

What can exercise do for pregnant diabetics?*

  • Lower blood sugar
  • Improve insulin sensitivity
  • Control blood pressure
  • Increase energy
  • Reduce after-meal blood sugar spikes
  • Encourage restful sleep
  • Lower gestational weight gain.

According to the American College of Obstetricians and Gynecologists (ACOG).

*Type 1, Type 2 and gestational diabetes

Remember: If you have diabetes, it is essential to get the all-clear from your doctor before starting an exercise programme, particularly if you are pregnant.

“Exercise in any form may require a reduced amount of insulin because exercise increases glucose uptake in the cells,” explains biokineticist Sarah Hall. “The intensity of the exercise you are doing will determine this: lower-intensity exercise can lead to a recommended insulin reduction of roughly 20%, as opposed to a possible 50% with higher intensity exercise.” This is further complicated by insulin needs often doubling during pregnancy, so consulting a doctor is a must.

Healthy exercise tips during pregnancy:

  • Check your blood sugar before and after exercise (Type 1 diabetics).
  • Always take a ‘quick-fix’ snack, such as a banana, along with you when you exercise, so that you have a sugar source on hand in case of hypoglycaemia (low blood sugar).
  • Stay away from forms of exercise that carry a high risk of falling, and avoid lying on your back with the head below the level of the heart, as this can restrict the blood flow to your baby.
  • Wear a heart rate monitor during cardiovascular exercise, and keep your heart rate to 140bpm or below. In the past, there was a widely held belief that pregnant women should stay away from all cardiovascular exercise – but modern research has shown that this does not hold true.

The good news? If you’ve been exercising regularly, you can carry on very much as normal, agree Hall and Lewin – provided the activities are not extremely high impact, do not involve fast or sharp changes in direction, or cause surges in blood pressure or adrenalin.

Ideal pregnancy exercise

Both experts recommend 30 minutes of moderate physical activity three times a week, such as walking, swimming, aqua aerobics and light weight lifting under the guidance of a certified ante-natal instructor. The ligaments tend to naturally relax during the second and third trimesters of pregnancy, so be careful not to overstretch during warm-ups – and if you are weight training, use machines rather than free weights to avoid any hyperextension injuries.

“Building up core strength is important in pregnancy,” says Lewin, “but as your tummy grows, you should stay away from certain intense core exercises, such as tummy crunches – instead opt for opposite leg and arm lifts, or practice stability work on a Pilates ball.” Kegel exercises are also important during pregnancy, as they strengthen the pelvic floor muscles.

Be gentle with yourself during pregnancy: stay away from contact sports and aggressive forms of exercise. And be aware of your body and how hard you are pushing yourself during workouts. “The ‘talk test’ is always a good marker of whether you are pushing yourself too hard,” says Lewin. “If you are exercising at the right level, you should be able to talk at the same time – but if you’re struggling to take in breath and unable to hold a conversation, it means you are pushing yourself too hard.”

Find out more about pregnancy exercise at www.homefit.co.za

“Staying active is not only important for the physical and emotional health of the expecting mother – research has shown that unborn babies thrive if their moms are active.”

Ask the expert: Sarah Hall, Biokineticist

Warning Signs

Don’t exercise if you have:

  • Pregnancy-induced hypertension
  • Ruptured membranes
  • Placenta praevia
  • Vaginal bleeding of any kind
  • Incompetent cervix (when the cervix is weak and opens too early)
  • Or if you are expecting twins or more

If you experience any of the following during exercise, stop immediately and seek medical help:

  • Sudden calf swelling
  • Headaches
  • Decreased foetal movement
  • Chest pains
  • Any amniotic leakage
  • Excessive overheating

Explore the outdoors

A weekend hike is not just a fun, affordable activity for the whole family, it’s also one of the best ways to enjoy South Africa’s natural beauty. And a great way to get fit! What more could you ask for? Nicole McCreedy leads the way.

Hiking is good for the heart and the soul. Being in nature can help you to de-stress and reduce anxiety levels after a busy week, and when you hike you get all the same benefits of walking – and a few more. Hiking is a powerful cardiovascular workout that is known to reduce cholesterol, which means less risk of heart disease, and it can improve blood pressure. Keeping your heart fit and healthy is important for all diabetics.

So what’s in a hike? The following ingredients:

1 x beautiful trail

1 x pair of shoes

1 x backpack to carry all the essentials

1 x spirit of adventure

What to bring on your hike:

Luckily, you don’t need much equipment to hike. It’s important to research the route beforehand, though, especially if you’re going seriously off-road. Make sure you always hike with other people and pack these essentials:

  • A cellphone in case you need to make an emergency call
  • A GPS or map so that you don’t get lost.
  • Enough water. It’s easy to become dehydrated, especially in warm weather.
  • A low blood sugar snack (like dried fruit or juice).
  • A mid-hike snack (like fresh fruit, crackers or nuts) to help you maintain your blood sugar levels.
  • Your glucometer, strips and insulin, if necessary.
  • A hat and sunblock to shield you from the sun.
  • Rain gear if it looks like rain!

How to prepare for a hike

Ask the expert: Sarah Hall, Biokineticist

The nature of hiking means that your terrain is unstable and unpredictable. Each step is different from the one before and requires a combination of balance, strength and stability, using one leg at a time. Here’s how to prepare for a hike:

  • Start by doing exercises with one leg at a time to isolate muscle groups and encourage improved balance and joint stability. This is called unilateral training.
  • Strengthen your glutes and calves to help with climbing and hiking for a longer period of time. Choose exercises like step-ups, standing side leg raises, static lunges and single leg balancing. Try to do 3 sets of 20 of each.
  • Alignment is key. Your spine will be taking the load with each step, so be sure to keep your hip, knee and ankle in one straight line for all exercises.
  • Always include core exercises that strengthen your abdominals and try to keep your posture upright during the hike.
  • To prevent injury during the hike, ensure that you take regular breaks and stretch. 

Taking care of your feet

Ask the expert: Anette Thompson, Podiatrist

Here are 5 tips to take care of your feet while out and about hiking:

  1. Condition your feet It is important to train the muscles, tendons, and ligaments of your ankles and feet for hiking with a backpack.
  2. Get good footwear
and socks Shoes that fit correctly are the most important way to keep your feet happy. When choosing socks, avoid moisture-retaining cotton: instead choose wool or synthetic socks.
  3. 3.  Manage your toenails and skin
 Socks will catch on nails that are too long or that have rough edges, putting pressure on the nail bed. Take special care of the skin on your heels.
  4. Learn how to prevent blisters
 Experiment with different blister patching products and different taping techniques. Find what works for your feet and then perfect the method.
  5. Carry a small foot care kit
 A small foot care kit carried in a ziplock bag is easy to carry with your backpack. Include either Vaseline or talcum powder, a few alcohol wipes to clean the skin, some blister plasters and a safety pin to drain blisters (if necessary!).

