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Pre-diabetes and exercise

Discussion in 'Prediabetes' started by Murphyorky, Aug 27, 2017.

  1. Murphyorky

    Murphyorky · Member

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    Hello, I'm fairly new to these forums but was diagnosed with pre-diabetes some years ago. I've been inspired by the advice here and have recently adjusted my diet towards lower carbs. So far I haven't seen any reduction in my HBA1c level, but this may be because I need to take the carbs even lower, or do it for longer. (My BMI is normal and always has been. I've lost a couple of stone since the diagnosis but after an initial reduction in my HBA1c to 41, it is now back up again to 44.)

    I'm keen to do more exercise, and wonder if there is any advice about whether exercise pre or post-meals is more beneficial for glucose levels? I am assuming that all exercise is good, but wonder if I can target better the effort I am putting in. I am also wondering if certain types of exercise are more useful than others. I do some brisk walking 5 times a week 9 (to and from work) and go running a couple of times a week. I've heard good things about resistance training and wondering if I should be doing some of that. Any advice on how others have used exercise to improve glucose levels would be very welcome - thank you!
     
  2. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    I can't advise from personal experience, but I am struggling with this myself and came across the following, with some useful info. on the value of brief post-meal exercise: https://www.diabetes.org.uk/Guide-t...d-about/Sports-nutrition-and-Type-2-diabetes/ I was pleased to see that just 10 minutes after meals can do great things. I have been trying to do 20 minutes after meals, but since I also exercise for longer periods at other times of most days I am finding this very time-consuming and tiring. 10 minutes x 3 times a day seems to me a lot more sustainable.

    As regards weight training, I do this and have read that it is good, but not as good as aerobic training for diabetics. However I have a diabetic friend at my gym who only trains with weights and refuses most aerobic activity. His GP is wowed by his results. (He also has developed a terrific body!) However, he also seems to eat practically nothing except tinned mackerel and kale!!!
     
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  3. derry60

    derry60 Prediabetes · Well-Known Member

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    I tell you what I have noticed. If I have been moving around say just walking to another room and then take my BG level, my level has gone up. When I sit for 10 mins and take the test again, my BG goes down quite a bit..Happens every time. Same thing happens with my husband.
     
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  4. Murphyorky

    Murphyorky · Member

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    Thanks very much for this Alexandra, and that guidance looks very useful. I will take heart from the idea of doing ten minutes after meals - that sounds very do-able. I agree that tinned mackerel and kale sounds very, er, challenging!! Many thanks again.
     
  5. Murphyorky

    Murphyorky · Member

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    That's interesting to hear, derry60, and just seems to underline how personal this is!
     
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  6. AloeSvea

    AloeSvea Type 2 · Well-Known Member

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    I would say - do the same with exercise that one does with food - but instead of eating and metering - move and meter. This way you see what works for you in the range of exercise types and times available to you in your life. It's also about maintenance as well - to find what you enjoy and can keep up over - well - over the rest of your life! :).

    But absolutely re resistance training, or, lifting heavy things regularly. This is supposed to be really good for improving insulin sensitivity.

    And always good to know that aside from shunting excess glucose in our blood into the muscles - exercise and movement is about increasing oxygen flow and using those muscles and keeping them functioning well - it's good for avoiding strokes and CVDs, keeping the heart healthy and the arteries as undamaged as possible.
     
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  7. Murphyorky

    Murphyorky · Member

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    Thanks AloeSvea and I'm certainly going to start doing something about resistance training.

    You are right about the various benefits of exercise. I've also found that the familiar point about trying to fit it into the daily routine as part of normal life has been helpful. I now park about 20 minutes from work which means I get a brisk walk twice a day. This is a!so very much in line with the information in the link that Alexandra shared here.

    Thanks again, and I must say I'm finding these forums very helpful and supportive.
     
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    #7 Murphyorky, Sep 3, 2017 at 9:05 AM
    Last edited: Sep 3, 2017
  8. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    Hi @Murphyorky the article @Alexandra100 provided covered I believed most angles, I just disagree with the fuelling before / using gels, in the mornings I would train fasted if maximally just on Metformin or no drugs.

    The psychology of training I think is the hardest part. Whilst the doing something you enjoy can be important, I think habit forming and sèeing results that encourage is more important, for me this will trump enjoyment and breed a cycle of participation and eventually lead to enjoyment, e.g, I don't enjoy brushing my teeth, but I do it through habit and minimising cavities and oral hygene is the incentive.

    Pre Routine
    I would start with baseline measurements (to get the progressive results to drive adoption), so if possible get some body composition scales, I recommend Tanita as these are relatively cheap at circa £35,00 from Argos and measure aspects such as obviously weight, visceral fat muscle mass etc (others also use Omron). An authorisation from your medical professional, maybe a stress test.

