IN GOOD No more excuses

Rob Brown explores some of the issues people with diabetes imagine they will face when they try to become more active – and discovers how to break through them

For people living with diabetes, getting moving can have a huge impact on their health and mental wellbeing. But working out can also cause anxiety. And it can be a struggle to find the motivation and time while juggling the stresses of life and a health condition. You could be managing blood sugars, mobility issues and associated medical complications too.

To mark Diabetes Awareness Week, which starts tomorrow, we debunk some of the more common excuses those living with the condition make.

I’m scared of hypos

This barrier is easy to understand. At best, hypos – when your blood glucose level falls too low – are unpleasant and inconvenient. At worst, they are frightening and dangerous.

“For lots of people who have diabetes, having hypos when doing different types of activity is a real worry,” says Diabetes UK’S Senior Clinical Advisor, Emma Elvin. “Your healthcare team can give help and advice if you’re thinking about doing a new activity.”

They will recommend ways of managing blood sugar levels by adjusting diet and dosage of blood sugar-lowering medications. It’s also advisable to regularly test sugar levels and ensure you are with someone who knows that you have diabetes and how to spot the symptoms of a hypo.

“Depending on the type of activity, it can make you more sensitive to insulin for 24 to 48 hours after you’ve finished,” adds Emma. “This creates a higher risk of hypos. So, talk to your healthcare team about adjusting doses of insulin, test regularly and make sure you have hypo treatments to hand.”

I can’t get motivated

Replacing the calories you’ve just burned off in order to treat a hypo can affect motivation, particularly for those who are trying to lose weight. “It’s easy to see why people ask ‘what’s the point?’ in that situation,” says Neil Gibson, Diabetes UK’S Senior Physical Activity Advisor. “But the benefits of activity aren’t just about weight loss.”

Moving more has positive effects on everything from blood pressure to mood and sleep patterns.

Your healthcare team may be able to help with strategies to manage your insulin doses before exercise. But it is important to get this individual advice before you make any changes. Blood sugar levels can be difficult to predict and no two days or two people are the same.

“There is no ‘right’ activity, so find something you enjoy and can maintain,” says Neil. “Making sure you have a bag packed with all your equipment. Getting a waterproof jacket and the right shoes make it easier to maintain a new routine when the weather’s bad or time is tight.”

I’m too busy

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Take the stairs instead of the lift or walk rather than drive

Time is always tight, but it’s important to remember that any kind of activity counts. You don’t have to dedicate hours to pumping iron at the gym or doing endless lengths of the swimming pool.

Weave simple things into your day. Take the stairs instead of the lift or walk to the shops instead of driving. If you live in a busy town or city, you might find that cycling allows you to dodge the rush hour traffic.

“Thinking creatively about movement is key,” says Neil. “Walk on the spot while you are waiting for the kettle to boil, move during TV ad breaks or do stretches at your desk.”

It’s too challenging

Too often, insecurities about how much we weigh, what we look like, or our ability at a given sport can hold us back. Try not to let them.

“So many people have image issues and are nervous about going to gyms,” says Neil. “If you’re thinking of joining one, visit first with a friend and get a feel for the atmosphere and people there. You’ll see others who are or were once in your position.”

Mobility issues or complications arising from diabetes can also be barriers to becoming active. But moving more can help with these.

“Diabetes UK volunteers organise walking groups for people of all abilities around the country,” says Emma.

“You can adapt almost any activity for people’s individual needs,” she adds. “You can do seated exercises, and there are non-weight bearing activities for people with mobility issues. If you have any existing complications, talk to your healthcare team for advice.”

Additionally, you should make sure you look after your feet.

“Wear appropriate socks and shoes. If you notice changes in temperature or sensation, or cuts and blisters that are not healing, it’s important you get them looked at and allow them to heal.

“With the right care, most people can do some form of activity,” advises

Emma.

My blood sugar will be erratic

Moving more can have unexpected effects on blood sugar levels. Activity, particularly aerobic, increases insulin sensitivity. So, you are more likely to experience lower blood sugar levels – but not always.

“Blood sugar levels can go up, which can really confuse people,” says Neil.

“That’s usually caused by intense, anaerobic movements like weightlifting or sprinting. If you play golf and are zigzagging all over the fairway, it may lower your blood sugar levels. But big swinging shots are explosive movements. They can have the opposite effect. In sport, stress hormones can also make your sugar levels go up.”

These spikes are often short-lived and followed by a sharp decline. This can lead to hypos. Check blood sugar levels after exercise and ensure you have hypo treatment on you.

“But being active can have a really positive impact on your health and diabetes,” says Neil. “Try not to let anything hold you back.”

■■Diabetes UK has a new programme to help everyone move more and track progress over 10 weeks. Visit diabetes.org.uk/bal-exercising to download a guide. This feature is taken from Balance, the magazine for Diabetes UK members. Sign up at diabetes.org.uk