Islets of Hope healthy living for persons with diabetes

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Researchers Show Traditional Chinese Exercises Can Help Combat Diabetes (December 6, 2005) — A pilot study for Australia's first clinical trial to evaluate the effectiveness of traditional Chinese exercises in preventing the growing problem of diabetes has produced startling results...

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Lantus (glarine) Insulin Unaffected by Exercise

"In people with insulin- dependent type 1 diabetes, exercise does not appear to increase the rate of absorption of insulin glargine (Lantus), a long-acting insulin analog, according to study findings."

You can be active at any size!  I was once 287 lbs and incorporated exercise into a lifestyle plan.  If I could do it so can you!  Lahle, IOH Founder

For a free online (or hardcopy) brochure on being active at any size visit NDDK.

Walking . . . A Step in the Right Direction.
NIH Publication No. 01-4155. 2001. This pamphlet explains how to start a walking program, presents a sample program, and shows stretches for warming up and cooling down. Available in English and Spanish from WIN..

Active Living Every Day: 20 Weeks to Lifelong Vitality
Steven N. Blair, Andrea L. Dunn, Bess H. Marcus, Ruth Ann Carpenter, and Peter Jaret, Human Kinetics, 2001. This book offers a step-by- step plan for getting and staying active. The information, suggested activities, and self-help tools in each chapter were successfully tested with people who followed the plan and learned to make activity a part of their daily lives. The 20 chapters correspond to the 20 weeks of the program, but readers are encouraged to go at their own pace.

Great Shape: The First Fitness Guide for Large Women.
Pat Lyons and Debby Burgard. iUniverse, 2000. This book urges women to be physically active for fun, fitness, and positive body image instead of for weight loss. The authors describe a healthy lifestyle program including walking, swimming, dancing, martial arts, bicycling, and more.

Don't Weight: Eat Healthy and Get Moving NOW!
Kelly Bliss. Infinity Publishing, 2002. This book provides motivation and information for healthy eating and plus-size fitness. It also teaches problem solving techniques. It offers information that can help the large person plan and achieve a fitness program that can be sustained for a lifetime. Available from, P.O. Box 572, Lansdowne, PA 19050; phone: 1-877-KellyBliss.

Water Exercise.
Martha D. White. Human Kinetics, 1995. This book presents water exercises for fitness and muscle tone as well as exercises for injuries, postsurgical rehabilitation, and other special needs. Available from Human Kinetics, P.O. Box 5076, Champaign, IL 61825; phone: 1-800-747-4457.

Easy Does It Yoga.
Alice Christensen, American Yoga Association. Fireside, 1999. This book presents a program of exercises, breathing, meditation, philosophy, and nutrition for older adults and those with physical limitations. Simple chair exercises and more challenging standing and floor exercises are described. Available from the American Yoga Association, P.O. Box 19986, Sarasota, FL 34276; phone: (941) 927-4977.

Real Fitness for Real Women: A Unique Workout Program for the Plus-Size Woman.Rochelle Rice. Warner Books, 2001. This book describes a 6-week introductory fitness program that includes warm-ups, aerobics, strength training and stretching techniques, and meditation. Photos of plus-sized women demonstrate the exercises. The book also addresses getting motivated, creating support, evaluating current abilities, and increasing self-acceptance. (I have had the pleasure of interacting with Rochelle when I worked for the PCOSA.  She is an excellent writer, and has a heart for women.)

Walking: A Step in the Right Direction

Physical Activity and Weight Control

Weight-Control Information Network
1 WIN Way
Bethesda, MD 20892-3665
Phone: (202) 828-1025
Toll-Free Number:

American College of Sports Medicine (ACSM)
P.O. Box 1440
Indianapolis, IN 46206-1440
Phone: (317) 637-9200

National Strength and Conditioning Association (NSCA)
1955 N. Union Blvd.
Colorado Springs, CO 80909
Phone: (719) 632-6722
Toll Free: 1-800-815-6826

President's Council on Physical Fitness and Sports
Department W
200 Independence Avenue, SW
Room 738-H
Washington, DC 20201-0004
Phone: (202) 690-9000

Shape Up America!

For More Information

To find diabetes teachers (nurses, dietitians, and other health professionals) near you, call the American Association of Diabetes Educators toll-free at 1–800–TEAMUP4 (1–800–832–6874). Or look on the Internet and click on "Find a Diabetes Educator."

