Just because you are getting older doesn’t mean that life has to slow down. People who stay active or who become more active when they get older are stronger and more flexible. They are able to walk up stairs or carry groceries with ease. Overall, they report a better quality of life. Research shows that it is being less active—not the natural aging process—that is the cause for much of the decline in strength and mobility and the increase in illness that occurs as we get older.

Being active is even more important if you have diabetes. Physical activity can increase your body’s ability to use the insulin it makes, decrease blood glucose levels and reduce blood pressure and blood cholesterol levels. But if you have difficulty walking, have poor balance or are new to exercise, just getting started can be a challenge. One option that many people are not aware of is that they can get exercise even while sitting down.

Sitting exercises, such as chair aerobics, stretches or weight training, are a great way to keep fit. You can get started by taking a class at your local community center, health club, YMCA, senior center or hospital. There are also several exercise tapes you can use in the privacy and comfort of your own home.

Getting Started

When you start an exercise program, it helps to start out slowly. Break up your exercise into 10-minute sessions. If you can’t do 10 minutes at one time, do what you can now and add two minutes of exercise each week. Try to build up to a total of at least 30 minutes of activity on most days. It is OK to break those 30 minutes into three 10-minute intervals, if you find that more manageable.

Choose activities you enjoy and vary them to avoid boredom. Exercise with a friend, your spouse or a child. Working with a partner can help keep you motivated and on track. Remember, physical activity does not need to be strenuous to be healthy, but you do need to fit it in nearly every day to help keep your blood glucose level down. Try to include different types of exercises in your program, choosing from these groups:

• Muscle-strengthening exercises: Strengthening exercises help build muscles, burn calories and keep your bones strong. Keep the amount of weight you use light at first, and build up gradually. Use slow, controlled movements. You can use hand and ankle weights or items you have around the house, such as soup cans. You can use milk jugs filled with sand or water. Other options include weighted exercise balls and resistance bands.
• Aerobic exercises: Aerobic exercises increase your heart rate, help to strengthen your heart and lungs and increase your stamina. In addition, aerobic exercises can help lower blood glucose and blood pressure and improve your blood lipid levels. Do chair-based – jumping jacks, leg kicks, arm lifts and seated marching.
• Stretching exercises: Stretching exercises improve flexibility and balance and help prevent joint stiffness. Always do stretches slowly and carefully, and never force a stretch. Gently rotate your head and neck, do shoulder rolls, arm and leg stretches and waist turns. Point your toes up and down, rotate your wrists and ankles or write the alphabet with your foot.

Tips for safe exercise:

• If you are older than 35, check with your health care provider before starting an exercise program. It’s also a good idea to do so if you have had diabetes for more than 10 years, have heart disease or have other diabetes complications.
• If you have retinopathy (eye disease), check with your eye doctor before starting to exercise.
• Avoid exercises that require you to bend over, placing your head lower than your waist because this causes your blood pressure to change.
• Start slowly and build up gradually. If you do too much too soon, you could hurt yourself.
• To see how activity affects your blood glucose level, check it just before and about an hour after you are active.
• If you take insulin or a blood glucose-lowering medication that can cause your blood glucose to go too low, keep a source of carbohydrates nearby.
• Don’t hold your breath during exercise—breathe normally. Holding your breath while exercising can cause changes in blood pressure.
• If you have ever had a hip replacement, check with your surgeon before doing lower-body exercises.
• If you are on any medications that change your heart rate, such as beta blockers, don’t use your pulse rate as a way of judging how hard to exercise. Make sure to speak with your health care provider.
• Drink plenty of water to keep yourself hydrated.
• Stop exercising if you feel dizzy or are in pain, light-headed or short of breath.
• Muscle soreness lasting up to a few days after exercise is normal, but exhaustion, sore joints or painful muscle strains are not. If you are very sore, you are overdoing it.

Being physically active is one of the most important steps people with diabetes can take to maintain their health and quality of life. Strength, aerobic and stretching activities will help you manage your blood glucose levels and also handle daily tasks with more ease.

Remember, it’s never too late to become more active and, whatever your age, you’ll see and feel the benefits.

Sustaining Insulin Sensitivity after Age 40

A recent study found that insulin sensitivity (how well the body uses insulin) is not maintained to the same degree in healthy middle-aged and older people as it is in younger people. Insulin sensitivity increases with exercise. What this means is that older people must exercise more often to experience the full benefits of exercise.

“As people age, they typically experience a decline in insulin sensitivity, a key underlying factor that makes them more prone to developing diabetes,” said K. Sreekumaran Nair, MD, a Mayo Clinic endocrinologist.

Nair published a study in the August 2003 issue of Diabetes, the Journal of the American Diabetes Association. The results show that middle-aged and older people must exercise daily in order to maintain their degree of insulin sensitivity. Other studies suggest that more vigorous exercise programs and exercise programs that promote weight loss also are beneficial. (Subjects in the current study were asked to maintain their body weight.)

Dr. Nair hopes that these results will help people with pre-diabetes (a condition in which fasting blood glucose levels are above 100 mg/dL, but less than 126 mg/dL) or diabetes and their health care providers to plan better exercise regimens.