Gather the group

Struggling to get started on a fitness routine? Maybe you need to try exercising in a group. It’s far more fun, and just as good for you!

There’s something about pounding the pavement on your own that is just no fun. Swimming lengths can also be lonely, and so can going to the gym. But who said getting fit had to be a solo exercise? Here are some of our favourite ways to get active with your friends and family members.

Walking group

All you need is a pair of walking shoes and an adventurous spirit and you can start a walking group. Decide on a route that you want to follow, and start slowly – just a kilometre or two will do. It’s a good idea to have a goal in mind so that you can work up to longer distances. How about 10km by the end of the year?

5-a-side soccer

Finding enough people for a full soccer team might be a challenge, but 5-a-side soccer only needs ten people to play the whole game, and ensures that everyone gets a real work-out. You can play on any field or in a garden (because there are fewer players, you need less space) and the game doesn’t last as long – generally an hour in total. 

Boot camp

While you can pay a lot to attend official boot camp classes, you can also set up your own boot camp with a few friends. Decide what areas of the body you specifically want to work and set out a four-week exercise programme. You might want to include things like sit-ups, push-ups, jogging around a track or on the spot, doing star jumps, short sprints, skipping and lifting weights. Just make sure everyone is in agreement with what the session looks like – and don’t leave anyone behind!

Ask the expert: Ilona Padayachee, Biokineticist

The FITT principle is very helpful to keep in mind with walking.

F – Frequency

I – Intensity

T – Time

T – Type

Frequency: Aim to exercise for 3 to 5 days a week.

If you are a beginner try not to overdo it, start off slowly and progress to longer and faster walks.

Intensity: This is very important in any exercise programme.

Walking at the correct speed can make a huge difference to how effective the exercise is.

Time: Start slow and build up your time.

A beginner walker should start out at 10 to 12 minutes, including 5 minutes warm-up. Then increase it to 20 minutes by adding 2 minutes to the walk every week.

Type: Choose the type or kind of activity that you enjoy.

It’s always easier to stick to something you like doing!

Diabetic foot care tips:

No matter how much fun you’re having getting fit, don’t forget to look after your feet! As a diabetic, foot care is really important. Bad circulation in the feet and legs, often noticed as leg pain and leg cramps, is one of the problems facing diabetics, and can lead to chronic ulcers, numbness and even gangrene. Daily care for the feet is essential.

Here are some great tips:

  • Exercise and regular movement is good for circulation.
  • If possible, raise your feet when you’re sitting down.
  • Check your feet every day for swelling, marks and red spots.
  • Check your feet for ‘cold areas’ (a sign of poor circulation).
  • Check your feet for ‘hot areas’ (a sign of infection).
  • Dry your feet well after bathing, showering or swimming.
  • Apply a good natural cream to the feet every day.
  • Wear comfortable shoes that do not pinch the feet or toes.
  • Keep toenails trimmed and file sharp edges.

Take to the trail

Tired of pounding the pavement or looking for a fun way to get active? Trail running may be the sport for you. More and more people are heading to the mountains, the veld and the forests to get away from the city, spend time in nature and run free.

More than just a work-out

Trail running is good for the body, mind and soul. It’s also good for the wallet – except for the price of running shoes, it doesn’t cost a thing. Trail running is different to road running because the ground you’re running on changes all the time and isn’t flat and hard like a road. It helps “proprioception”, our sense of balance and body awareness. It also develops strength in muscles and joints, and gives you stronger ankles and hip joints. Softer surfaces like grass, sand, and gravel are easier on the joints than tar. Trail running will help you burn more calories and shed fat faster as your body uses a greater amount of energy to use more muscles to move on the uneven surface. Paying attention to each step you take will also distract your mind from your everyday To Do list (always a good thing!) Don’t forget to stop for a moment, breathe in the fresh air, and give thanks for where you are.

Heading off-road

Although there is less risk of injury with trail running than road running, it’s a good idea in the beginning to include some exercises in your routine to strengthen your core, pelvic muscles, legs, knees and ankles to cope with the impact to these parts of the body. Follow a careful training programme where you can gradually build up your distance and speed. It’s important to be aware of your diabetic needs while you’re trail running, too. Don’t push yourself too hard in the beginning, and make sure you snack before you start running so that your blood sugar doesn’t go low while you’re on the trail.

When you’re trail running, it’s important to look where you’re going – vehicle tracks, puddles, logs and rocks are all obstacles that can trip you up, and low-hanging tree branches need to be ducked in time.

Here are some tips for different types of terrain:

Sand is difficult to run on, especially when it’s loose. Don’t run in a straight line, rather search for the firmest footing. The harder sand can usually be found on the very edge of the trail.

Muddy surfaces can be slippery, be careful!

Rocky trails mean you need to lift your legs higher to avoid tripping. Try to step lightly with a flat foot, so that if it’s not stable or you slip, you can quickly move your foot.

Forest paths can hide rocks and roots. Be on the lookout and avoid stepping on them if you you can.

Looking for runs in you area? Take a look at www.nightjartravel.com/trail-running

Want to see more of our favourite trails? Visit www.sweetlifemag.co.za/community

Expert tip: Get the right shoes.

Ask the expert: Nelfrie Kemp, Podiatry Association of South Africa

The most important tip when taking up any running is to buy the right shoes and make sure they fit properly. Foot care is vital if you have diabetes. When fitting a running shoe, choose a pair one size larger than your normal shoe size as your feet swell when you exercise. It’s a good idea to use sport socks that are thick from toe to heel and fit you perfectly. This will help prevent pins and needles or a burning sensation in the feet. Preferably wear ankle-height socks as secret socks can move and curl up under your foot, which can cause blisters. Always tie your laces, but make sure that it they are not tied too loosely or tightly.

Get more diabetic foot tips at www.podiatrist.co.za

Expert tip: Be aware

Ask the expert: Sarah Hall, Biokineticist

  • As well as the trail running, do some balance training either at home or in the gym by doing single leg exercises or balancing on wobble boards.
  • Use your whole body while you are trail running: your arms for balance and support, your core to help draw your legs up for climbing the rocky parts, and a mid-foot to front-of-foot strike with shorter, quicker strides for more control and adjustment.
  • Pay close attention to what you eat and drink before and during the run, especially on longer runs. Always have something sweet on you in case your blood sugar goes low, and never run alone.
  • Know the route you are running by mapping the route on GPS. It will give you a good idea of the height you may be climbing and the exact distance you will be covering. Remember to start with shorter routes and slowly build up distance.