    Morning
    Drink some water or black filter coffee (burns more calories througout the day). I would do some fasted walking after taking blood readings first thing, starting off at a comfortable pace and hitting maximal pace after a few minutes and bringing back down a couple of minutes before finishing for around 15 minutes. This will increase blood flow and prepare you for some resistance.

    (Stick the TV, radio or music on) With no rest straight into either body weight or dumb bell compound exercises. This can be simple such as 3 sets of 10 push ups, 10 squats, 10 crunches, 10 back extensions, 10 trick dips - 30 seconds to 1 minute of rest and repeat a further 2 times. It is important to maintain form, so if you can do on 5 quality push ups, this is better than 10. Watch youtube and cross reference to ensure your form is perfect, I.e. pull in your core (tummy) and try to keep this under tension whilst breathing / breathing out at the top of the exercise (this is technically harder than it sounds). If you've got a dog, he she will appreciate the change of pace and it makes the routine easier. An alternative is cycling, either road or cycling, or maybe swimming.

    For dumb bells I would suggest compound exercises all the way, this will send oxygenated blood to the muscles in use. You could start with something like 5 kg (go into a sports shop and see what you are comfortable with) and do a simple compound routine such as 10 squat to bicep curl to should press, 30 second rest and repeat routine 3 times. Again the same applies as for the non weighted exercises with breathing, form and core tension. Once this is comfortable double up, I.e. 2 squats, 2 bicep curls, 2 shoulder presses (do not use body momentum, remember form and quality). An alternative is to get some resistance bands, go for the ones with 3 different types and an exercise plan.

    I would suggest up to 2 - 3 minutes of focused stretching at the end of your routine. This isnaround 30 minutes and will rev up your metabolism.

    Evening
    As soon as you feel comfortable go for a walk after dinner. If you can at any stage do what I call a finisher, something like squats to exhaustion rest, push ups to exhaustion. If you do this you can get increased insulin sensitivity and glucose metabolism, should take only seconds.

    So my advice is both pre and post meal exercise, building up to what fits your lifestyle and your goals, which can and will shift, try a rope in others if you can. Exercise is fantastic, as it can be team based, dancing or incidental, I have just found at the gym the benefit of high inclination, slower treadmill walking to mix things up. Once the habit is formed this is a good addiction to have. It is not necessary to go too heavy, this should be done under guidance especially if you have eye or hypertension concerns. To get more gains without too much hassle perform the exercises slower, e.g. try 15 push ups with a slow decent and equally slow accent, the same with squats etc either weighted or not. For either bigger gains get professional advice a sports scientist, level 3 or 4 personal trainer or a program such as Athlean X.

    Finally you can't out run a bad diet, if you look at every top commercial exercise program such as P90x, Insanity, T25 etc, they also up front and centre spell out that results are dependant on dietary intake (I would add sleep).
     
  9. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    Lots to read here as soon as I can give it my attention after doing some exercise! Thanks for taking the time to write all this thoughtful and useful stuff. My caveat - as for everything around diabetes, not everyone rreacts in the same way. I have tried fasting exercise and it just led to my feeling very shaky and uncomfortable without seeing any lowering of BG.
     
  10. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    I think the shaking might be your body reacting to a place it is not used to. I used to get shaky and light headed when I would go from 8's to 4's after hard static cycling, now if I get a late 3 I feel nothing and 4's are completely comfortable even weight training hard through from this point. Your right to be cautious about different reactions, so it is a learned experience. I do go into detail as hopefully this will provide route 1 information of options to try for anyone interested.
     
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  11. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    Sadly, this argument won't work, as when I am feeling wobbly my BG is not low.
     
  12. Murphyorky

    Murphyorky · Member

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    Thanks @Mbaker for this very informative reply, and it has given me a lot to consider and work with. Grateful for your advice on this. As Alexandra says, a lot of this comes down to working out what suits individually.

    "You can't out run a bad diet": very true:)
     
  13. AloeSvea

    AloeSvea Type 2 · Well-Known Member

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    There's no way I can exercise/move/be active fasted to any degree, let alone a serious bout of activity. I need fuel before I expend it, else my body is a slooooow train, that's for sure. This is where that old adage about different strokes for different folks comes in, and about us having different metabolisms and body types. The good thing is it's pretty easy to check out how your body works best! As in - try it and see. Compare exercising/moving/being active at different times, and fasted and unfasted. And check your blood glucose levels after at various intervals. And sometimes there is going to be a time that is hunky dory for your blood glucose levels but just doesn't fit into your life.

