August 14, 2012

Exercise key component for proper diabetes control

By DR. JONATHAN BEACH, Ask the Diabetes Doctor

---- — Patients often find that their blood-glucose levels and general diabetes control improves over the summer months. 

I have noticed this with many patients and attribute much of the improved control to increased exercise. Although we never like to admit it, in the next few months, there should be a considerable amount of snow and ice limiting outdoor activities and safe driving. With increased exercise during the summer months, patients often notice that they need less insulin and that blood sugars improve. Through exercise, patients improve their sensitivity to insulin and general metabolism and can loose weight. Both activity and weight loss improve the function of insulin in the body and the general health of a patient. I find that I am often stressing to patients the importance of making every effort possible to increase their exercise regardless of season.

Along with improved blood sugars, exercise can also increase the risk of low blood sugars, and patients need to prepare for that possibility. All patients should carry extra food with them during exercise and need to make sure that they have some form of quick-acting sugar such as glucose tablets or orange juice. Any patient on insulin should speak to their provider about proper medication adjustments for exercise. 

It is also essential that all patients keep blood meters with them and test frequently to avoid hypoglycemic events. It is important that those patients on insulin make efforts to reduce the insulin dose rather than eat more food, as increased calories will work against the weight-loss efforts of exercise.

Another important aspect of being a resident of northern New York is planning for the winter. If patients can develop a plan to increase their exercise during the winter months, the positive effects can be experienced year-round. Extra caution must be taken with driving and outdoor activities during the colder season.

As a general rule for exercise, I suggest that patients carry an additional 15 to 45 grams of carbohydrates, including a rapid-acting form. A blood meter with all necessary components for frequent testing is also necessary. A medication list should always be available, and notes concerning medical providers can be very helpful. If exercising alone, make sure family or friends know where you are going to be and an approximate return time. Some sort of communication device and a medic-alert tag indicating any and all significant medical issues is highly recommended to ensure safety. If planning on overnights, make sure you double the number of supplies you anticipate using. Thankfully, most of these items can be carried in a knapsack or bag rather easily.

Improved insulin sensitivity and weight loss can have a dramatic effect on diabetes control. Efforts should be made to find forms of exercise for the entire year with respect to seasonal challenges.

Dr. Jonathan Beach, who has lived with diabetes himself since age 4, heads the Northeast Center for Diabetes Care and Education at Urgicare of the Northeast in Plattsburgh. Send questions for this column, which runs the second Tuesday of every month, to: Features Editor, P.O. Box 459, Plattsburgh, NY 12901 or email