Chris Jordan MS, CSCS, NSCA-CPT, ACSM EP-C/APT

Director of Exercise Physiology

Johnson & Johnson Human Performance Institute

Physical Activity and Diabetes

Agenda

• Physical Activity and Diabetes – Benefits

• Movement vs. Exercise

• Strategic Movement - What? Why? How?

• Exercise Basics

• Exercise Components - Aerobic, Resistance, Flexibility

- What? Why? How?

- Special Considerations and Tips

• Behavior Change – Johnson & Johnson Human

Performance Institute Model

• Q&A

Physical Activity and Diabetes – Benefits

• Glycemic control - Glucose tolerance

- Insulin sensitivity (reduced insulin requirements)

- Glucose uptake (by muscles)

• Weight loss - Improved body composition

• Cardiovascular function - Blood pressure

- Cholesterol

- Functional capacity

• Psychological benefits - Mood/self-esteem

- Energy levels/fatigue

Movement vs. Exercise

Strategic Movement

• What? - Simple, accessible physical activity as part of daily routine

- Breaks in sedentary time (e.g. prolonged sitting)

• Why? - Increase total daily calorie expenditure

- Glycemic control

- Help boost energy levels

- Help improve sense of well-being

- Promote physical activity - moving more, sitting less

Strategic Movement – How?

Strategic Movement – Examples

• Take the stairs, not the elevator

• Take a walk after lunch

• Walk to another department, don’t e-mail

• Take a shower, not a bath

• Avoid drive-through facilities

What is the most serious problem for people with diabetes

who exercise, particularly those taking insulin?

a) Dehydration

b) Hypoglycemia

c) Heat illness

d) Hypertension

Polling Question

Exercise Basics

• Exercise means moving, challenging, regular

• Safe, effective & efficient

• Medical clearance!

• Always warm-up/cool-down

• Quality first, quantity second

• Some exercise better than no exercise

• Simple and accessible

• One program does NOT fit all – adjust as necessary

Exercise – What does “challenging” mean?

Zones of Intensity

Zones P pain

Zones D discomfort

Zones C comfort

Zones R rest or sleep

Exercise Components

• Aerobic training

• Resistance training

• Flexibility training

Aerobic Training

• What? - Continuous movement, large muscles

• Why? - Glycemic control

- Weight loss

- Cardiovascular function/fitness

- Quality of life

Aerobic Training

• How? - Brisk walking, cardio equipment, recreational activities

- 3-7 days/week (no more than 2 consecutive days off)

- 150 minutes per week (minimum)

- Moderate-intensity

• 5-6 perceived exertion (10-point scale)

• Talk-Test

Interval vs. Continuous (aerobic workouts)

Aerobic Training – Special Considerations & Tips

• Glucose monitoring

• Decrease insulin dosage

• Consume carbohydrate snack before and after exercise

• Exercise with a partner

• Observe for signs/symptoms hypoglycemia

• Tips: - Variety

- Fun

- 10-minute bouts

Using the Talk-Test, which of the following represents

“moderate-intensity” aerobic exercise?

a) You can sing to yourself

b) You cannot speak

c) You can hold a conversation, but NOT sing

d) You can speak a few words before pausing for breath

Polling Question

Resistance Training

• What? - Pushing, pulling, carrying, lifting load/resistance

Why? - Maintain/increase lean mass

- Improve body composition (healthy weight loss!)

- More muscle, more glycemic control

Resistance Training

• How? - Weight machines, resistance bands, body weight

- 2 non-consecutive days per week

- All major muscle groups

$$$ FREE

Resistance Training - Special Considerations & Tips

• Glucose monitoring

• Decrease insulin dosage

• Consume carbohydrate snack before and after exercise

• Exercise with a partner

• Observe for signs/symptoms hypoglycemia

• Tips: - Circuit training

- Avoid exercises that greatly increase blood pressure (BP)

- Keep workouts short and simple

- Emphasize correct form and technique/proper breathing

Flexibility Training

• What? - Stretching to maintain range of motion

• Why? - Help prevent muscle imbalances/potential injury

• How? - After exercise

- Point of tightness or slight discomfort

- Hold stretch for 10-30 seconds

- 2-4 repetitions

• Tips: - Focus on least flexible muscles first

- Try foam roller

- One repetition still worthwhile

For people with diabetes and retinopathy, which of the

following should generally be avoided when performing

resistance training?

a) Deep squat or leg press

b) Isometric exercises

c) Valsalva maneuver (holding your breath)

d) All the above

Polling Question

Behavior Change –

Johnson & Johnson Human Performance Institute Model

Step 1 Step 2 Step 3

Purpose – Truth – Action

Who & what matters most? Current reality? Small, actionable steps

Rituals to habits

Purpose can be a source of intrinsic motivation!

Q & A