Have a ball

No matter the season exercising outdoors beats running on a treadmill in the gym. If you want to keep fit and have a social life, then soccer, touch rugby or rounders is the answer. Nicole McCreedy tells us how to get started.

The beauty of ball sports is that they’re so easy to learn. All you need to do is find an open space to play, organize some equipment and two teams, and learn a few basic rules. While your focus is on winning, you’ll be walking, running and laughing your way to better health.

Touch Rugby

The basics of touch rugby are similar to the traditional version of the game – the ball is passed backwards during play. However, in touch rugby you don’t tackle your opponent but rather touch the person running with the ball on any part of their body, clothing or the ball itself using your hand. Because touch rugby is less physical, women can also play without fear of injury.  Once touched, the player in possession of the ball is required to stop, return to the mark where the touch occurred and perform a ‘rollball’ without delay. Facing the defending try-line the player rolls the ball between his/her legs. After six touches the ball is handed over from the attacking team to the defending team and the game starts again from the halfway line in the centre of the field. The aim is to score a touchdown over the defending team’s try-line. Five to six players are on one team at a time, and a game lasts for about forty minutes per side.

Soccer

A game of soccer can be as simple as kicking the ball around with a few friends. Players dribble the ball on the ground, kicking it to pass to each other. For most games, there are eleven players per team – the goalkeeper is the only player allowed to use his/her hands. Teams are made up of defenders, midfielders and forwards. Two defenders patrol the left and right area while the two central defenders play in the middle. The midfielders play both defence and attack, and the forward positions focus on scoring the goals. The centre forwards play in the middle flanked on each side by a wing. In soccer be aware of the offside rule. If you are behind the other team’s defenders without the ball, you are offside. But if the ball is kicked past the defenders, you can pass them. Laduuuuuuuma!

Rounders

To play rounders you need a small ball (a tennis ball will do) and some kind of bat. There must be a minimum of six players per team. A match consists of two innings, giving each team a chance to bat and bowl. An innings is over when the last batter is caught out, and each person on the team gets a chance to bat. When bowling, the ball must not bounce and it must be above the batter’s knee, below the batter’s head, and not at the batter’s body. The batter hits the ball and then runs in a circle, passing a series of markers on the way. A ‘rounder’ is when the batter makes it all the way around the circuit in one hit of the ball. The team with the most rounders wins. A batter is out if the ball is caught before it hits the ground or if the ball is fielded before the batter reaches a marker. A batter who has missed the ball can run to the first marker and then continue to the next three when the next batsman strikes the ball. Only one person can stand at a base at a time.

Team ball sports are a great cardiovascular workout because they increase your heart rate. They are particularly good for people with diabetes because the body uses up extra glucose and decreases resistance to insulin. Muscle strength, endurance and eye-coordination also improve. Best of all? You lose weight while having a ball!

Ask the expert: Anette Thompson, Podiatrist shoes or barefoot?

SEMDSA, the Society for Endocrinology, Metabolism and Diabetes of South Africa, recently released 2012 guidelines which state that a person living with diabetes should not walk or run barefoot. There are a number of reasons for this – even well controlled, highly active people who have not developed any complications will experience a delay in healing if their skin punctures or cracks. Any break in the skin is a potential entry point for infection: bacterial, viral or fungal.

The goal is to wear footwear that most closely approaches the benefits of being barefoot. ‘Barefoot-like’ sports shoes allow maximum flexibility and give the feet the most natural workout. The benefits are improved blood flow to the feet and lower limbs, which feeds nerves and muscles during exercise. Ensure that the shoes are wide enough, as well as being the correct size. It’s a good idea to invest in good quality socks as well.

You only get one pair of feet – take good care of them.

Sport tips Sarah Hall, Biokeniticist

When playing outdoor sports, especially those you’re not used to, keep these tips in mind:

  • A sport specific warm up is essential. Try and focus on the muscle groups you’re about to use and make sure that you pay particular attention to those during your warm up. If you’re about to play soccer, try to loosen up the ankle joints with some ankle circle exercises. Stretch the groin muscles with some lunges and do a couple of lengths of sideways shuffle running along the field.
  • Wear supportive footgear to support your feet and cushion the rest of your body as you run.
  • Be as prepared as possible. Make sure you have enough water for the extended length of time of play. You must also keep some fast acting snacks handy as the game, although fun, may use up more energy than you think.

 

 

 

 

 

Stretch it out

Want to have a more flexible body and improve your circulation? Nicole McCreedy tells us why stretching should be part of everyone’s day.

When we’re young, it’s easy to imagine that our bodies will always do what they’re told. But as we age, our muscles tighten and all of a sudden something as easy as bending over to pick up your keys might be a struggle. Stretching is important because it keeps the body flexible and allows your joints to move through their full range of motion. Here’s all you need to know to keep flexible.

Why stretch?

For people with diabetes, improving circulation is essential for maintaining good health. Because stretching increases blood flow to the muscles, specifically the legs, it is great for circulation, but that’s not all. Regular stretching will increase nutrients to the muscles, improve your co-ordination, lengthen your muscles, reduce lower back pain, and even increase your energy levels.

How to stretch

While you can stretch anytime, anywhere – in your home or at work – you want to be sure to do it safely. Each stretch should be done in a slow and controlled manner till you feel ‘mild discomfort’. If it feels painful, you’ve stretched too far. Do not bounce or force the stretch.

Ideally, you should stretch before you start exercising. To avoid injury, first warm up your muscles. Run on the spot for a few minutes or do some jumping jacks to get your blood flowing and increase your heart rate. Stretch again at the end of your training sessions to help your muscles recover.

Types of stretching

What kind of stretching you choose to do will depend on your fitness and flexibility.

Static stretching is the most common form and is safe for beginners. Give this a try: to stretch the back of your upper thigh lie down on your back. Lift your right leg up in the air, heel facing the ceiling. Make sure that your lower back stays in contact with the floor and the left leg remains straight on the floor. Grip your raised leg with both hands. You may be comfortable holding your thigh, or you may be able to clasp your knee. Do what feels best for you. Keep your head and neck relaxed. Hold for 30 seconds or less. Change legs.

