The Benefits of Exercising Indoors—How Does it Help People with Diabetes?
"I tried going to a local gym when I was first diagnosed, but discovered that it was inconvenient and very expensive," says Francis, who started acquiring her personal gym one piece at a time when she moved into a house. Today, her at-home gym includes a stationary bike, rowing machine and weight machine. Francis says that she uses her exercise equipment every day, and alternates her aerobic and strength training. "Strength training decreases insulin resistance and sucks the glucose out of my blood. I can be a bit high, hit the weights for a few minutes and be right back in target range. Increasing muscle mass keeps my insulin requirements down."
Francis considers aerobic exercise to be "all-around good stuff," giving her heart, lungs and liver a good workout.
"I learned that strength and cardiovascular training are equally beneficial when it came to controlling my diabetes."
Sheri Colberg, PhD, assistant professor of exercise science at Old Dominion University in Norfolk, Virginia, says that she knows of no exercise equipment that is "designed especially for people with diabetes." However, she does recommend some exercises that would be more appropriate for the diabetic workout.
A treadmill can be used for fast walking or running indoors, and are usually a little more gentle on the lower leg joints than asphalt or concrete. In addition, treating low blood sugars becomes easier as you are already at your destination on a treadmill and would not run the risk of being caught far from home with hypoglycemia.
"Treadmill exercising, like all prolonged, aerobic exercise, improves diabetes control by improving muscle insulin sensitivity for approximately 24 to 48 hours following the exercise," says Colberg, who attributes this to an increased glucose uptake by muscle used for muscle glycogen repletion. When more glycogen is depleted during intense or prolonged exercise, insulin sensitivity remains heightened for a longer period of time following the exercise.
Treadmill exercising increases glucose control by increasing muscle mass and decreasing body fat. However, Colberg says that the measurable improvements in insulin sensitivity from training are lost fairly rapidly if you stop training.
Jerome Thielgesm, 55, of Bellevue, Washington, recently had triple-bypass surgery and now uses a treadmill approximately 4 to 5 times per week for about 20 to 40 minutes per day.
"I am trying to be more religious about the treadmill," says Thielgesm. "I am a tax accountant so I feel treadmill exercise is a good stress reducer along with being beneficial to my diabetes control. I seem to notice the neuropathy in my feet when I am under more stress...so that's one more reason to use the treadmill."
Janice Bramen has type 2 diabetes and also uses a treadmill every day to help control her blood sugars.
"I try to walk at a fast pace for about 15 minutes at a time," says Bramen. "I find it helps me keep my fasting blood sugar below 120 mg/dl with proper diet. Usually I can keep it about 110 mg/dl. On days when I don't use the treadmill, it is a little higher, in the 130s."
"Exercise on a stationary cycle is a good, non-weight-bearing exercise that gives all the same benefits as walking or running," says Colberg, who adds that if a person has painful neuropathy, using a stationary bike gives them the advantage of not placing weight on their feet.
B.S. Prakash of Uganda is a type 1 who has been exercising regularly for six years. He uses a stationary bike 4 to 5 times per week for 20 to 30 minutes per day.
"I burn about 200 calories each time," says Prakash. "Exercise gives me a sense of well-being and helps me maintain my blood sugar levels. I don't need to go to a gym because a stationary bike at home gives me the flexibility, the leisure and the informality of doing the exercise when I want it."
Pam Robbins, a type 2 from West Grove, Pennsylvania, also uses a stationary bike at home. She says that it gives her a good cardiovascular workout and is beneficial in lowering her blood sugars.
Stephen McGurk, 33, is a type 1 from Toronto. Each day, he uses a Stairmaster for 30 minutes and a rowing machine for 15 minutes.
"The Stairmaster and rowing machines help bring down high blood sugar, reduce heart disease risks and keep my weight off," he says.
Colberg feels that a Stairmaster can be similar to treadmill exercise, except that localized muscle fatigue (in the quadriceps) can limit one's ability to exercise for prolonged periods.
"It's generally a higher-intensity workout compared with walking, therefore, making it a more effective means to controlling blood sugars," says Colberg, who compares the benefits of using a Stairmaster to that of running.
Colberg adds that rowing machines are another good exercise, but, once again, the rower is limited in their ability to row for extended periods of time due to its emphasis on upper-body musculature.
The Jane Fonda-workout may have been popular in the 1980s, but for BG control, some people feel that working out in front of a television screen is still the best thing possible.
Katherine Halvorson of Mara, British Columbia, has diabetes. In addition to using free weights, she owns approximately 50 exercise videos.
"These videos have helped me lose body fat and gain muscle, thus, enabling me to use less insulin," says Halvorson. "I have fewer bouts of depression and my A1C [6.1%] is good. The circulation in my legs also improved.
Halvorson says that some of her favorite videos include Power Max Step Works (step exercises), Interval Max, Body Max (step and weights), Maximum Intensity Strength (weights) and the Pure Strength Series (three separate weight tapes for different body parts).
"I also do Aaron Lankford and Billy Blanks' kickboxing tapes."
Colberg says there are several exercise videos that deal with water and other non-weight bearing activities.
"Several of these videos are available, and many YMCAs and gyms offer aqua aerobics and other water exercise," says Colberg.
In "The Diabetes Sports and Exercise Book" (RGA Publishing Group, 1995), author Claudia Graham, CDE, PhD, MPH, says that fitness centers and gyms have a wealth of machinery to enhance aerobic fitness.
Joanne Stawicki is 38-years-old and has had type 1 diabetes for 21 years. She has a membership at an athletic club which allows her to do several activities including kickboxing, step aerobics, athletic conditioning and racquetball.
"I get to the gym usually 3 to 4 days per week plus," says Stawicki. "I seldom have the lows I use to have and I am still learning about the different effects of energy-burning across all these different activities."
The Diabetic Athlete
Colberg has also written her own book, entitled "The Diabetic Athlete," which is due to be published in September by Human Kinetics Publishers. It is a unique users guide to every conceivable sporting and recreational physical activity. In the book, Colberg discusses insulin use, diet and supplements relative to exercise and type 1 and 2 diabetes.
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Editor's Note: Exercise can cause hypoglycemia and it is advisable to always have glucose tablets or a quick-acting sugar substance to correct such problems. Also, make sure to test several times after engaging in any form of exercise and see a physician to have a your exercise program individualized.