American Diabetes Association
National Service Center
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1–800–342–2383
Fax: 703–549–6995


diabetes healthy lifestyle diet exercise sports stress management                        back to main Lifestyles page
Exercise, Calorie, BMI Calculators
Diabetes and Exercise
Reprint of NIH Publication No. 04–5180, June 2004

Mini Site Index
How can I take care of my diabetes?
What can a physically active lifestyle do for me?
What kinds of physical activity can help me?
Can I exercise any time I want?
Are there any types of physical activity I shouldn't do?
Can physical activity cause low blood glucose?
What should I do first?
What can I do to make sure I stay active?
What can I do to make sure I stay active?

More Exercise Information
Weight lifting or aerobics for diabetes?  Benefits & Considerations

How can I take care of my diabetes?

Diabetes means that your blood glucose (also called blood sugar) is too high. Your body uses glucose for energy. But having too much glucose in your blood can hurt you. When you take care of your diabetes, you'll feel better. You'll reduce your risk for problems with your kidneys, eyes, nerves, feet and legs, and teeth. You'll also lower your risk for a heart attack or a stroke. You can take care of your diabetes by:

  • Being physically active,
  • Following a healthy meal plan,
  • Taking medicines (if prescribed by your doctor).


What can a physically active lifestyle do for me?

Research has shown that physical activity can

  • lower your blood glucose and your blood pressure
  • lower your bad cholesterol and raise your good cholesterol
  • improve your body's ability to use insulin
  • lower your risk for heart disease and stroke
  • keep your heart and bones strong
  • keep your joints flexible
  • lower your risk of falling
  • help you lose weight
  • reduce your body fat
  • give you more energy
  • reduce your stress and depression

Physical activity also plays an important part in preventing type 2 diabetes. A major government study, the Diabetes Prevention Program (DPP), showed that a healthy diet and a moderate exercise program resulting in a 5 to 7 percent weight loss can delay and possibly prevent type 2 diabetes.


What kinds of physical activity can help me?

Four kinds of activity can help. You can try:

  • Being extra active every day (take steps instead of the elevator, park far and walk more),
  • Doing aerobic exercise (brisk walking, jogging, biking, dancing, etc.),
  • Doing strength training (i.e., lifting weights),
  • Stretching.

Be Extra Active Every Day

Being extra active can increase the number of calories you burn. There are many ways to be extra active:

a man walking up stairs
  • Walk around while you talk on the phone.
  • Play with the kids.
  • Take the dog for a walk.
  • Get up to change the TV channel instead of using the remote control.
  • Work in the garden or rake leaves.
  • Clean the house.
  • Wash the car.
  • Stretch out your chores. For example, make two trips to take the laundry downstairs instead of one.
  • Park at the far end of the shopping center lot and walk to the store.
  • At the grocery store, walk down every aisle.
  • At work, walk over to see a co-worker instead of calling or emailing.
  • Take the stairs instead of the elevator.
  • Stretch or walk around instead of taking a coffee break and eating.
  • During your lunch break, walk to the post office or do other errands.
    Other things I can do: ______________________________________

Do Aerobic Exercise

Aerobic exercise is activity that requires the use of large muscles and makes your heart beat faster. You will also breathe harder during aerobic exercise. Doing aerobic exercise for 30 minutes a day, most days of the week, provides many benefits. You can even split up those 30 minutes into several parts. For example, you can take three brisk 10-minute walks, one after each meal.

If you haven't exercised lately, see your doctor first to make sure it's OK for you to increase your level of physical activity. Talk with your doctor about how to warm up and stretch before exercise and how to cool down after exercise. Then start slowly with 5 to 10 minutes a day. Add a little more time each week, aiming for 150 to 200 minutes per week. Try:

a couple dancing
  • walking briskly
  • hiking
  • climbing stairs
  • swimming or taking a water-aerobics class
  • dancing
  • riding a bicycle outdoors or a stationary bicycle indoors
  • taking an aerobics class
  • playing basketball, volleyball, or other sports
  • in-line skating, ice skating, or skate boarding
  • playing tennis
  • cross-country skiing
  • other things I can do: ______________________

Do Strength Training

  a woman exercising with hand weights while watching the television

Doing exercises with hand weights, elastic bands, or weight machines two or three times a week builds muscle. When you have more muscle and less fat, you'll burn more calories because muscle burns more calories than fat, even between exercise sessions. Strength training can help make daily chores easier, improving your balance and coordination, as well as your bones' health. You can do strength training at home, at a fitness center, or in a class. Your health care team can tell you more about strength training and what kind is best for you.



