Diabetes Type 2
Exercise and weight control for diabetes type 2
Most people with diabetes are advised to increase the amount of exercise they take. Diabetes UK for example advises people to try to walk (or cycle, or swim) for at least 30 minutes 5 times a week. Taking regular exercise will help lower blood glucose levels and should, if combined with healthy eating, help most people lose weight. Taking regular exercise is good for the heart and can help reduce blood pressure. All kinds of exercise including swimming, walking, fishing and karate had made many people we talked to feel much better about themselves and their diabetes.
Nicky lifts weights when food programmes are on TV and recently joined a karate club with her...
Nicky lifts weights when food programmes are on TV and recently joined a karate club with her...
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And about six months ago, I took up karate by accident. My youngest wanted to do it again, she'd had a break and her teacher had given up and she'd found another school. And so I taxied both kids over to the karate thing, and the teacher assumed that I was there to try it out too, so, you know, rather than sit in a dark car park for an hour, I thought, okay, fine, we'll do this, and it turns out that I really, really, really enjoy it. I'm lousy at it, but, you know, hey it's ever such fun, and it's something that the kids and I can do together. And then they take it out on me at home as well, but you can't have everything. And, you know it strengthens our relationship. It's a fantastic form of cardiovascular exercise. It's also got a resistance element to it. We go twice a week, and that is a big part in my health and fitness routine, and it's also something that will continue to challenge me for the rest of my life.
James grows vegetables on two allotments and says that all the digging as well as the cycling...
James grows vegetables on two allotments and says that all the digging as well as the cycling...
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So what do you grow?
Oh everything. Potato. Sweetcorn. Cabbage. Lettuce. A lot of tomatoes. Lots of beans. Spinach. Beetroot. Peas - garden peas. And I grow some, too much of these things and I give things away to people at times. When I have a lot of sweetcorn there - sweetcorn. I enjoy eating sweetcorn.
The exercise which my GP advised me to take up, some exercise, go for a walk, if it is even twenty minutes either way and if I can cycle. But I do a little bit of cycling - not too far. But the joy of it is my allotment which I do physical work there, and I sleep very well after doing the allotment. I never feel too tired and I sometimes, sometimes if I am up the allotment again and I haven't eaten anything then I feel I get too hot and sweaty and I know I have to finish and then get something to eat. Not very often this happens. because my wife always insists I take some food if I am going there or a drink or something.
Okay so when you are at the allotment how long would you spend up there?
About two hours.
Not everyone wants to take 'exercise' in a formal or structured way. It may suit some people much better to do extra bits and pieces of physical activity in the course of their daily lives. Strategies such as getting off the bus one or two stops early and walking the extra distance to work or the shops or going out for a walk at lunchtime, were two kinds of informal exercise that people said had helped them lower their blood glucose levels and also lose weight.
Helen says even a 20 minute walk at lunchtimes helped lower her blood glucose levels.
Helen says even a 20 minute walk at lunchtimes helped lower her blood glucose levels.
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Well, the exercise programme, I didn't go to exercise class or anything like that. I just went out at lunchtime and I took a break for twenty minutes and I walked fast in my local environment. And also if I went to my mother's, my husband took me and I walked back. So I, or [if] I was going down to the doctor's, I walked to that. So I was actually building in exercise to my normal lifestyle. Because I knew there was no way I could go to exercise classes with how much my work took up and my family life took up. So that was fine. And then I went back to the doctor in three months and the tests were done again and, yes, it had come down a lot in that time. But by this time I'd started to ask questions of my family. And it turned out I had, my mother's cousin, at 62 he had been diagnosed with type 2 diabetes. And then out of the blue an aunt, a great-aunt of mine, my aunt said something about, 'Oh, yes, she had, she had sugar, and we used to weigh her food out.' But by this time I had been reading books about it and I said, 'She had type 2 diabetes.' So that was, in both my father's family and my mother's family so there was that.
Those who felt they did not exercise enough and those who used to exercise regularly but no longer did so, gave a variety of reasons for not getting round to regular exercise. Reasons included the cost and time that could be involved in taking exercise - several people said they couldn't afford gym membership, others said they felt too tired after a day's work to go out and exercise. Several people said that they were too busy with other more immediate problems in their lives such as caring for their families to devote time to themselves. Several people said they just didn't like taking exercise.
