5 tips to put you back in the race

Is an ongoing health concern holding you back from your dream of walking or running a 5K, half-marathon or a marathon?

Whether it’s diabetes or another health issue, there may be ways to safely join in the next race.

The following five tips are offered by Megan Haugen, RDN, CDCES, a nutrition educator with PeaceHealth’s Nutrition & Diabetes Clinic in Bellingham, Washington.

1. Talk with your doctor.

“Talk to your doctor before starting a new exercise program.” You’ve probably heard this advice for years.

Why? Exercise is good for all of us. But if you have a condition that requires medication or symptom management, exercise can change how those things work.

“Most people with diabetes can safely begin an exercise program without undergoing a full screening from their doctor,” says Haugen. “However, because exercise can lower blood sugar levels, it’s a good idea if you’re taking certain diabetes medications or insulin to check with your doctor before starting something new. That way your doctor can review and recommend adjustments to your medication or insulin.”

Additionally, if you have certain diabetes complications such as retinopathy (eye damage) or neuropathy (nerve damage) you will want to have a full workup. That way you’ll know for sure what types of exercise are safe for you.

2. Start slow.

It often works best to start slowly with exercise and build gradually as endurance and fitness improves.

Doing this not only reduces your risk of injury but it also helps you form a more lasting habit. You’ll make exercise more enjoyable in the long run.

“For my patients who are just beginning an exercise routine, I often encourage them to start with 10 minutes per day,” says Haugen. After a couple of weeks, increase to 12-15 minutes or add a second 10-minute session to their day. 

“The goal is to eventually incorporate 150 minutes of aerobic activity per week with 2-3 strength training sessions per week,” she says.

3. Monitor how you feel.

Because exercise can cause low blood sugar, it is important to check blood sugar levels before each exercise session. Watch for symptoms of low blood sugar during exercise (dizziness, shakiness, lightheadedness, headache, etc.), says Haugen.

It’s important to keep an eye on your blood sugar after exercise too. Depending on how hard or long you exercise, low blood sugar may last hours later because exercise can increase insulin sensitivity. 

Haugen says, “Always carry a source of fast-acting carbohydrate, such as glucose tablets or glucose gel, with you while you exercise in case of low blood sugars, especially if you take insulin.”

You might consider using wearables or other devices such as:

• Continuous glucose monitors. These are helpful for alerting you to low blood sugar levels during and after exercise.
• Heart rate monitors. This can help you know if it’s time to slow down your pace. Aim for a heart rate that’s not too high or too low. Calculate your target heart rate.

4. Eat and drink well.

Adequate hydration is important during and after exercise. Because hydration affects blood sugar levels, you’ll want to replace any fluids you lose through sweat.

”Aim to drink primarily water rather than carbohydrate-containing sports drinks unless your workout is particularly intense or longer than 60 minutes,” says Haugen.

In terms of eating well before you exercise, aim for a balance of carbohydrate and protein to stabilize blood sugar levels.

Consuming additional carbohydrate snacks before exercise may not be necessary. If your blood sugar levels are <90-100 mg/dL before exercise, then you might need to bump up your intake. The same is true if the exercise you’re planning will be particularly intense or prolonged. Work with your diabetes care team to create a plan that will work well for you.

If you have type 1 diabetes, work with your doctor or diabetes care specialist to set up a plan to adjust insulin doses and carbohydrate intake around exercise sessions. This will help keep blood sugar stable during activity. For some people this looks like using specialized insulin pump settings, taking less insulin at a meal before you exercise, and/or incorporating a pre-exercise snack. Always carry glucose tablets, glucose gel, or other fast-digesting carbohydrates in case of low blood sugar during exercise. 

5. Set realistic goals.

“We encourage patients to incorporate physical activity on a regular basis and be realistic about expectations — start slowly, build gradually, and listen to their bodies,” says Haugen.

It’s a good practice to set SMART goals. That means goals that are specific, measurable, achievable, realistic, and time-specific, she says.
Doing this can help you see your progress over time. As you achieve the goals you set out to accomplish, you may feel motivated to set new goals.