Stretching increases your flexibility, lowers stress, and helps prevent muscle soreness after other types of exercise. Your health care team can tell you what kind of stretching is best for you.


Can I exercise any time I want?

Ask your health care team about the best time of day for you to exercise. Consider your daily schedule, your meal plan, and your diabetes medications in deciding when to exercise.

If you exercise when your blood glucose is above 300, your level can go even higher. It's best not to exercise until your blood glucose is lower. Also, exercise is not recommended if your fasting blood glucose is above 250 and you have ketones in your urine. For information about preventing or treating low blood glucose, see Can physical activity cause low blood glucose?


Are there any types of physical activity I shouldn't do?

a man sitting down checking his feet

If you have diabetes complications, some exercises can make your problems worse. For example, activities that increase the pressure in the blood vessels of your eyes, such as lifting heavy weights, can make diabetic eye problems worse. If nerve damage from diabetes has made your feet numb, your doctor may suggest that you try swimming instead of walking for aerobic exercise.

Numbness means that you may not feel any pain from sores or blisters on your feet and so may not notice them. Then they can get worse and lead to more serious problems. Make sure you exercise in cotton socks and comfortable, well-fitting shoes that are designed for the activity you are doing. After you exercise, check your feet for cuts, sores, bumps, or redness. Call your doctor if any foot problems develop.


Can physical activity cause low blood glucose?

Physical activity can cause hypoglycemia (low blood glucose) in people who take insulin or certain diabetes pills, including sulfonylureas and meglitinides. Ask your health care team whether your diabetes pills can cause hypoglycemia. Some types of diabetes pills do not.

Hypoglycemia can happen while you exercise, right afterward, or even up to a day later. It can make you feel shaky, weak, confused, irritable, hungry, or tired. You may sweat a lot or get a headache. If your blood glucose drops too low, you could pass out or have a seizure.

However, you should still be physically active. These steps can help you be prepared for hypoglycemia:

a man sitting at a table recording his blood glucose level

Before Exercise

  • Be careful about exercising if you have skipped a recent meal. Check your blood glucose. If it's below 100, have a small snack.

  • If you take insulin, ask your health care team whether you should change your dosage before you exercise.

During Exercise

  • Wear your medical identification or other ID.
  • Always carry food or glucose tablets so that you'll be ready to treat hypoglycemia.
  • If you'll be exercising for more than an hour, check your blood glucose at regular intervals. You may need snacks before you finish.

After Exercise

  • Check to see how exercise affected your blood glucose level.

Treating Hypoglycemia

If your blood glucose is 70 or lower, have one of the following right away:

  • 2 or 3 glucose tablets
  • 1/2 cup (4 ounces) of any fruit juice
  • 1/2 cup (4 ounces) of a regular (not diet) soft drink
  • 1 cup (8 ounces) of milk
  • 5 or 6 pieces of hard candy
  • 1 or 2 teaspoons of sugar or honey

After 15 minutes, check your blood glucose again. If it's still too low, have another serving. Repeat until your blood glucose is 70 or higher. If it will be an hour or more before your next meal, have a snack as well.


What should I do first?

Check with your doctor. Always talk with your doctor before you start a new physical activity program. Ask about your medications—prescription and over the counter—and whether you should change the amount you take before you exercise. If you have heart disease, kidney disease, eye problems, or foot problems, ask which types of physical activity are safe for you.

Decide exactly what you'll do and set some goals.  Choose:

  • The type of physical activity you want to do,
  • The clothes and items you'll need to get ready,
  • The days and times you'll add activity,
  • The length of each session,
  • Your warm up and cool down plan for each session,
  • Alternatives, such as where you'll walk if the weather is bad,
  • Your measures of progress.

Find an exercise buddy. Many people find that they are more likely to do something active if a friend joins them. If you and a friend plan to walk together, for example, you may be more likely to do it.

Keep track of your physical activity. Write down when you exercise and for how long in your blood glucose record book. You'll be able to track your progress and to see how physical activity affects your blood glucose.

Decide how you'll reward yourself. Do something nice for yourself when you reach your activity goals. For example, treat yourself to a movie or buy a new plant for the garden.


What can I do to make sure I stay active?

