Post on 11-Aug-2020
Chris Jordan MS, CSCS, NSCA-CPT, ACSM EP-C/APT
Director of Exercise Physiology
Johnson & Johnson Human Performance Institute
Physical Activity and Diabetes
Agenda
• Physical Activity and Diabetes – Benefits
• Movement vs. Exercise
• Strategic Movement - What? Why? How?
• Exercise Basics
• Exercise Components - Aerobic, Resistance, Flexibility
- What? Why? How?
- Special Considerations and Tips
• Behavior Change – Johnson & Johnson Human
Performance Institute Model
• Q&A
Physical Activity and Diabetes – Benefits
• Glycemic control - Glucose tolerance
- Insulin sensitivity (reduced insulin requirements)
- Glucose uptake (by muscles)
• Weight loss - Improved body composition
• Cardiovascular function - Blood pressure
- Cholesterol
- Functional capacity
• Psychological benefits - Mood/self-esteem
- Energy levels/fatigue
Movement vs. Exercise
Strategic Movement
• What? - Simple, accessible physical activity as part of daily routine
- Breaks in sedentary time (e.g. prolonged sitting)
• Why? - Increase total daily calorie expenditure
- Glycemic control
- Help boost energy levels
- Help improve sense of well-being
- Promote physical activity - moving more, sitting less
Strategic Movement – How?
Strategic Movement – Examples
• Take the stairs, not the elevator
• Take a walk after lunch
• Walk to another department, don’t e-mail
• Take a shower, not a bath
• Avoid drive-through facilities
What is the most serious problem for people with diabetes
who exercise, particularly those taking insulin?
a) Dehydration
b) Hypoglycemia
c) Heat illness
d) Hypertension
Polling Question
Exercise Basics
• Exercise means moving, challenging, regular
• Safe, effective & efficient
• Medical clearance!
• Always warm-up/cool-down
• Quality first, quantity second
• Some exercise better than no exercise
• Simple and accessible
• One program does NOT fit all – adjust as necessary
Exercise – What does “challenging” mean?
Zones of Intensity
Zones P pain
Zones D discomfort
Zones C comfort
Zones R rest or sleep
Exercise Components
• Aerobic training
• Resistance training
• Flexibility training
Aerobic Training
• What? - Continuous movement, large muscles
• Why? - Glycemic control
- Weight loss
- Cardiovascular function/fitness
- Quality of life
Aerobic Training
• How? - Brisk walking, cardio equipment, recreational activities
- 3-7 days/week (no more than 2 consecutive days off)
- 150 minutes per week (minimum)
- Moderate-intensity
• 5-6 perceived exertion (10-point scale)
• Talk-Test
Interval vs. Continuous (aerobic workouts)
Aerobic Training – Special Considerations & Tips
• Glucose monitoring
• Decrease insulin dosage
• Consume carbohydrate snack before and after exercise
• Exercise with a partner
• Observe for signs/symptoms hypoglycemia
• Tips: - Variety
- Fun
- 10-minute bouts
Using the Talk-Test, which of the following represents
“moderate-intensity” aerobic exercise?
a) You can sing to yourself
b) You cannot speak
c) You can hold a conversation, but NOT sing
d) You can speak a few words before pausing for breath
Polling Question
Resistance Training
• What? - Pushing, pulling, carrying, lifting load/resistance
Why? - Maintain/increase lean mass
- Improve body composition (healthy weight loss!)
- More muscle, more glycemic control
Resistance Training
• How? - Weight machines, resistance bands, body weight
- 2 non-consecutive days per week
- All major muscle groups
$$$ FREE
Resistance Training - Special Considerations & Tips
• Glucose monitoring
• Decrease insulin dosage
• Consume carbohydrate snack before and after exercise
• Exercise with a partner
• Observe for signs/symptoms hypoglycemia
• Tips: - Circuit training
- Avoid exercises that greatly increase blood pressure (BP)
- Keep workouts short and simple
- Emphasize correct form and technique/proper breathing
Flexibility Training
• What? - Stretching to maintain range of motion
• Why? - Help prevent muscle imbalances/potential injury
• How? - After exercise
- Point of tightness or slight discomfort
- Hold stretch for 10-30 seconds
- 2-4 repetitions
• Tips: - Focus on least flexible muscles first
- Try foam roller
- One repetition still worthwhile
For people with diabetes and retinopathy, which of the
following should generally be avoided when performing
resistance training?
a) Deep squat or leg press
b) Isometric exercises
c) Valsalva maneuver (holding your breath)
d) All the above
Polling Question
Behavior Change –
Johnson & Johnson Human Performance Institute Model
Step 1 Step 2 Step 3
Purpose – Truth – Action
Who & what matters most? Current reality? Small, actionable steps
Rituals to habits
Purpose can be a source of intrinsic motivation!
Q & A