Which exercises are the safest and most fun for people with diabetic neuropathy (i.e., nerve damage due to diabetes)? What is the best way to stay motivated once the initial passion for exercise has subsided?
“It depends on where the patient was when they first started exercising,” said Dace L. Trence, MD, director of the Diabetes Care Center at the University of Washington Medical Center in Seattle, WA, and an endocrinologist. “For people who have never exercised before, the exercise at the beginning should be relatively comfortable, fun and easy for the patient to stick with.”
Patients who are experiencing diabetic nerve pain in their feet, legs, arms or hands can refer to a 2006 research article published in the Journal of Diabetic Complications that lists the important benefits of exercise for managing peripheral neuropathy. The study also showed that if patients walked briskly on a treadmill 4 times a week for 1 hour each time, they could quickly control the tendency for nerve damage to worsen, although this had to be maintained. The study lasted 4 years.
Let’s face it.
Let’s face it: for a lifelong disease like diabetes, adherence to long-term management is critical. If you want to avoid diabetic nerve damage, the most important thing is to make lifestyle changes. Increasing exercise can help control blood glucose levels and restore good sensation, as well as reduce the burden on the (painful) feet and legs, which is especially relevant for overweight people. These tips below can help patients start an exercise program and help them stick to it.
Before you start: safety first
If a patient has nerve pain, it is important to consult a doctor before starting any kind of new exercise. Because most people with diabetes are at risk for damage to the heart and circulatory system, it is necessary to have a doctor check the heart, eyes, and feet before starting a new exercise if you don’t want diabetic neuropathy to worsen.
If blood glucose levels are above 250 mg/dL (13.9 mmol/L), exercise should be approached with caution, Deiss said. “It’s an approximation, some will be higher, some will be lower,” she said, “but when a patient’s blood glucose is around 250, it’s best to watch what happens after exercise and to know how your body reacts to exercise.”
The American Diabetes Association (ADA) recommends testing blood glucose levels before and after exercise to see how the body and medications respond to different types of exercise.
Recommendation 1: Choose low-intensity exercise
To ensure safety during exercise, especially in patients with diabetic nerve pain or dulled sensation, knowing the safety of exercise can help overcome the psychological barrier to exercise: fear. Consider switching to low-impact or even weightless exercise, says Deiss, for example, aerobics or exercise balls performed while sitting in a chair. Other options:
- Swimming: When swimming, the water supports the patient’s muscles, bones and joints, which is especially good for overweight diabetics or those with diabetic nerve pain in the feet. Swimming has been a favorite among exercise experts for years because it avoids the impact of high-intensity exercise such as jogging on the feet, lower back and hips.
- Yoga: “I think yoga is underutilized for people with diabetes in terms of its benefits,” says Deiss. “It’s a great exercise, especially for patients who have limited movement and aren’t comfortable running on the floor.”
- Riding: Cycling is also a safe, low-impact exercise, provided you don’t fall, and patients can ride outside to see the sights or go to a health club to ride a stationary bike.
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Recommendation 2: 30 minutes per day, 5 days per week
The ADA recommends that patients exercise for 30 minutes a day, 5 days a week. The good news is that chores such as raking leaves and vacuuming can be considered exercise.
Before you start exercising, warm up briefly so your muscles, heart and lungs are ready. Stretching gently for 5-20 minutes can help reduce the damage to your body.
Fitness should be gradual and don’t set your goals too high so that you can feel accomplished and have fun.
Some patients may not be able to complete 30 minutes of exercise in one sitting, but don’t let that bother you. Patients can break down their daily 30-minute exercise goal into 10 minutes of yard work in the morning, 10 minutes of room cleanup after lunch, and 10 minutes of brisk walking outside after dinner.
Start simple, says Deiss, such as parking farther away or using the stairs instead of the elevator.
Advice 3: You don’t have to sweat
Different exercises have different characteristics. Aerobic exercise speeds up heart rate and reduces weight, and you sweat when you exercise. But for people with diabetes, you don’t have to sweat to benefit from exercise. Patients can try strength training, such as lifting weights, or they can increase flexibility through stretching exercises or taking a yoga class.
Combination exercises. Patients can try a combination of exercises to increase aerobic capacity, strength, and flexibility to get more benefit, though avoid injury and over-exercise.
Adapt to your situation. For example, if a patient is unable to do regular floor push-ups, they can instead do push-ups facing a wall, which can greatly reduce the load on their arms and shoulders. Set small goals so that a sense of success can be achieved. If the patient has a regular sense of success, it is more beneficial to keep the exercise going.
You don’t have to go to a paid health club. There are lots of exercise videos and DVDs everywhere now, and Des says it’s perfectly fine for people to exercise at home or to try some new form of exercise.
Advice 4: Choose exercises you like
Choose a sport that you like, or at least some aspect of it. Otherwise, it’s easy for patients to give up when the momentary enthusiasm subsides. So don’t follow the crowd, and don’t follow your wife just because she likes to dance. Maybe you like music, but it may not be right for dancing, maybe bowling is better for you instead. If the hand-eye coordination is not good, then it is not suitable for tennis or volleyball.
Think back to high school or college: what was your favorite sport back then? Was it softball, golf or basketball? Find a sports club, gym or community center and join one of the “back to the hobby” groups.
Find people at your own fitness level to help ease the frustration of playing sports.
Everyone’s interests are unique. For some people, what’s new is always the most fun. For others, pleasure can only come from what is familiar and comfortable. It’s important to know yourself and trust your feelings.
Recommendation 5: Exercise in pairs
Behavioral medicine experts agree: group support helps people persevere when things get tough. And what could be more difficult than making a lifestyle change?
Patients are more likely to stick with it when they agree to a weekly time to go out walking or do other exercise with a friend, neighbor, or family member, and who wants to let a friend down?
Patients might consider joining a local walking or hiking club to meet new people, get out together, and get some fresh air. You will find it easier to exercise when someone else is making the exercise plan.
Find groups like a softball team, volleyball team, or cycling club. There may also be a local swim team for adults, or the local school may need a volunteer coach.
Recommendation 6: Try new things
With increased physical fitness, patients will have more new forms of exercise to choose from than before. Patients can try new exercises often to avoid feeling bored and bored with exercise as if it were a chore.
Try a water aerobics class or other swimming class at your local pool.
Learn a new form of exercise or recreation, such as golf, badminton, kayaking, or national standard dance.
Practice yoga, Tai Chi and other exercises that unite the mind and body, promote relaxation and bring a sense of well-being.
The more significant the pleasure that exercise brings, the more likely patients are to successfully move to a healthy and active lifestyle, and a healthy and active lifestyle can inspire patients to be active and manage their diabetes effectively throughout their lives.