Harold knows he needs to lose weight but feels that 'human nature' often gets in the way.
Harold knows he needs to lose weight but feels that 'human nature' often gets in the way.
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And if you're someone like me who's been outstandingly healthy all his life and who has had very few operations for serious sicknesses that denial problem occurs, it's, you think oh well it'll go away. Or if you don't think that, once it gets a little better you think oh well it's gone away and frequently it hasn't gone away very far.
So I recognise that human nature being a teacher, both a teacher and a clergyman by experience I recognise that human, human nature is a very tricky business and that we're all in various times and states of denial about various things. And sort of, it's a very imprecise term but, but, but lets say you need to live thinking the glass is half full, but sometimes its, if it's only one tenth full then maybe you shouldn't think its that full and you, you need to take your, your , the things that are following you closely, seriously. And as you get past 50 and 60 there are a lot of things following you.
Stuart says he has a 'series of excuses' of not taking as much exercise as he should at the moment.
Stuart says he has a 'series of excuses' of not taking as much exercise as he should at the moment.
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And do you think' Do you have a plan at the moment?
I have a series of excuses why perhaps I'm not doing as well as I should. And one, the big one at the moment is the, is the fact that my daughter's getting married next month. And sort of a lot of time is taken up with, with helping her to plan and to get things organised and get the, all the wedding stationery out the way and various things. So that's an excuse. It's not a reason. And we always - I think it's the human animal - decide that we're going to do these things, '[I'll] start tomorrow.' But you know, tomorrow never comes. And I am aware that it needs to be done, and that it will, it does take a long time with me to, for these things to sink in. And maybe once, once I've started, then, yes, we can carry on. As I say, the golf is a good way of, of exercising and it's a good way, the way that I enjoy. Because I, you know, just, just walking is boring to me. So if there's a purpose behind it, then, yes, I might, I might exercise more frequently.
Mrs Patel knows she should take more exercise but she doesn't enjoy walking at all.
Mrs Patel knows she should take more exercise but she doesn't enjoy walking at all.
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Why?
[Laughs] You have to have an initiative to do it, it's exercise, yes I do a bit of it, because of my back, not that I, but it would help. But the exercise you see my brother as I said, he used to swim a lot. He was a very good swimmer. Every day he would swim about three, four miles in sea water, not swimming pool, swimming pool was different. And whenever you see he had controlled his diabetes so much that he whenever he goes to swim, before swimming he would check his blood sugar, look at the levels. And then he comes back and he checks it immediately. There is a drop in sugar level always, but after two hours of resting, after swimming two hours of resting, sugar level is same like before. It hasn't gone down or it hasn't been more or less but still the same and when he eats after that, obviously, it will go up.
But with exercise, you see, with him it has happened so I don't know how much will it help? It can control your weight, that is for sure you can't put on weight. But if your weight is stabilised and if it is just the same, I don't think exercise will help. But they say it is proved that exercise will help [laughs].
Have you as a family always taken exercise? I mean you said your brother loved swimming. Have you ever done anything regularly?
No, no, no. I haven't. Not now. Not after diabetes. I used to swim, I used to be a life-saver as well [laughs]. But not, not for the last forty years. I haven't gone in waters at all [laughs].
What about going out for a walk?
Yeah, that would help. That is very good but I, with me, I am a different person for walking. If I had to walk I would walk, but not on a regular basis. It is very good.
It's just when you were talking about if you take your blood glucose levels and they're too high in the morning, you said to me you'll eat one less chapatti.
Yeah.
Yeah. I mean another of approaching that would be to go for a walk.
Walk.
But you don't do that?
No, I don't do. If I do exercise, I know it is good for me and good for my health and for my physical but somehow it doesn't appeal to me. Going for a walk. It's me only. Lot of people do and it would help.
Yeah.
You see. I am sure.
Is it more difficult for people from your background, women your, from your culture to take exercise?
No, no.
No, it's not a problem?
No, no. No problem. Everybody does it, nowadays, very few, one maybe like me, [laughs] not so many.