Passive stretching means you are using something outside yourself to help you stretch. Here’s a passive stretch to try: Relax the muscle you are trying to stretch and rely on a strap, gravity, another person, or your own body weight to stretch the muscle gently. Make sure you are well balanced before you start stretching!

Passive stretching is useful for those who have been injured or are frail. A recent study has found that passive stretching can help regulate blood glucose and is beneficial in treating people who are less physically able.

Dynamic stretching is moving through a challenging but comfortable range of motion repeatedly. Take shoulder circles for instance: stand tall, feet slightly wider than shoulder-width apart, knees slightly bent. Lift your right shoulder towards your right ear, take it backwards, down and then up again to the ear in a smooth action. Repeat six to ten times. Do the same with the left shoulder. What you are doing is actively contracting the muscle in the opposition position to the one that you are stretching.

Love stretching and want to take it further? Try yoga or pilates – both involve active stretching. With yoga, the postures are timed with the breath and are designed to put pressure on the glandular system. In pilates, the sequence of movements focuses on strengthening your core muscles – the deep, internal muscles of the abdomen and back.

What to keep in mind while stretching – Sarah Hall, Biokineticist

Remember that – just like people – each muscle group and joint is individual.

  • Make sure that you warm up before you do any activity, and stretch afterwards as well. A quick rule of thumb is to stretch a muscle only if it is tight.
  • Do not stretch in such a way that you put another joint or muscle at risk of injury.
  • Try to isolate a muscle when stretching. If you are working the hamstring, do not put weight on that leg. Breathe into the stretch to allow the benefits of the stretch to move through that muscle.
  • Decide on a reason for stretching a particular muscle: is it to relax, release tightness or restore length to the muscle? Aim to stretch each muscle for between 10 and 30 seconds.

Ask the expert: Dr. Zaheer Bayat, Endocrinologist

Exercise is good for everybody. But for those with diabetes, there are added benefits:

  • Exercise lowers glucose levels as muscles require more glucose for fuel.
  • Exercise helps in losing weight, which in turn improves morale. Not only will you feel better, you will also look good.
  • Exercise improves insulin sensitivity. This can go a long way to stabilizing blood sugar levels

When starting any exercise program, it is important to spend a few minutes stretching, which will help lessen the risk of doing damage to yourself.

Ask the expert: Prof. Wayne Derman, Professor of Sports and Exercise Medicine

“Flexibility is an important part of fitness, so stretching should be included in any exercise programme. It’s also a great way to manage and prevent muscle cramps. Not sure what to do? Get a physio, biokineticist or trainer to assist you with the right stretches for the muscle groups in which you are particularly tight.”

Exercise is medicine

It’s more than just good for you. Nicole McCreedy tells us why.

Regardless of the type of diabetes you have, your doctor is likely to recommend a combination of diet, exercise and, if necessary, medication to help control your blood sugar levels. Many studies have shown that adopting a healthy lifestyle is effective in treating diabetes.

Being newly diagnosed with diabetes can be overwhelming at first. For some, doctor’s orders to exercise regularly may feel like a big obstacle to overcome on this new journey. But don’t stress if you’re someone who can’t recall the last time the word exercise passed your lips: even small steps in the right direction count.

The decision to exercise is the first step to better health. “Exercise is literally the best medicine,” according to biokineticist, Sarah Hall. “This is not saying you can stop taking what the doctor has prescribed,” she advises, “but exercise will generally improve your health, decrease your stress levels, help with weight loss and improve your wellbeing.”

No matter what your medical condition, there is usually some form of exercise that you can do. Make an effort to find an activity that you like, and are able to perform at your current level of health and fitness. This will make it a much easier habit to keep.

Diabetes educator, Kate Bristow, has put together a list of five activities suitable for people with diabetes you can consider trying out:

Walking briskly for thirty minutes, five days a week is the global recommendation for all adults – with or without diabetes. For exercise “newbies”, you can break this up into shorter sessions throughout the day. In fact, a recent study from New Zealand found that taking a ten-minute stroll immediately after a meal may be better for lowering blood sugar levels than a full half hour session once a day.

Cycle for 15 to 30 minutes three times per week. Maintain your heart rate at no more than 65 to 75% of your max, which is a great way to increase your blood circulation and the demands on your body gently. Depending on where you live, consider using a bicycle to commute to work or to nearby places you need to visit. Not only is it a good way to increase your daily level of activity; it can also make the trip more interesting.

Low intensity whole body weight training helps the body to absorb sugar (glucose) into the muscles. As a result, your body becomes more sensitive to insulin and this can lower blood sugar levels. The more muscle you have, the more calories you burn – even when your body is at rest. Preventing muscle loss with weight or strength training is also the key to maintaining an independent lifestyle as you age. Get help from a qualified professional who can supervise you while performing the exercises. To start, your weight training programme may include two to three sets of 15 repetitions (reps) for each muscle group twice a week.

Tai Chi or Beginner Yoga are both forms of exercise that allow for gentle movements, through breathing and controlled contraction of the muscles of the entire body. It is best, when first learning either of these disciplines, to join a class so that you learn the correct, safe techniques. A beginner class is approximately 45 minutes. Let the instructor know if you are new to the class, so that they know to help you with the postures. 

Swimming allows once again for the whole body to be involved, with movement performed in a supportive environment.  As long as you take regular breathing and rest breaks, you will see rewarding results.

Tips from biokineticist Sarah Hall:

  • Don’t begin something that you cannot commit to – financially or time-wise.
  • Exercise, to be beneficial, needs to be regular and sustained.
  • Any little bit of regular exercise is better than none at all.
  • Start slowly and build it up – there is no point in hurting yourself in the first session.
  • When you begin an exercise programme, it’s a good idea to consult with your doctor – especially those with health risk and those who are a bit older.
  • Exercise can lower your blood sugar levels and the effects can last up to two days after, therefore it is important to test regularly especially before and up to four hours after exercise and understand the effect exercise has on your own levels.
  • Know how to manage a low sugar level if it happens.
  • Set realistic, clear and concise goals.

No matter what kind of exercise you choose, your body will thank you!

10 fun ways to fitness

Not a natural fitness fanatic? Don’t worry about it! Susan Erasmus shows how even the most determined couch potato can get some exercise this winter.

If the thought of going to the gym makes you curl up under the duvet and reach for the TV remote, you’re not alone. The good news is that anything that gets your heart rate up and gets you out of your comfort zone counts as exercise. We all know how good getting active is for us: it relieves stress, prevents colds, reduces diabetic complications, promotes heart health and keeps your weight in check…

But can it be fun? Here are 10 easy ways to sneak exercise into everyday life:

Follow the 1km rule.

