Get More Energy to Exercise
What's Slowing You Down?
It's a message you hear everywhere: Exercise is one of the most important things you can do to control your diabetes. It's also a catch-22: Controlling diabetes can be so exhausting that some days just leaving the house feels like climbing a mountain.
Why is lack of energy such a big problem for people with diabetes (PWDs)? And what can you do about it?
One big cause is an imbalance in blood glucose. "If your blood sugar is out of control in either direction -- too high or too low -- you can feel tired and drained," says Aaron Vinik, M.D., Ph.D., director of the Strelitz Diabetes Center at Eastern Virginia Medical School in Norfolk. Many PWDs also must cope with other factors, such as high blood pressure and excess weight, that can make you feel as if there's a giant hole in the tank of your energy reserves.
It doesn't have to be this way. You can find the energy to exercise -- you just need to know where to look.
Stop watching last-chance workouts on The Biggest Loser and thinking that's what you should aspire to. "That will turn you right away from exercising," says Camille Eroy-Reveles, MPH, a fitness instructor and exercise consultant at Beth Israel Hospital's Friedman Diabetes Institute in New York City, who also has prediabetes. "Do what you can, right at this moment. If that means five minutes of walking, then that's what you can do. You have to start somewhere."
Sometimes the best way to get started is to give yourself permission to stop. "If you're feeling horrible, tell yourself that you're just going to walk for a few minutes. After that, if you're still feeling horrible, you can quit," she says. "Exercise is going to be hard for the first few days. Give yourself two weeks for it to feel better. You can do anything for two weeks!"
Time It Right
For a couple of days, pay close attention to your energy levels and try to figure out what time of day you have the most energy. Is it first thing in the morning or later in the afternoon? What time of day do you usually feel most productive? That's often the best time to schedule your exercise.
Get a Baseline
You could have low blood levels of key nutrients. An imbalance in potassium, magnesium, and calcium may cause fatigue. Ask for a blood test to check.
Blood glucose numbers aren't the only pertinent data to record. "Keep a journal, and on the days when you're really fatigued and experiencing pain, look at what you've been doing," says Julie Silver, M.D., a rehabilitation physician and assistant professor at Harvard Medical School.
For three days, write down what you're doing every half hour, and rate your pain and fatigue level on a 0-to-5 scale (0 = feeling great; 5 = a lot of pain and fatigue). Then review the data. "On bad days, did you use coffee as a pick-me-up, skip a meal, or drink alcohol? On days when you felt really good, what did you do?" Silver asks. Identifying your fatigue triggers can help you eliminate them and restore your energy.
Finally, Vinik says, whatever you do to move more, don't call it exercise. "That sounds like a punishment, a prescription," he says. "Choose something that's fun for you."
Track Blood Glucose
Uncontrolled blood sugar can cause a lot of fatigue with diabetes. Keeping your blood glucose levels on target is key, and the best way to monitor that is to test regularly with your meter.
If you've had type 2 diabetes for a while and fatigue is a major issue, talk to your health care provider about adding insulin to your therapy toolbox.
It's not a treatment of last resort, Vinik says. He recommends early, aggressive use of insulin as the boost some people need to get up and get moving.
"Our research has shown that insulin is associated with much less fatigue and more energy than oral medications," he says. "So many patients say things like, 'My tennis game has improved so much since you put me on that small dose of insulin.' Only after they start feeling much better do they realize how bad they were feeling before."