Have Diabetes-Related Complications? Exercises to Avoid

Chances are, you've heard about the benefits of exercise so often, you could list them in your sleep: it can lower your bad cholesterol and raise your good cholesterol, help you lose weight, reduce body fat, reduce your stress level, and give you more energy. But if you're dealing with any diabetes-related complications, the rules are a little different.

"The benefits of exercise are enormous," says Kellie Rodriguez, RN, CDE, CPT, director of patient education at the Diabetes Research Institute. "But you need to be super-careful about doing exercise that is high impact, or that involves lifting weights and straining, when you have certain complications from diabetes."

Here are a few of the complications that should be a yellow light for you. Depending upon your doctor's recommendation, you'll be able to switch to a different form of fitness. There is an exercise program out there for nearly everyone; it's just a matter of finding one that's right for you.

● Peripheral neuropathy. When this complication occurs, an individual may not have good sensation in the feet, Rodriguez explains. And if you have no sensation, you could injure yourself while running, jogging, or skiing-or even just walking-and not even realize it. "This can be incredibly dangerous," Rodriguez says. "If you have peripheral neuropathy, after exercise you need to look at the bottoms of your feet for scratches, cuts, and blisters." Also be sure to wear cotton socks and well-fitting, comfortable shoes for exercise. One good activity for those who aren't supposed to be jogging, Rodriguez suggests, is swimming.

● Eye disease (diabetic retinopathy). If you develop this condition, you'll want to stay away from weight lifting. "It can raise the blood pressure, which can lead to bleeding in the back of the eye," Rodriguez says. Be sure to check with your eye specialist to find out what types of exercise are safe for you to do.  

 ● Autonomic neuropathy. This condition affects the nerves that control such organs as the bladder, genitals, and intestinal tract. When an individual has autonomic neuropathy, he may no longer feel the symptoms of low blood sugar or he may even have a silent heart attack, Rodriguez explains. Be sure to get medical clearance before doing exercise, and plan a fitness program carefully.

Most individuals will be able to safely do a variety of exercises, says Hope Warshaw, RD, CDE, MMSc, co-author of the "Real-Life Guide to Diabetes."  "Your doctor may want you to see an exercise physiologist or physical therapist to help you figure out what exercise is right for you," she says. "For people with type 2 diabetes, exercise has myriad benefits.  It's all about finding the right program."

When you do choose an exercise program, be safe by following some simple rules. Wear your medical identification bracelet or necklace, carry your ID in your pocket, and always travel with food or glucose tablets to treat low blood sugar. Check your blood sugar regularly if you exercise for over an hour: you may need a snack before you finish.

Sources:

"What I need to know about physical activity and diabetes." National Diabetes Information Clearinghouse (NDIC), National Institutes of Diabetes and Digestive and Kidney Diseases,  National Institutes of Health.
http://diabetes.niddk.nih.gov/dm/pubs/physical_ez/index.aspx

Colberg, Sheri R., Sigal, Ronald J., Fernall, Bo, Regensteiner, Judith G., Blissmer, Bryan J., Rubin, Richard R., Chasan-Taber, Lisa, Albright, Ann L., Braun, Barry. "Exercise and Type 2 diabetes." Diabetes Care. Volume 33, Number 12, December 2010.
http://care.diabetesjournals.org/content/33/12/e147.abstract

What's Really Causing Your Foot Pain?

Your feet bear the weight of your entire body and when they're not properly supported or they're expected to bear more than they're designed to carry, they react with pain. The delicate network of bones that make up the feet and allow us to walk and balance can get pushed out of alignment, which can irritate the joints, skin, nerves and connective tissue. 