Unless you’re in a tearing hurry, it’s pouring with rain or it’s the middle of the night, don’t take the car if your destination is less than a kilometre away. Just 10 minutes of walking a day will cut your heart disease risk by half, according to the Mayo Clinic in the USA. “Weight-bearing exercise like walking will also make your bones stronger,” says biokineticist Sarah Hall.

Top tip: Get a pedometer so you can track your progress and count how many steps you take each day.

Play with your kids.

Kids are like Energizer bunnies: they just keep going. Why not join them – even if it’s only for twenty minutes in the park? Ball games or a game of frisbee are a fun way to take your mind off the fact that you’re getting exercise… Best of all? Your kids will love it too!

Move your feet.

It’s as easy as pacing while you talk on the phone (instead of slouching in your chair), walking to the furthest toilets, making the trek to the printer at work or getting up off the couch to change the channel on the TV. Take every opportunity to move your feet and you’ll be surprised how much more active you feel!

Take the stairs… Every time.

The beauty of taking the stairs instead of the lift is that even if it’s raining outside, you’re still doing your daily exercise. You don’t have to climb 20 floors if you work in a high-rise, but even one or two floors will have you feeling stronger than you did before.

Top tip:  Watch your posture as you climb the stairs, and ground your heel on each step so you don’t stretch your calf muscles too much.

Walk the dog.

A 20 minute walk with your dog will not only make your pet happy but take you out in the fresh air and get your heart pumping. Make a promise to walk your dog every day – before or after work – and see how quickly your fitness improves.

Make your garden greener.

You don’t have to start chopping down trees or clearing bushes – a bit of light weeding, planting and raking for half an hour a few times a week is all it takes to loosen up the muscles.

Take two wheels, instead of four.

Riding a bike to work or school is not only good for your health, but also for the environment – and your wallet, seeing as you’ll spend less on petrol. As an added bonus, you’ll never have to search for parking again…

Go dancing.

Dancing is a fantastic workout – and so much fun you won’t even notice it! You also get to dress up, not down, and being out of breath is part of the fun… Even if it’s freezing outside, you can still work up a sweat dancing – and you never know who you might meet on the dance floor…

Top tip: Dancing is a great way to become more supple. The more we rest, the stiffer we get. So dance away!

Rethink the way you work

Instead of slumping into your office chair every day, why not invest in an exercise ball – it’s not only more fun to sit on, it will also strengthen your core muscles. Another option that is becoming more and more popular is a standing desk, where you’re on your feet all day instead of in a chair.

Laugh it off.

Looking for the most fun way to strengthen your stomach muscles? Rent a funny DVD, go to a live comedy show, or spend some time with a friend who cracks you up. Laughter is a fantastic form of exercise, and the best possible way to get fit!

Ask the expert: Sarah Hall, Biokineticist

“It’s very important to set yourself a definite goal if you want to get fit. This can be done by exercising with a friend, hiring a trainer, or just setting your own personal goal. If possible, a fitness test from a professional can help you deal with an old injury or a medical condition (like diabetes).”

Dance your way to better health

Who said exercise had to be at the gym? Here are some fun ways to get active without even noticing it.

The joy of dancing is that it’s good exercise, but so much fun that you won’t even notice you’re getting fit… Much better than trying to jog around the block! Dancing is, at heart, both art and sport. If you’ve been tempted to pull some moves like you’ve seen on TV’s Strictly Come Dancing and So You Think You Can Dance, but haven’t managed to make the move from the couch to the dance floor, this is the year to do it!

Why dancing is good for you

What many people don’t realise is that dancing has a number of health benefits. Dance is a full mind and body workout that burns calories and lowers your heart rate, blood pressure and cholesterol. As with all kinds of exercise, dancing makes the body more sensitive to insulin, which means the insulin works better in your system. Because dancing is a weight-bearing activity, where the body works against gravity, it can also help strengthen bones, improve balance, posture and coordination. Dancing offers the opportunity to socialise and make friends, and moving your feet to a good tune can be a real pick-me-up. Apart from reducing stress, the biggest benefit of dancing is that it is fun (lots of fun!)

How to get involved

Whether you like to jive, tap, or tango, shake your belly or let yourself go to the beat, there’s a style of dancing that’s right for you. Different types of dance include ballroom, ballet, nia, afro-fusion, hip-hop and free dance, among others. The first step is to have a plan. Ask yourself what style of dance you think you might enjoy – do you like something more formal, or free? Then, consider how much time you can spare in your week, how fit you are and if you have any pre-existing injuries.

Once you know what you want, it’s time to find it! Check community noticeboards and local gyms to find out when and where classes or events are being held, and invite a friend to go with you if you feel too shy to go to the first class on your own. Convinced you have two left feet? Take lessons. Most dance studios hold beginners’ courses and welcome people with disabilities. Learning a new skill can be a real confidence booster and if you start now, you’ll definitely have new skills to show off at your end-of-year Christmas party!

What to wear

Wear comfortable clothing that gives you freedom of movement and shoes that fit the dance form. Some classes, like ballet, tap or jazz, might need special footwear depending on your level. Avoid wearing jewellery, as earrings, rings and necklaces can scratch you or get caught in clothing. Most importantly? Wear a smile.

How to warm up

Remember that because dancing isn’t the same movements that you do in daily life, you need to warm the body up and treat the dance hour like an exercise session, with a warm-up, movement preparation, dance, and cool down. Once you’ve done your warm-up and you understand the main demands of the type of dance you’re doing, you can let your body go and enjoy.

Ask the expert: Sarah Hall, Biokineticist

Here’s how to warm up for each of these dance styles:

Ballroom: A large focus of ballroom is technique and posture, so you need to ensure that in your warm-up you help lengthen your spine. The goal is to engage your neck, shoulder blades and core muscles, so that you reduce strain and tension from this form of dancing.

Nia: This dance is about moving with balance, without too much effort. It is a combination of yoga, modern dance, jazz and tai chi. A whole body warm-up with deep breathing would be best here.

Ballet: Although rhythmic and seemingly calm, ballet is one of the most demanding kinds of dance. Muscle endurance, power and strength, as well as flexibility of joints, are all required. Before starting ballet classes, it’s a good idea to try a few one-on-one classes or test out the poses so you know how far you can move.

Hip-Hop: This is an extremely physical but hugely enjoyable dance form. Hip-hop uses movements that require strength and balance to control your body weight. Body weight exercises that prepare the body for this challenge, like dips, push-ups, sit-ups, lunges and squats, would be great to include in your warm-up. It’s also a good idea to strengthen and protect the spine because it’s such a high impact form of dance.