One of the keys to staying on track is finding some activities you like to do. If you keep finding excuses not to exercise, think about why. Are your goals realistic? Do you need a change in activity? Would another time be more convenient? Keep trying until you find a routine that works for you. Once you make physical activity a habit, you'll wonder how you lived without it.

Read our article on weight training versus aerobic activity.

Other Publications

Ample Hygiene for Ample People.
Nancy Summer. Willendorf Press, 1997. This booklet offers tips for dealing with reach problems, chafing, skin fold irritations, and more. Available from the National Association to Advance Fat Acceptance, P.O. Box 188620, Sacramento, CA 95818; phone: (916) 558-6880; Web:

Plus Size Yellow Pages.
Over 3000 online resources for fitness clothes up to 6X, casual wear up to 10X, bikes, bike seats, kayaks, sports bras, supportive tights/leggings, supportive fitness shoes, and much more. Web:

Size Wise: A Catalog of More Than 1000 Resources for Living With Confidence and Comfort at Any Size.
Judy Sullivan. Avon, 1997. This book describes resources that offer products or services for large people. It tells where to buy items like swimsuits, bicycle seats, and walking shoes. It also has information on exercise classes and sports instruction for large people throughout the United States, Britain, and Canada. Available from or your local bookstore.


Yoga for Round Bodies, Volumes 1 and 2.
Linda DeMarco and Genia Pauli Haddon. These videos offer a fitness system based on Kripalu yoga to promote strength, flexibility, stress relief, and cardiovascular health. Round-bodied instructors tailor classic yoga postures to large people at both beginner and intermediate levels in each video. Available from Plus Publications, Box 265-W, Scotland, CT 06264; phone: 1-800-436-9642; or

Chair Dancing.
Jodi Stolove. This no-impact video series is designed to improve muscle tone, flexibility, and cardiovascular endurance without putting stress on your knees, back, hips, or feet. Available from Chair Dancing International, Inc., 2658 Del Mar Heights Road, Del Mar, CA 92014; phone: 1-800-551-4386; Web:

Tai Chi Chuan.
Dawn Fleetwood. This 50-minute instructional video features slow, gentle movements and breathing exercises that involve all of the muscles and organs in the body. Available from Orchid Leaf Productions, P.O. Box 72, Flint, MI 48501; phone: (810) 235-9864.

BIG MOVES: Yoga for Chair and Bed.
Mara Nesbitt. This video is designed for people who have difficulty getting down to or up from the floor. Led by a plus-sized instructor, it includes stretches done standing, sitting, and lying on a bed, plus a guided meditation. Available from Mirage Video Productions, P.O. Box 19141, Portland, OR 97280; Web:

Organizations and Programs

The Young Men's Christian Association and Young Women's Christian Association offer physical fitness and health awareness programs in many locations throughout the United States. Contact YMCA of the U.S.A., 101 N. Wacker Dr., Chicago, IL 60606; phone: (312) 977-0031; Web: Contact YWCA of the U.S.A., 1015 18th St., NW, Suite 1100, Washington, DC 20036; phone: 1-800-679-1209; Web:

Council on Size and Weight Discrimination, Inc.
This nonprofit organization seeks to improve health care and access to services for large people through educational programs, media monitoring, and medical conference attendance. Contact CSWD at: P.O. Box 305, Mount Marion, NY 12456; phone: (845) 679-1209; Web:

National Association to Advance Fat Acceptance.
This nonprofit organization seeks to end discrimination based on body size and to improve the quality of life for large people. It offers a variety of publications and videos on size acceptance, self-esteem, and health and fitness. Contact NAAFA at: P.O. Box 188620, Sacramento, CA 95818; phone: (916) 558-6880; Web:


Body Positive.®
This site addresses issues ranging from self-esteem to fitness to finding respectful health care providers. It includes resources and links to related sites. Web:

Big Folks Exercise and Fitness Resources Frequently Asked Questions (FAQ).
This site provides information on where to buy clothing, videos, and books on physical activity and fitness for big people. It also lists organizations and classes worldwide for large people. Web:

Healthy Living with Bliss.
This site includes information on walking, swimming, aerobics, stretching, and other fitness activities for large and very large people. A resource section includes fitness wear, books, exercise equipment, classes, and information on where to buy fitness videos for large people. There is an online workbook, eNewsletter, and a chat with plus-size personal fitness trainer Kelly Bliss. Web:


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Page Updated 05/11/2006