    About not worrying about enjoyment levels - I guess here we are all different too. For me enjoyment is crucial for sustainability - especially at the level I must do to keep myself as fit as possible and as healthy as possible as a diabetic. (ie - I can't drop the ball.) And it is good that enjoyment levels being up enough is as simple as walking, or HIIT running (both of which I actively enjoy) instead of say - mountain climbing or rowing - which I would hate. But I know what you mean @Mbaker, re the routine being important. But rather than teeth cleaning, I would aliken it more to a good meal! In which mealtimes are rather routine bound. But eating is enjoyable, if you see what I mean.

    Agree on squats being a very powerful exercise. And very good for insulin sensitivity (as well as just about everything.) One of my friends was prediabetic, and all he had to do was cut out the raspberry buns to get to normal BG levels (I saw him recently eat a large plate of mashed potato washed down with a pint of beer - me and my own bod would be climbing the walls with a sugar rush going nowhere fast on such a supper). I put it down to the fact he is a professional painter and squats continuously most days of the week, that he is keeping blood glucose dysregulation at bay. But even then - I'll keep you (and me!) posted on how long he can keep up the beer and spuds thing and remain insulin sensitive. Naturally I am hoping he can do it! And I am even envious too. (Beer! Potatoes! Sigh.) But I am keeping an eye out, for sure.
     
  14. Murphyorky

    Murphyorky · Member

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    Thanks @AloeSvea and I'm really getting the picture in terms of how personally tailored exercise has to be.

    By the way, my new forays into testing alarmed me this morning, as I did a test on getting up (6.0) and then again after a short brisk walk to work, (still before eating anything) and found that my reading had actually gone up to 6.6. I know that this exercise probably wasn't enough to effect any positive change, but was nevertheless alarmed by it.

    I've just come across this article about how exercise can sometimes initially cause readings to go up:

    https://mysugr.com/high-blood-sugar-after-exercise/

    But the important message is still clearly that exercise is the right way to go.

    Sleep is also a priority for me. I am having bad problems with insomnia at the moment and can almost literally feel the cortisol skittering around me. I had a particularly bad night last night and so tried testing myself first thing to see what effect that would have. This is the first fasting test that I have done and I am really hoping that the reading will go down if I repeat it after a decent night.
     
  15. Alison Campbell

    Alison Campbell Prediabetes · Well-Known Member

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    Hi @Murphyorky

    You might be also interested in learning about the dawn phenomenon/liver dump which maybe more related to your morning rise.

    http://www.diabetes.co.uk/blood-glucose/dawn-phenomenon.html

    I will say that the fasting blood glucose levels for me and many others are the last to go down after lifestyle change so keep an eye on it but focus on pre and post meal readings to start.

    Have you had @daisy1 new member advice. This was really helpful to me when I was diagnosed with prediabetes 6 years ago. This advice will also have information about the low carb programme which was not available then.

    Exercise reduces my blood sugar's always to a base of around 4 but some type 2's do report a rise.

    There is a lot of experienced people around the forum so keep asking questions.
     
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  16. daisy1

    daisy1 Type 2 · Legend
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    @Murphyorky

    Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you want and someone will be able to help.


    BASIC INFORMATION FOR NEW MEMBERS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 250,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

    There are two approaches to controlling your carbs:
    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes.

    Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips

    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic.

    Note: This post has been edited from Sue/Ken's post to include up to date information.

    Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.
    • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
    • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
     
  17. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    The rise after exercise is normal for many, you get the benefit either later or cumulatively. Some lower the intensity and increase the length if this is a concern.
     
  18. Glink

    Glink Prediabetes · Well-Known Member

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    I agree with the advice to treat exercise as another variable that affects your blood sugar, like food, and test by trial and error to see what will work for you. Many people find a bit of exercise after eating helps lower sugars, but some see a rise. For me, and some others, the time of day matters a lot as well (I, for example, have trouble with IFG, and have to eat something before morning exercise or my sugars just keep rising and I feel ill). Obviously exercise is better than no exercise, and a mix of aerobic and anaerobic is ideal, but beyond that there's a lot of trial and error to find one's best routine.
     
  19. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    Like you, I absolutely have to eat before exercising. I see from Wikepedia that IFG = impaired fasting glucose and I'm wondering if this is something I suffer from. I've no idea if my sugars rise if I exercise fasting, but I definitely feel awful. I'm still trying to work out how to fuel my exercise sessions without over-doing the carbs. What have you tried?
     
  20. Glink

    Glink Prediabetes · Well-Known Member

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    I have 2 low carb chicken/turkey sausages (1-3g carb total depending on which flavour) and coffee every morning before I bike to work. That seems to do the trick. If I'm out of sausage I scramble up a couple eggs instead. Eating something seems to halt my morning rise and a couple eggs/sausages are enough to get me through no problem (until my "10:30 nuts" snack!). I have just given in and eat the same thing nearly every day. Boring, but fairly effective.
     
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