Free dance: Spontaneous and with no choreography, free dance has no rules and boundaries. So it’s important to combine the tips of all the types of dance above and ensure that you follow the structure from the warm-up to the cool down.

Ask the expert: Fiona Prins, Diabetes Educator

“Being active helps control blood sugar levels, so when you have diabetes it’s really important to exercise. As a rule, aim for 30 minutes a day, five days a week. Regular physical activity will help keep your weight down, reduce blood pressure, raise good cholesterol (HDL) and lower bad cholesterol (LDL) in the bloodstream. Other benefits of exercise include being able to sleep better and better health in general.”

The daily sweat

Getting active every day can feel like a bit too much to ask for… Which is why Cindy Tilney’s asked the experts to give us easy ways to keep fit – no matter how old you are!

We all know exercise is good for us, but exercising to the max – especially in later life – can be too much of a good thing. It’s essential not to stress the body by exercising too hard, says Professor Wayne Derman, the Director of the U-Turn Chronic Disease Lifestyle Rehabilitation Programme based at the UCT Sports Science Institute of South Africa. “When planning an exercise routine, it’s important to consider any medical condition you might have, as well as any medication you’re taking and how it may affect you while exercising,” says Prof. Derman.

Older age also comes with a bigger chance of aches and pains because of problems like osteoarthritis and rheumatoid arthritis – if these names ring a bell, it’s a good idea to be more careful about the kind of exercise you choose, and to consult a medical professional (a biokineticist, physiotherapist or sports physician) when planning an exercise routine. Be sure to check if any medications you are on will interfere with this routine, reminds Prof. Derman.

Be informed

“It’s essential to go for a health check and orthopaedic assessment before starting any exercise programme,” says biokineticist, Sarah Hall.

Get checked for:

  • Cardiac weakness
  • Any existing injuries
  • High blood pressure
  • Ischaemia (restriction in blood supply)
  • Uncontrolled diabetes

Also be aware that falls are more likely if your balance isn’t what it used to be.

Warning signs:

The right kind of exercise has benefits for every chronic condition, says Prof. Derman.  But watch out for:

  • Feeling breathless to the point that you can’t talk when exercising
  • Any pain.

“The saying ‘no pain no gain’ is not true,” he says. “Your body should be in a state of relative comfort while exercising.”

So what should you do?

It’s important to include all of these steps in an optimal exercise programme, as they all have different functions, say Derman and Hall. These include:

  1. The warm up: This involves stretching and preparing your body for exercise.
  2. Flexibility training/stretching: This focuses on increasing the range of motion of the joints and stretching the body to release tension in the major muscle groups – calves, quads, glutes, hamstrings, back, chest and arms.
  3. The aerobic phase: Involves movement of the large muscle groups to increase the heart rate. It can be walking, jogging, cycling, aqua aerobics or rowing, for example.
  4. Muscle strength resistance training: Using elastic bands or circuit training to make muscles stronger. This is particularly important for people with diabetes, as it can help the muscles involved in the absorption of insulin to become more sensitive, which helps blood sugar control.
  5. Stability training: Exercises like plank position that help balance and core stability.
  6. The cool down: This involves stretching and relaxation to allow the heart rate to go back to normal and the body to return to a resting state.

Remember: The goal is to exercise 20 to 30 minutes on most days of the week.

3 Top tips for people with diabetes:

  1. Don’t begin exercising if your blood sugar is either too high or too low (over 16 or below 4.8).
  2. If you are using insulin, always take something sweet with you when you exercise, in case of hypoglycaemia (low blood sugar).
  3. Avoid injecting into large muscle groups just before exercising.

What kind of exercise is best for older people with diabetes?

We asked biokineticist Sarah Hall to give us a sample exercise routine. Here’s what she said:

Warm up: 5-10 minute brisk walk

Stretch: Standing calf and quad stretch, chest, shoulder and bicep stretch, lying down hamstring stretch and cat stretch for the back

Aerobic: Step for 2 minutes

Muscle strength: Like bicep curls, wall push-ups and abdominal crunches (sit-ups)

Aerobic: Walk or jog on the spot for 2 minutes

Stability: Plank position

Cool down: Repeat stretches

Exercise made easy

Who said getting fit has to be a big project? With these five 20-minute workouts, you’ll be on your way to getting active in minutes! Daniel Sher shows us how. 

Let’s be honest: most of us have a lot of things on our To Do Lists, and exercising is not the one we want to do most! Our busy lifestyles often get in the way of our health, but how hard is it, really, to get active? Exercising can be easier than you think – there’s no need to run marathons or spend hours at the gym. In fact, a recent study* showed that just twenty minutes of daily exercise is enough to lose weight and control your diabetes better. Here are five simple ways to get active that only take twenty minutes to complete. We all have twenty minutes every day… Why not use them to feel great?

  1. Before (or after!) work

It might be a part of everyday life, but walking is also a great way to exercise. Taking a walk is a simple and relaxing way to get your heart rate up. Beaches, forests, parks and rivers are all great for a refreshing twenty minute walk, but a quick stroll through your neighbourhood can be just as enjoyable. Choose a time for your daily walk – twenty minutes before work, for example – and try to do this every day. Walk quickly and keep things interesting by changing which way you go from time to time. Join up with a few friends and it will make your walk even more fun.

Ask the expert: Sarah Hall, Biokineticist

“It’s important to practise correct posture when you walk. Follow these tips: walk tall, imagine a piece of string pulling you from the top of your head, lengthening your spine, and use your arms so that you have more power.”

  1. On your way to work

Most people sit in a taxi, bus or car to get to work. Believe it or not, this is a great opportunity to get some exercise! If you live close to your workplace, choose to walk, jog or cycle instead. And if your home is too far away, get out of the taxi a few stops early, or park further away than usual. Using your morning commute to exercise can help you save time, and also make you feel refreshed for the day ahead. Choosing to walk home (or part of the way home) after work can help to burn away the day’s stress and clear your mind.

Ask the expert: Sarah Hall, Biokineticist

“Buy a pedometer and track how many steps you take and the time it takes you to get from home to work. This is a great way to figure out how active you are during the day, and to encourage you to work on beating your own time and setting your own goals.”

  1. In the office

Quiet times at work are ideal for a quick workout: you can do an easy muscle-toning routine while sitting at your desk. Start by tightening your three main muscle groups, one at a time (legs, stomach and arms). Begin with a deep breath and clench your legs for five seconds; then take a breather for ten seconds before tightening up your stomach muscles for five seconds. Take another breather, and finish by clenching your arms and chest, which you tighten by pressing your palms together as if you’re praying. Repeat this routine until twenty minutes are up for a quick and easy muscle workout!

