tu diabetes winter fatigue stay positive update

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Winter Fatigue:

Staying Positive and Active While Waiting for Spring Jacqueline Shahar, M.Ed., RCEP, CDEJoslin Diabetes Center Boston, MA

Joslin Diabetes Center

Objectives Exercise options in the springFuel metabolism with exercise Blood glucose management with exercise

Exercise OptionsWalking Running CyclingHiking YogaPhysical activities: Raking leaves Painting

Additional Exercise Options Outdoor TRX training Resistance band training in the park Combine aerobic and resistance training outdoors Sign up for an event/activityADA: Tour De Cure, Walk to Stop DiabetesJDRF: Walk to Cure DiabetesInsulindependance: regional chapters and events

Fuel Metabolism and Exercise

Chu et al., The Physician and Sportsmedicine, Volume 39, 2011

Blood Glucose Control & ExerciseWhat is best BG range to perform your exercise and prevent lows and highs?

Target BG: 140-230mg/dl

Low-moderate vs. vigorous exerciseBG may be differentCheck BG before, half way and after exerciseCheck amount of Insulin on Board in your pump

Insulin Adjustments on Exercise Days Reduced bolus (meal/snack insulin) by 30% to 50% with the meal close to activity timeReduced long acting by 10-30% for activity/sports performed over a long period of timeBasal, temp basal or disconnect If BG high, small correction dose maybe required Be aware of lag effect Principle method - trial and error

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 carryDo not cause stomach upsetAbsorb quicklySports drinks Gatorade, Powerade Gels, GUFruit: dried fruits, bananaJuice Avoid protein shakes

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 Meal

Ivy, Journal of Sports Science and Medicine, 2004

Hydration Hydration 250mL of fluid intake every 20mins of exercise Water or sports drinks Replace electrolytes Dehydration causes cramps, hyperglycemia, heat stroke

How to Achieve Your Goals? Use SMART goals to start your spring exercise routineSpecific; Measurable; Adjustable; Realistic; Time frame Manage your time Exercise with your family and friendsDevelop alternative activity plans

Summary Find the right activity for you: outdoor vs. indoor; group vs. individualized. Check BG with exercise to adjust meds as needed. Use SMART goals to move in the right direction and achieve your goals. Find the right snack that helps manage your BG with exercise.

Thank You!