Weight loss, proper hygiene, and the right shoes are among of the most common recommendations doctors make when their patients come in with painful feet and ankles. They might also look for medical conditions associated with foot pain like diabetes and heart disease, (which can cause nerve damage and circulatory problems in the lower extremities) or broken bones. But while those conditions do cause feet to become painful, the most common causes of foot pain are:

• Fallen arches, flat feet, or high arches that don't get enough arch support in a shoe
• Bunions, calluses and corns, often caused by poorly fitting shoes
• Hammer toes that curl down into a claw-like shape
• Arthritis, inflammation of the joints in the foot
• Plantar warts, which form on the sole of the foot and become painful when stepped on
• Bursitis or tendonitis of the ligaments, tendons and surrounding areas
• Morton's Neuroma, a bundle of thick nerve tissue between the toes
• Gout, a disease process caused by buildup of uric acid in the toe
• Sprains, especially in the ankle
• Plantar fasciitis, inflammation of the connective tissue in the bottom of the foot
• Stress fractures, caused by pressure, impact, or trauma
• Fungal infections like athletes foot

Foot Pain Prevention

How do you avoid becoming a foot-pain victim? Try these methods:

1. Wear good shoes with low to medium heels and good arch support. Make sure they're appropriate for the activities you engage in. Don't substitute tennis shoes for running shoes or wear your old Keds to play basketball. Instead, consult a sport shoe expert and invest in the right shoe for your sport. Wear high heel shoes and flip-flops as rarely as possible. 

2. Practice good foot hygiene. Wash and dry your feet thoroughly every day, wear clean socks, and contact your doctor if you see any rashes, cuts, sores, or abrasions. Always wear non-skid shoes on wet, slippery surfaces and locker room floors. 

3. Exercise regularly and cross train to keep all the muscles in your ankles, legs, and back strong and to prevent overuse injuries in your ankles and feet.

Have your feet checked as part of your regular physical examinations. If you have diabetes or heart disease, have your doctor examine your feet every time you see him/her and as soon as you notice any alterations.

How to Get an Accurate Blood Pressure Reading

Blood pressure measures the force of blood against the walls of your arteries as your heart pumps. The top number (systolic) indicates the maximum pressure the heart exerts while beating. The bottom number (diastolic) is the pressure in the arteries between beats. Physicians consider a difference of more than 40 mm Hg between the two abnormal (this is called pulse pressure).

Factors That Affect Blood Pressure Readings

Stress and anxiety. A stressful situation can cause a dramatic, temporary spike in your blood pressure. A single incident is not cause for alarm; however, if this happens frequently, it can damage your blood vessels, heart, and kidneys. Stress can also cause you to engage in behavior that may further damage your heart, such as smoking or drinking.

The season. Blood pressure tends to be higher in the winter because low temperatures cause your blood vessels to narrow so you need more force to push the blood through your body.  

Alcohol. Drinking three or more drinks at once may cause a temporary uptick in blood pressure. Over time, excessive drinking may cause a long-term increase.

Daily patterns. Your blood pressure is usually lower while you sleep and shortly after waking, then rises throughout the day, peaking in mid-afternoon.

Caffeine. Coffee and other caffeinated beverages can also cause a short but dramatic increase in your blood pressure.

Measurement errors. Your blood pressure measuring device may not be working properly, or you (or your healthcare provider) may not take your blood pressure correctly, which can cause a false high reading. Even something as innocuous as a tight belt can affect your reading.

If you experience a high blood pressure reading, try again later. Take a walk or practice slow, deep breathing so you're calm before you try again. Drinking water and avoiding certain foods, such as dark chocolate, garlic, and bananas beforehand may help ensure an accurate reading. If you continue to get high readings and you've ruled out outside factors as possible culprits, then see your physician. You can make simple lifestyle changes to lower your blood pressure, or if appropriate, seek medical care.

Sources:

Sheldon G. Sheps, M.D. "High blood pressure." Mayo Clinic. Web. 26 August 2011.http://www.mayoclinic.com/health/white-coat-hypertension/AN02014

Mayo Clinic. "High blood pressure." Web. http://www.mayoclinic.com/health/blood-pressure/AN01786

Ray, Claiborne. "Pressure Problems." New York Times. Web. 13 December 2010.
http://www.nytimes.com/2010/12/14/science/14qna.html