Ask the expert: Sarah Hall, Biokineticist

“Add a few arm and neck stretches as well! Hold your drawer, roll your shoulders back and down, and lengthen your spine whilst you sit.”

  1. At home

We all make excuses to stay inside: it might be raining, you might have a lot of chores to do, or the TV might be calling your name. Don’t let this stop you from getting your twenty minutes of exercise – you can easily transform your household routines into a workout. When you’re talking on the phone, pace around the house or climb up and down stairs, rather than sitting down. What about your errands? Sweeping, mopping, scrubbing and washing can give you a great workout and a clean house at the same time. Feel like watching your favourite TV show? No problem – use this time to jog lightly on the spot, whilst gently punching your arms in front of you like you’re boxing. Just be sure to pull the curtains so your neighbours don’t think you’re crazy!

Ask the expert: Sarah Hall, Biokineticist

“Treat this just like any other exercise session. Start with the easy tasks first, then stretch. Follow this with the activities that get your heart rate up, and then end with the chores that involve lifting things. Remember: if you are treating it as a workout, don’t forget to cool down and stretch at the end.”

  1. On the weekend

If you’re looking for a simple way to exercise and to have fun at the same time, dancing might be the answer. And what better time to dance than on the weekend? Listen to your favourite playlist, focus on letting loose and try to enjoy yourself – before you know it you’ll have worked up a sweat. If you know any ballroom steps ask a partner to join you for twenty minutes – fast-paced dances like the swing, salsa or tango are all great for increasing your heart rate. If you don’t know any dance moves, make up your own! Nobody’s watching…

Ask the expert: Sarah Hall, Biokineticist

“Dancing can be a great way to challenge your balance and a useful way to become aware of any imbalances between the left and right side of the body.”

How does exercise help diabetes? Exercise is recommended for most people, but an active lifestyle is especially helpful for diabetics. Why? Exercise can:

–       Help your body to use insulin better.

–       Prevent cardiovascular (heart) disease and other diabetes-related complications.

–       Reduce stress and anxiety, which makes it easier to manage your condition.

–       Improve your blood sugar control.

* In the September 2012 issue of The Journal of the American Medical Association.

Exercise meets meditation

Looking for a sport that’s relaxing and good for you? Yoga is not only a fantastic form of strengthening exercise, it’s also great for calming the mind – something most diabetics need! Here are some simple poses to try at home.

As a diabetic, the one thing you’re told over and over is that exercise is good for you. And it is! But sometimes exercise feels a bit too much like hard work. Now that the weather is colder it’s hard to get out for a walk or a run, and gym is not for everyone. That doesn’t mean you can sit back and wait for the weather to warm up, though! Yoga has just the right mix of strengthening, balancing and heart-racing poses, and you should take a few quiet minutes to lie down at the end of each class. Yes, that’s right! Exercise that makes you lie down!

There are specific reasons why yoga is good for people with diabetes, too. Yoga teacher Tasha Saha explains: “As well as better fitness and cardiovascular (heart and vein) health, yoga massages and increases the function of the internal organs, balances the endocrine system and has great effects on the release of stress hormones,” she says. “All of these are factors that affect blood sugar, so it’s no surprise that a number of big studies have shown that regular yoga can reduce blood sugar levels.” Another part of yoga that sets it apart from other exercise is that it increases body awareness – understanding how your body feels – which makes it easier to stay at a healthy weight and to make better food choices.

But which yoga to choose? In general, hot yoga (Bikram) and flow yoga (Ashtanga) are more difficult, so it’s better to begin with a slower practice like Hatha or Iyengar. Some poses (especially those that are active in the belly and lower back) are particularly good for diabetics because they target the pancreas, which can help to lower blood sugar levels. “But a balanced yoga session will work on every system in the body,” says Tasha, “as well as the mind and emotions too – lowering stress levels and helping you towards balance.” As every diabetic knows, balance is the magic word!

Here are a few yoga poses to try at home – these are very good for lowering blood sugar. If you can’t get to the full pose, go as far as you can. As you become more flexible, you will be able to stretch more. If something is sore, stop! Yoga should never be painful.

Seated twisting poses and forward bends

These stimulate the digestive organs and help the insulin work better in the system.

Seated forward bend

First: Sit on the floor with your legs out in front of you. Flex your feet and press down through your heels. Place your hands on the floor next to your hips and sit up straight, opening your chest.

Then: Take a deep breath in, and without curving your back, lean forward from the hips, not the waist. Either hold on to your feet or use a strap around the soles of your feet. Make sure your elbows are straight, not bent. Be careful not to pull yourself down – you want to lengthen the spine, not force it. Keep your head raised and aim to get your belly touching your thighs, and then your ribs. This might take a few months!

Finally: When you’re ready to come up, lift the body away from the thighs, take a deep breath in and slowly straighten up. Stay in this pose for: 1 to 3 minutes.

Half Lord of the fishes

First: Sit on the floor with your knees bent and your feet on the floor. Slide your left foot under your right leg to the outside of your right hip, with your left leg on the floor. Step your right foot over your left leg and place it on the floor outside your left hip. The right knee will point up to the ceiling.

Then: Exhale and twist your body towards the inside of your right thigh. Press your right hand against the floor behind you, and your left upper arm on the outside of your right thigh near the knee. Stay in this position, breathing deeply, then exhale and release.

Finally: Return to the position you started with, and repeat on the other side for the same length of time.

Stay in this pose for: 30 seconds to 1 minute. 

Standing poses and flow poses

Any pose where you have to stand or flow from one pose to another is excellent for the blood and heart systems.

Warrior

First: Stand up straight, with your feet together and your hands at your side. Breathe out, and step your feet apart, as wide as you can while still feeling balanced. Turn your left foot in 45 degrees, and your right foot out 90 degrees. Make sure the right heel and the left heel are in line with each other.

Then: Breathe out, and rotate your body till you are facing over the front foot. Raise your arms over your head, and reach towards the ceiling. Drop your shoulders and arch your upper back a little. With your back heel firmly pressing into the floor, breathe out and bend your front knee over your front ankle.

Finally: Reach through your arms and, if possible, bring the palms together. Keep your head looking forward or looking up at your thumbs.

Stay in this pose for: 30 seconds to 1 minute.

Poses which ground the body

These help to refresh the pancreas, liver and other abdominal organs.

