Tu diabetes winter fatigue stay positive update


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Tu diabetes winter fatigue stay positive update

  1. 1. Winter Fatigue:Staying Positive and Active While Waiting for Spring Jacqueline Shahar, M.Ed., RCEP, CDE Joslin Diabetes Center Boston, MA © Joslin Diabetes Center
  2. 2. Objectives• Exercise options in the spring• Fuel metabolism with exercise• Blood glucose management with exercise
  3. 3. Exercise Options• Walking• Running• Cycling• Hiking• Yoga• Physical activities: – Raking leaves – Painting
  4. 4. Additional Exercise Options• Outdoor TRX training• Resistance band training in the park• Combine aerobic and resistance training outdoors• Sign up for an event/activity – ADA: Tour De Cure, Walk to Stop Diabetes – JDRF: Walk to Cure Diabetes – Insulindependance: regional chapters and events
  5. 5. Fuel Metabolism and ExerciseChu et al., The Physician and Sportsmedicine, Volume 39, 2011
  6. 6. Blood Glucose Control & Exercise• What is best BG range to perform your exercise and prevent lows and highs?• Target BG: 140-230mg/dl• Low-moderate vs. vigorous exercise • BG may be different• Check BG before, half way and after exercise• Check amount of “Insulin on Board” in your pump
  7. 7. Insulin Adjustments on Exercise Days• Reduced bolus (meal/snack insulin) by 30% to 50% with the meal close to activity time• Reduced long acting by 10-30% for activity/sports performed over a long period of time• Basal, temp basal or disconnect• If BG high, small correction dose maybe required• Be aware of “lag effect”• Principle method - trial and error
  8. 8. Snacking Choices with ExerciseBefore exercise:• A mix of carbs and healthy fats to help sustain BG with exerciseDuring exercise - choose snacks that are:• Convenient to carry• Do not cause stomach upset• Absorb quickly • Sports drinks – Gatorade, Powerade • Gels, GU • Fruit: dried fruits, banana • Juice • Avoid protein shakes
  9. 9. Snacks Post Exercise/Recovery • To replenish muscle glycogen stores and repair muscle damage eat: • Carbs • Proteins - ~20g protein within 1 hour after exercise. Essential for muscle growth and recovery. • Whey protein shakes • MealIvy, Journal of Sports Science and Medicine, 2004
  10. 10. Hydration• Hydration • 250mL of fluid intake every 20mins of exercise • Water or sports drinks • Replace electrolytes• Dehydration causes cramps, hyperglycemia, heat stroke
  11. 11. How to Achieve Your Goals?• Use SMART goals to start your spring exercise routine – Specific; Measurable; Adjustable; Realistic; Time frame• Manage your time• Exercise with your family and friends• Develop alternative activity plans
  12. 12. Summary• Find the right activity for you: outdoor vs. indoor; groupvs. individualized.• Check BG with exercise to adjust meds as needed.• Use SMART goals to move in the right direction andachieve your goals.• Find the right snack that helps manage your BG with exercise.
  13. 13. Thank You!