Exercise Progression
With increasing fitness, you can gradually increase the intensity and volume of your exercise program. This is best done under the supervision of a qualified trainer. Here are some tips on how to do that.- Increase the intensity of the aerobic workouts by increasing heart rate from 50% to 70% to closer to 70% or slightly above. At this intermediate pace, you should be able to talk less easily, although you should not be struggling for breath.
- Increase the time of the workout from 30 to 45 minutes.
- Include intervals in your walking or running by striding out at a much increased pace for a one-minute interval in every five minutes for the length of the session.
- Gradually increase the weight load you lift in your weight-training program as you get stronger. You should struggle to do that last lift of the third set. Don’t increase the number of sets or repetitions; just increase the weight you lift as you get stronger. You can vary the exercises but remember to work all major muscle groups.
- Add a third weight training session to your weekly program, preferably on one of the aerobics days so that you maintain at least one day of complete rest.
- Be aware of niggling injuries of the joints, muscles and tendons and don’t train through acute pain or persistent sub-acute pain. See your doctor. When weight training, be especially aware of shoulder impingement pain or discomfort in the rotator cuff, which can be an issue in older trainers. Go easy on the shoulder exercises if this gives you warning.
- Every month, take 3 consecutive days off to allow the body to recover and rebuild.
American Diabetes Association Consensus Statement on Exercise
In its consensus statement of 2006, The American Diabetes Association recommends a combination of aerobic and resistance exercise as follows:- For people with impaired glucose tolerance (IGT), 150 minutes of moderate to vigorous physical activity each week including aerobic exercise and weight training.
- Performing 4 hours each week of moderate to vigorous aerobic and, or resistance exercise physical activity is associated with greater CVD (heart disease) risk reduction compared with lower volumes of activity.
- In the absence of contraindications, people with type 2 diabetes should be encouraged to perform resistance exercise three times a week, targeting all major muscle groups, progressing to three sets of 8 to 10 repetitions at a weight that cannot be lifted more than 8 to 10 times (8 to 10 RM).
It is important to note that special exercise considerations may apply to individuals with the following complications. Consult your doctor on these conditions.
- Uncontrolled blood glucose levels -- high or low
- Uncontrolled high blood pressure
- Unstable heart conditions
- Retinopathy (eye and sight condition)
- Peripheral neuropathy (nerve damage to extremities, foot ulcers etc)
- Autonomic neuropathy (nerve damage to internal organs)
- Microalbuminuria and nephropathy (poor kidney function)
Summary of Training for Diabetes and Pre-Diabetes
- Get a medical checkup and doctor’s clearance to exercise. If you have type 1 diabetes, ask your doctor if, and how, you should exercise.
- For best results, employ an experienced trainer to supervise your program and a diabetes expert to adjust medications if required.
- Do both aerobics and weight training.
- Start slowly and increase volume and intensity over time as you get fitter. If you're on insulin or medications, don't suddenly and substantially increase or decrease your exercise volume or intensity without consultation.
- Stop if you feel dizzy, acute or ongoing pain or discomfort and see your doctor.
- Eat well in conjunction with any physical activity program.
Sources:
Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2006 Jul 19;3:CD002968. Review.
American Diabetes Association. Diabetes mellitus and exercise. Diabetes Care, 25, Supp 1, 2002.