Locust

First: Lie on your belly with your arms on either side, palms facing up, and your forehead resting on the floor. Turn your big toes towards each other and clench your butt.

Then: Exhale and lift your head, upper body, arms, and legs off the floor (this may take some practice!) Firm your butt and strengthen your legs. Raise your arms and stretch back through your fingers. Look ahead, but be careful not to stick your chin out. Keep the back of your neck long.

Finally: Breathe out and release. Take a few breaths and repeat (if you want to!)

Stay in this pose for: 30 seconds to 1 minute. 

Poses where the feet are higher than the head.

These direct the flow of blood towards the pancreas and relieve pressure in the feet.

Legs-up-the-wall

First: Lie with your back on the floor, in as straight a line as possible, with your legs up against the wall in a 90 degree angle (your body should form half of a square). Rest your shoulders on the floor and allow a small gap between your hips and the wall.

Then: Rest in this pose.

Finally: When you’re ready to come out of it, turn to the side for a few breaths and then come up into a sitting position.

Stay in this pose for: 5 to 15 minutes.

Want to give it a try? Many yoga studios offer free classes to beginners. Most gyms also offer yoga classes at a fraction of the price of private classes.

“Remember that everyone is different, so the range you will be able to work into will be different in each pose. It’s a good idea to start with a one-on-one yoga session so that you learn how your joints and muscles work within a safe range of motion. That way, you’ll be in control of the intensity and can adjust it for your fitness levels.”

– Sarah Hall, Biokineticist

Lift it!

Are you struggling to carry your shopping? Does moving boxes make you groan? Nicole McCreedy has the answer: simple weight training.

A simple weight training programme can make these everyday chores much easier for you – and get you in great shape. How? Well, lifting weights challenges your muscles, causing them to adapt and get stronger. Strength training builds strong muscles, bones and connective tissue. Not only does this help prevent osteoporosis and muscle loss as one gets older, it is also one of the most natural ways for people with diabetes to improve glucose tolerance and insulin sensitivity.

Weight training and diabetes

When you eat carbohydrate, it breaks down into smaller sugars (glucose, fructose and galactose) that get absorbed and used as energy. Any glucose that is not used gets stored in the muscles and the liver in the form of glycogen. Once the glycogen stores are filled up, any extra gets stored as fat. During exercise, the stored glycogen is transported to the active muscle to burn as fuel. Because muscle burns more kilojoules than fat, more muscle and less fat means better insulin use and glucose storage.

Lean muscle also boosts the metabolism and enables your body to burn kilojoules at a faster rate – even after you have finished exercising. A faster metabolism helps insulin to work better.

Getting started at home

Does the thought of weight training make you feel weak at the knees? Then start by learning the lingo before training at home.

A strength training workout is broken down into exercises, repetitions and sets. An exercise is a specific movement that works a muscle group. A rep, or repetition, is one complete motion. For example, to do a bicep curl repetition hold the weight or dumbbell at your shoulder then lower it in a controlled movement as you count to four. Lift the weight back to the starting or recovery position counting to six. A set is the number of repetitions performed together separated by a short rest period.

A workout plan

The next step is to set goals. Goals are a good way to keep yourself motivated. Do you want to tone your body, improve your strength or increase your endurance? Be realistic: results take time. Take photographs or simple body measurements every six to eight weeks to help you notice gradual changes.

Your aim in the beginning should be to develop the right technique. Maintaining the correct posture, while lifting a suitable weight, is important to prevent injuries. Try this side bend in front of the mirror: in one hand hold a weight along the side of your body. Slowly bend sideways sliding the weight toward your knees. Straighten up again. Check that you are not leaning backwards or forwards.

Weighing up the options

You can either buy hand-held (free) weights to use at home or you can improvise. Grab a tin of canned food from the cupboard to start. If that is too light, use a full 1 litre water bottle or a 2 litre milk bottle. Fill with sand to make the bottles heavier. If you are fairly strong, then fill two buckets with sand and try this squat: stand with your feet hip or shoulder width apart and hold a bucket by the handle in each hand.  Then bend your knees and lower yourself into a squat, as though you are about to sit in a chair. Stop when your thighs are parallel to the ground. Make sure your knees do not go beyond your toes. Exhale as you stand up slowly. Repeat without locking your knees.

The amount of weight you use depends on what you want to achieve and how strong you are. Choose a weight that allows you to do the repetitions you want to do without too much strain – only the last few repetitions in the set should feel like a struggle. The idea is that you give the muscle more to lift than it is used to. As the muscles grow stronger, you need to increase the weight until you reach your goal.

Stronger muscles will not only make your daily load feel lighter, but will also help prevent minor accidents from becoming serious injuries.

Ask the expert: Dr. Joel Dave, Endocrinologist

General advice for diabetics:

  • Before embarking on any weight- lifting programme, first discuss it with your doctor.
  • Do not lift any weights if you have proliferative retinopathy, severe non-proliferative retinopathy or a severe peripheral neuropathy
  • Do not lift weights if you have any foot injury or open skin lesions on the feet.
  • Wear adequate protective footwear at all times.
  • At your first session check how the exercise affects your blood glucose so that you will know what to expect in the future.
  • Check your fingerprick glucose before starting each session and proceed only if it is above 5.6 mmol/L.
  • Keep your glucometer and some kind of sugar nearby at all times.
  • It is best to exercise with a partner – do not lift heavy weights without a partner.
  • For the safest route, start with low weights and increase slowly under the guidance of an instructor.

Ask the expert: Sarah Hall, Biokineticist

Ask yourself the following questions when doing a weight-training programme:

– Are you training for strength, power or endurance?

A basic programme for each goal is:

Power:  4-6 reps, 2-3 sets;

Strength:  6-8 reps, 3-5 sets;

Endurance: 15-25 reps, 3 sets

– Do you have any previous injuries?

Previous injuries may rule out particular movements or ranges of motion in certain joints.

– Have you warmed up?

Do a light cardio warm up, stretching the muscles you are about to use so that you don’t strain.

– How much time do you have?

If you have limited time, rather focus on either upper body or lower body. That way you can target each muscle group in that part of the body and even do more than one exercise per muscle group for greater benefit.

– Have you allowed enough rest?

You need to rest for 40-60 seconds between sets, and 24-48 hours for each muscle group.

– Do you know how to practice good body mechanics?

Your body is the best machine you own.  Treat it like one and don’t abuse it!  Make sure that you move slowly and with control, breathe, and maintain a neutral spine. Never sacrifice form just to add more weight or repetitions.