Exercise, Diabetes and You!

Last Sunday morning when I was reading my Newspaper, relaxing in my front Balcony, I noticed a sudden bout of activities arising from the third house from mine, which happens to be Mr. Sainis residence. I could see Mr Sainis son rushing out from the colony gates and then two more cars went rushing after him , I was sure there is some real emergency. Something wrong must have happened with Sainis. I got curious but continued with my newspaper and then went in to have my morning rituals and practically forgot all about the hectic morning activities involving Saini family! It was around 11.30 AM, when my maid brought the sad news that Mr. Saini died a sudden death while he was having his morning walk in the park early this morning! So.. that was the reason for all that rush in the morning! I knew Mr Saini was a Diabetic for past 8-9 years but he was never a very disciplined patient. He showed me three four times last year but then he just stopped coming to me, probably because I continuously kept telling him that he should reduce his weight by at least 10 Kgs,Since he always was reluctant to start any such weight management programs, he simply stopped seeing me! The news of his sudden demise was shocking and saddening but I was wondering how come a person like Mr Saini started going for a morning walk in the first place ! The story unfolded later that last month only how his daughter and wife both literally forced him out to the colony park for a morning walk,which he himself then started taking seriously also! Now I Got it! Being a Doctor and Diabetologist I could immediately sense what went wrong with Mr.Saini on that fateful morning! I took up to my laptop and here I am with my readers with some serious suggestions on What should you do Before you start with ant Lifestyle changes involving sustained Physical Exertion and Exercise! This time I have decided to come out in this point-wise format so that it becomes easier for my readers to have a complete and quick grasp of the subject! 1. You must have a Complete Medical check-up and obtain your Physicians Approval before starting an exercise program. Prefer to consult a Doctor who knows your case or understands Cardio-Diabetes and is aware of the basics of preventive cardiology. If you have never gone for regular exercising before then this is even more important for you! 2. If you are exercising regularly BUT you want to Increase the Intensity of your workouts or you want to add some new form of exercise in your schedule, then it is again important to have a re-consultation with your Doctor! 3. If you are a Diabetic and your treatment includes Insulin OR some drugs which can cause Insulin release from the system, that must also be discussed with your doctor. Because exercise can cause sudden lowering of Blood Glucose specially with Insulin OR Insulin providing Drugs like: Glimepiride/Gliclazide/Glbenclamide etc 4.. You should also learn how to prevent hypoglycemia(sudden lowering of Blood Glucose!) by adjusting your Insulin dosages or eating snacks that contain carbohydrate. If you take medications for your diabetes that could cause hypoglycemia, be prepared to treat low blood glucose episodes by always carrying glucose tablets/ or small packets of

Glucose say 2 Teaspoons per packet and you should always carry 4-5 such packets with you! 5.Be sure to stay hydrated and carry a water bottle with you. And always wear your medical or Personal identification.An ID card with your address,Phone numbers,who should be contacted in case of an emergency etc should be preferably worn by you or should be in your pocket all the times, more so when exercising alone in a Park! As happened with Mr.Saini ! 6.A good pair of running shoes pay there worth in just SIX months! Any reputed sports shoe meant for running or jogging will be OK but keep in mind that all standard companies only take enough care while designing a safe and comfortable footwear so there should be no compromise on quality here! 7. Allow enough time to enjoy your walk or jog. A 10-15 minute warming up period followed by 20-30 minutes of slower and then brisk walk ,followed by 10 minutes of cooling down should be the target for any Diabetic. This has to be achieved slowly over 3-4 weeks time! So dont be in a hurry! I always tell my patients that our aim is Physical Fitness and we are not planning to win a medal next month so GO SLOW ! 8.Most important: Listen to your body. Know when you need to slow down or take a day off. Remember your own system gives you warnings at the right time, so dont ignore any subtle changes happening with you after you started with an exercise session! A sudden weakness in limbs, discomfort in chest or head, any breathing difficulty which was never there before or sudden cold sweats ,palpitations etc should be taken seriously! Stop then and there, call for help, take your Emergency Glucose packet, swallow it plain and dont wait for water if not readily available( But I told you to keep a water bottle!)Never try to win over the situation by exerting more till help arrives! If you can move safely try to reach nearest possible help BUT DO NOT DRIVE ALONE in this situation! 9. Three to Five days a week of exercising is not a bad idea at all! Also you can try to alternate harder days with easier sessions, and you can take a full day off after a troubled session or each week for rest and recovery. But this is also true that the more times you exercise each week, the sooner you develop a healthy habit and achieve results. 10.Follow known and familiar tracks specially if you are alone.. Plan your course beforehand, always keep weather and terrain in mind. Begin your jog or walk into the wind (Not against the wind- more important for starters,cardiac patients and 50 yrs plus of age people!)and you may try to end up with the last stretch against the wind.Be extra cautious and even slower especially when it is cold. Jog at a running track or on dirt or bike paths; dont run on sidewalks, as concrete ,it is much harder and is too jarring to the joints. Listen to ypur Joints also.Many footwear companies do make specially designed shoes which can be protective to your toes ankles and can support your knees also saving them from jerks and jolts! Thats why I told you to go for a well-designed specialized footwear!

