Another kindred spirit, and this one found me! Sheri Colberg-Ochs is an author, lecturer, researcher, professor, exercise physiologist, and expert on exercise and diabetes. She is also a mother of three school-aged children, and living with Type 1 diabetes herself (just like me). She was diagnosed as a child, and has built her life around making a better world for people with diabetes. She writes numerous articles and columns in addition to her five book titles -- including the recent "The 7-Step Diabetes Fitness Plan" and "50 Secrets of the Longest Living People with Diabetes."
Sheri contacted me last month with some questions on blogging, so I seized the opportunity to query this veritable font of diabetes guidance. (btw, Sheri started her own weekly blog on Diabetes and Exercise April 2. Check it out!)
DM) Sheri, you've done extensive research on exercise metabolism in individuals with Type 2 diabetes. What are some of the most important findings to date?
SCO) Exercise is GOOD -- great, actually! I'm still convinced that it's one of the most important things you can do to prevent diabetic complications. I study changes in skin blood flow in the feet (which is improved by being regularly active), but others have shown improvements in kidney function, a
lower risk of clogged arteries, and even improvements in the health of your eyes and nerves with exercise. We also know that regular exercise is critical in improving insulin action in the body, which is a sure-fire way to keep your blood glucose levels under better control. I tell all about how to improve insulin action in my book published last year called "The 7-Step Diabetes Fitness Plan: Living Well and Being Fit with Diabetes, No Matter Your Weight."
DM) So what's the most important advice you give PWDs (people
with diabetes) about starting an exercise plan?
SCO) Everyone is unique, and you have to set realistic goals for yourself when embarking on a new exercise program. The most important thing to remember is to start out slowly, progressing only when you feel ready. If exercise is too hard, you'll likely end up finding excuses not to do it or, worse yet, injure yourself so that you have to take time off. Start at a lower intensity; increase duration first and then either frequency or intensity later.
DM) One of our biggest challenges always seems to be fitting
exercise into our busy schedules. When you have diabetes, how important
is timing of workouts really?
SCO) When you exercise is not nearly as important as just fitting it in somewhere. Studies have shown that you can do 10-minute bouts of exercise throughout the day that accumulate to reach the recommended 30 to 60 minutes a day. You may not get quite as fit, cardiovascularly speaking, as if you do the exercise continuously, but it will still have the same beneficial glucose-lowering effect. You should keep in mind, however, that pre-breakfast workouts will usually not cause as much of a drop in glucose levels as exercise done after breakfast or later in the day.
DM) What's your principal strategy for avoiding lows?
SCO) During exercise, the best way to avoid developing lows is to learn your body's response to particular types, intensities, and lengths of exercise. You really need to check your blood sugar more often when you start doing new activities. If you check before and after, you can find out your body's normal response and begin to predict what will happen next time. If you take insulin, you may need to lower pre-exercise doses and/or eat more carbs to compensate.
DM) You've had diabetes yourself since 1968. Can you tell us how your perspective has changed over the years —- especially with regards to exercise?
SCO) When I was a kid, I started exercising because it always made me feel better (and that was back in the days of not having blood glucose meters). Today, it still makes me feel better, but with a meter, I can see how beneficial of an effect it has on my blood sugar control as well. I've always been an exerciser, and I have no intention of stopping -- ever!
DM) What kind of exercise do you do personally?
SCO) I'm mainly a recreational athlete at this point. I vary my exercise routine because I've found that "cross-training," as it's called, is the best way for me personally to avoid getting tendonitis or other overuse injuries. I also alternate hard and easy days. Right now, two non-consecutive days a week I do heavy resistance training (8-12 reps with the heaviest weight I can lift that many times) and work out hard on conditioning machine, like the elliptical strider, StairMaster, or others. Another day a week I swim laps at a good pace for an hour. The other days of the week, I either ride a stationary bike at home (while reading) for 30-45 minutes (which I consider an easy workout), walk, or rest (at least 1-2 days per week). The real key to keeping insulin action high is to not take off more than one day in a row and to occasionally do some harder workouts, even if it's just some faster intervals during your exercise session.
DM) Your "Diabetes-Free
Kids" book is actually about preventing and treating Type 2 diabetes in
children. Other than avoiding junk food and becoming more active, what's the
main premise of the book?
SCO) You make it sound so simple! There's a lot more to it than just doing those two things, but they are an integral part of the needed lifestyle changes for kids to avoid getting Type 2. Obviously, you have to find ways to sneak more exercise into kids' daily lives, and I give tips on how to do just that. If they're going to eat less junk, you need to find kid-friendly alternatives for them to eat. I also talk about how certain vitamins (e.g., D and others) are critical to help prevent diabetes and how antioxidants may help prevent complications. It's good advice that anyone with kids in today's culture could benefit from reading.
DM) So you and Dr. Steven
Edelman have a new book coming out in October called "50 Secrets of the
Longest Living People with Diabetes." Can you give us a preview of some of
the coolest secrets?
SCO) The most amazing part, I think, is that I actually found a woman living in Washington State who has had diabetes for 83 of her 90 years (since 1924). Most of us only hope to live that long, but doing it with diabetes and for so many years without a blood glucose meter is totally amazing. We've profiled her, Bob and Gerald Cleveland (living 82 and 75 years with diabetes, respectively), and many other really inspiring people with both type 1 and type 2 diabetes. The secrets are, well, secret...until the book comes out. I can share with you, though, that every one of the longest-living people found regular physical activity and an active life to be a key to longevity.
you had unlimited time and resources, what would you most like to accomplish
for the Diabetes Community?
SCO) I'd like to be able to prevent the onset of Type 2 diabetes in everyone, and I'd also strive to help people learn what to do to prevent getting diabetic complications regardless of what type of diabetes they have. Personally, I watched my grandmother suffer through lots of diabetic complications (and with having only "borderline" diabetes, or so they called it back then) that completely obliterated her quality of life for the last six years she lived. I really wish I could help keep anyone from having to suffer like she did, and I want everyone to live a long and healthy life despite having diabetes. I think education is a large part of accomplishing these goals, so I have and am continuing to do my part to help educate everyone with the time I currently have to spare (and with some I don't).
Nice, Sheri, thank you! We'll keep an eye out for your new books.