Do they try to get you take exercise when you go to the hospital and the doctors?
They tell me and I said, I that is, I just can't do it. My husband walks three miles, with his eyesight and with all his problems, every day. He tells me to go every time, but I don't do. It's only me, as I said [laughs]. Not that, it is going to get any, I know it would benefit me.
Okay.
But is not' mentally I am not prepared to walk [laughs].
Swimming was favoured by many people - particularly those who had problems with their feet or people who for whatever reason found walking didn't suit them. However several people said they would go swimming more often if there were special swimming times or classes for people with diabetes. Several people said they felt embarrassed by their size and what other people might be thinking of them when they went swimming which could put them off (see our health & weight section for more on exercise).
Kay feels embarrassed in her local swimming pool and wishes there were special sessions for...
Kay feels embarrassed in her local swimming pool and wishes there were special sessions for...
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Would it help if there was a special session for sort of people over 30 or something?
Mmm' Or big people. I mean they say go to the women's one, but half the women that go there are slim. They are not as big as me. And I want to hide in the swimming pool and just, just like my sister can go, because she don't do nothing, and [daughter], and my auntie likes swimming and I just thought it was easier just to hire the swimming pool or whatever and friends and family can come along and I don't feel uncomfortable around them. I mean at one stage I couldn't even get a swimming pool, a swimming costume to fit me. And now I can and I feel like I can go swimming any time I want. But if I go to the local one it is cruel. And I don't like it.
That is a real shame I think. So what happens on holiday. Do you get away?
Yes. Occasionally we go away for a week, like once a year, or twice a week, just depends on the money, if we have got enough money. And I can just go till early in the morning till late at night. I could go all day long. It is just the different atmosphere, when you are away it is like I don't care. Well occasionally the kids can be cruel when you are on holiday but I just take it with a pinch of salt when I am away. I don't know why.
Wasim says he's never been keen on exercise and thinks he's probably become quite lazy.
Wasim says he's never been keen on exercise and thinks he's probably become quite lazy.
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So I had a really good session we did the track, we went swimming, we even did the fat blubby test where they pinch you. I'm obviously embarrassed because I'm a bit on the, and she's saying 'Oh look at me'' and you know [laughs]. But afterwards she takes me to blooming Pizza Hut doesn't she [laughs]. So I thought to myself, 'You know what...' I said to her, 'If this is what's going to happen every time I can't do it. There's no point, I'm going to put more on that I am losing.'
Did try obviously some sports in my life. Used to be part of an amateur badminton club in [name of town] nearby. I stopped when I married, moved away from there. We used to play cricket in my holidays as well. Used to play that with, you know, my best friend and other people from the college. And that's it.
I'm very conscious about me, me at me at pools. Thinking if I jump in the water, they'll all jump out kind of thing so it's, you know, the only, like the last time I went swimming was when I went to Florida in 2003. I made sure I'd worn one of those, you know the no-sleeves but like a those kind of things, I made sure I had that on when I went swimming I was just, I don't want people to laugh at me or something.
Before that, it was when I was a child, a very young child, there was a private swimming school and I just got my width and my certificates from there and then that was it. So no exercise is not'
I keep being asked by family members, do I want to go to the gym with them and things and it's a) through laziness, b) through family you know. Sometimes it's my turn to look after the baby. Finding, you know, the commitment and the time. Because it by the time you have time off so I, at the moment, my days off are Wednesdays, I'm' I think the word is shattered [laughs]. I'm, I am actually just want to lay back, you know, have a snooze maybe catch up on some of the [TV] programmes that I'd missed.
Weight control
These days being overweight is usually calculated by your Body Mass Index (BMI) which is a measure of body fat based on height and weight. If you have a BMI of 30 or over it is recommended that you lose weight. BMI within the healthy range according to NHS Choices is:
- 18.5 - 24.9kg/m² for the general population
- 18.5 - 22.9kg/m² for people of South Asian or Chinese origin ('south Asian' means Bangladesh, Bhutan, India, Indian-Caribbean, Maldives, Nepal, Pakistan and Sri Lanka)
Losing and keeping weight down was a constant battle for many people we talked to. People who knew they were overweight talked about the various diets they had tried, few of which worked out in the long run. Some people who had always seen themselves as fit and who had enjoyed sports such as rugby or football when they were younger, found it difficult to accept their weight in middle age.
