Small, gradual changes add up to powerful health effects.
By Lisa Esposito
Maria Ibarra couldn't control her blood sugar. Now 40, the Sacramento, California, medical records specialist was diagnosed with Type 2 diabetes five years ago and started on medication. But a year later her A1C – a measure of blood sugar levels over time ¬¬– was rising. And that wasn't OK.
Ibarra came from a family with a strong history of diabetes (although they didn't talk much about it). She had seen what diabetes can do if unchecked. Her late mother, who'd lost a sister to the condition, took medication and walked for her health. But Ibarra's brothers, diagnosed as adults, suffered serious complications: Both have had toes amputated, and one is now blind. "So I knew what the future held," she says, "and I didn't want to be that."
Exercise on the Agenda
Medication to lower your blood glucose, a healthy diet and exercise are three mainstays of diabetes treatment. "Exercise provides multiple benefits," says Deborah Greenwood, president of the American Association of Diabetes Educators. "It lowers blood glucose, or blood sugar. It can lower blood pressure and lower blood fats – and all of those are important in managing diabetes."
Among other complications, diabetes is a risk factor for cardiovascular conditions such as heart attack and stroke. "Physical activity helps all those pieces as well as weight loss, which is often an issue for people with Type 2 diabetes," Greenwood says. "Exercise is a free medication – it's free treatment, if you will, for diabetes."
Exercise can boost endorphins, and over time, many patients are surprised to find how much working out improves their mood.
At first, Ibarra thought she could get a handle on diabetes with routine care. But after a year with poor results, she knew she needed major lifestyle changes.
Diet was one issue. Raised on traditional Mexican cooking with plenty of rice, cutting calories and carbs wasn't easy for Ibarra. Exercise was the other area for improvement. Walking was her main activity, she says, but not that far or often – maybe a mile or so a few times a week.
Her physician suggested classes. That's how Ibarra connected with Greenwood, the program coordinator and diabetes clinical nurse specialist with the Sutter Health Integrated Diabetes Education Network in Sacramento.
If you've been recently diagnosed with Type 2 diabetes, Greenwood says, you should meet with a diabetes educator, who can help you develop a personalized management plan. Insurers and Medicare cover diabetes education, she says, but it's vastly underused, so ask your physician for a referral.
Active and Aware
By working with a diabetes educator, Ibarra learned to connect the dots between when and what she eats, the activity she does and her blood glucose afterward. "My health is definitely better now," she says. "My A1C is well controlled, and so is my regular blood sugar."
These days, along with her younger daughter, she works out at the gym four or five days a week, splitting cardio between walking and an exercise bike. Then she makes the short circuit of weight machines. Ibarra sticks with her routine: "It keeps it simple and easy – but wow, what a workout."
Fitbit is her friend. "It's really helped me stay accountable," she says. She tracks her daily 10,000 steps with the device and uses it to connect with her fitness buddies, including co-workers who don't necessarily have diabetes but also need a boost to stay active. They encourage one another with "Hey, keep going" messages.