11. Dress appropriately:Wear comfortable cloths according to the season.A lightcolored clothing at night with attached reflective strips to your jersey/Tshirt or clothing and shoes can add up to safety from traffic. You can clip a red bicycle light to your jacket. In hot and humid weather, the less clothes you wear, the better. In cold weather, prefer dressing in layers,instaed of one thick heavy jacket! Heavy outerwear is cumbersome also and can not be zipped off as body temperature rises. The new high-tech fabrics used for workout clothing are great at keeping you dry and comfortable in warm or cold conditions. All standard brands are now making good stuff as per Indian conditions. 11.We keep cracking jokes on Delhi being dug up every other day and on un-safe Delhi roads But dont forget India is developing!Jokes apart-jog and walk defensively. Watch out for cars, potholes, dogs and their contributions, ice, mud and other hazards. Carry some money with you and AGAIN reminding you - your identification and your cell phone for emergencies. 11. Set Goals-Take help of Pedometers! In terms of achieving a particular speed or distance covered or steps walked.Set reasonable weekly goals and try to achieve them. Thanks to China..!Yes - you can get good quality Pedometers with good battery life for Rs-200 300 /- only. You can set up your Body Wt BMI etc on some of them and they tell you the calories you burnt during the session in the end! Keeping a daily exercise log can help you meet your exercise goals. You can start with 10 minute sessions gradually increasing to 30-40 minutes! 12.Try to fit in the sessions in your daily routine in such a way that you dont have to struggle for getting some time OUT OF YOUR ROUTINE to get your exercise session completed! 13.Ensure that :You should be enjoying your exercise! Any exercise schedule is bound to fail in the long run if you dont find it enjoyable!A friend of younger age group or a Group of morning walkers is always a better idea! If alone take help of an MP3 player, any youngster in your family will help you if you are not tecno savvy, in getting your favorite melodies loaded on an iPod which you can carry with you on your walk! 14. And Last But Not The Least It has to be a Lifelong change in your Lifestyle!! For years and years to come you have to adhere to that active lifestyle which you ave finally achieved! 15.The so called Morning Walker Machines where an Electric motor raises your feet alternately while you are lying down !!! is NO EXERCISE at all! Just use your common sense, how this machine, moving your limbs can be compared with this-you standing, then your own body moving against gravity while you are lifting your own legs,using your own muscles actively for walking using your own energy for the job! How can anyone even think of that a machine lifting your legs is equivalent to walking! Unfortunately these motorized walkers are being sold to masses and no Medical authority, NGO or Health ministry ever raises questions against them! Typical of India! 16. Benefits Of Regular Exercise: You get enormoue benefits: Diabetes,Blood Pressure, Cholesterols ,Body Weight all improve.Your Muscles,Bones and Joints get a second life!

Reflexes ,Agility, alertness ,stamina,mood ,depression also improve! Tendency to fall,Osteoporosis,Sleep quality and duration too improve! Remember an overweight or Obese person who is physical active lives longer than a normal weight BUT Physically Inactive person! 17. A 30 minute session of Exercise for 4-6 days a week is good enough to keep you fit! BUT if your target is weight loss then you will have to have longer sessions coupled with DIET REGULATION,without which weight loss will never be satisfactory!