When he was younger Mike could eat and drink what he wanted but since having diabetes has had to...
When he was younger Mike could eat and drink what he wanted but since having diabetes has had to...
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I was told I needed to lose some weight, which I found difficult to do. But I am still a little overweight [laughs] so I do need to lose some more. And I have tried to cut down on the amount of alcohol I drink, and have done so. So I have had to take a lot more interest in myself, if you like. Exercise a little more. If I wanted to go round to the shops that are only five minutes away I always got the car out to go round and get a paper or whatever, whereas now I don't. I walk, it is ten minutes there, and ten minutes back which is twenty minutes exercise.
So I do walk where ever possible, which I never would have done before. I go to the local football down the road. It is just over a mile. So I walk down on a Saturday afternoon. Or if there is a mid week game. So I walk a mile there, just over and a mile back just over. So I have walked a couple of miles, besides having a game of football. I have got friends there, so if it rains I get a lift back, so I don't get wet, but I have tried to exercise more. And eat more sensibly and drink more sensibly to look after myself since I had the diabetes.
Once he knew he had diabetes Paul made slow but steady changes to his rugby-lifestyle which has...
Once he knew he had diabetes Paul made slow but steady changes to his rugby-lifestyle which has...
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I'd have a Chinese on a Saturday night, I'd have a Chinese on a Sunday. Then I'd have my ten pints on a Saturday and my fifteen on Sunday. But when you stop doing an activity and your life doesn't change, you can't keep doing the same as what you were when you were doing the activities. You've got to change your body, because your body can't cope then, because it is not burning anything off. So, yeah.
And do you do any exercise now?
Oh yeah, yeah. I play golf, I go to the gym, a bit of gardening, play with the kids, walk a lot, you know' I'm down to around sixteen and a half stone, but I have got it down, probably the right way, just taking off bit by bit, not sort of go berserk and lose a stone this month, because the minute you stop then doing something, you will put it straight back on, so you just don't drink anything down and get it to come down gradually. It has gone on gradually. So you have got to get it off gradually and then it will stay off as long as you keep to what you are doing.
Shahnaz knows she has to keep her weight under control for her kidney treatment.
Shahnaz knows she has to keep her weight under control for her kidney treatment.
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Yes, my weight had become quite low, then, my weight, I think, it was 50, no, it was 47, my weight was 47 kilograms. But when you are on dialysis, your weight, they themselves work it out, that this is what your weight should be. So, when I went on dialysis for the first time, my whole body had swelled up, I had swelling in my whole body. So, at that time my weight was 68 pounds, 68 kilograms, kg. So then, they [got me to] reduce it so now my weight is 54 kilograms. So now, by god's mercy, it has been constant. Dialysis patients have to keep it constant. Neither am I too fat, nor too thin.
And do you do any exercise?
Yes, yes, I definitely do exercise. At home, I do it myself, and I go outside for a walk.
And at home, what sort of exercise do you do?
Well, I do my exercise standing up, or I bend down, there are these exercises for your hands, neck exercises, there is some exercise for your legs. I do them all, yes, myself. Yes. I stretch my whole body.
And has your nurse, or your specialist given you any advice about exercise?
Yes, the nurses did, in the very beginning, in the beginning they had told me that it's very important for you to do exercise, you need to do exercise. So then once or twice the nurses had come and they had told me, but then since that time I have been doing it myself. Hmm. Definitely.
Some people wanted a lot more support to help them lose weight and develop a healthier approach to eating, dieting and exercise. Several women explained that they had trouble controlling their size and weight since childhood, and that knowing they were eating the wrong kinds of food for them, binge-eating, and even crash dieting might be forms of self-harm. Several women attributed the problems they were having with food, to things that had gone wrong for them when they were younger. (See 'Depression, feeling low and mood swings'.)
For more information on weight control see our health & weight section or resources page for links to further information.
Last reviewed March 2016.
Last updated March 2016.
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