Exercise Archives - Page 2 of 8 - Diabetes Counselling Online

The prick of a thing about blood glucose monitors

September 25, 2014 by Helen-Edwards 1 Comment

Image via http://www.mein-diabetes-blog.com/tag/stechhilfe/

Do you check your blood glucose regularly? I don’t ask in judgement, because we are all different when it comes to diabetes – some of you will check your blood many times a day, others not at all. It all depends on your type and stage of diabetes, management and personal preference. I am asking because I have been thinking a lot lately about how dependent we are on the technology for managing diabetes and how that is both great and not so great.

As a teenager I rebelled against checking my blood, after this replaced urine testing. You would think I would have embraced it as it is far better than checking your pee. But for me it was one change too many in a short space of time. Another thing to learn. Another sign of my diabetes. Another moment of distress in each day. And in those days it was an enormous process! There were many steps and it took a lot longer than the quick machines we have today. It wasn’t the kind of thing you carried with you. I had a testing station in my bedroom and that was where my tests were done.

After a while I mostly stopped checking and made up my results for my parents and the doctors. I could not have cared less about what my blood sugar was doing. I cared far more about being a teenager and having a good time.

This lancet machine (which I still have!) may have been part of the reason I rebelled! It really actually bloody hurt!!

Oh how that has changed. Now I am the complete opposite! I carry my machine everywhere and check up to 20 times a day. We have 5 second machines and virtually painless prickers. If I do not check before driving, eating, exercising, sleeping…..I feel stressed, anxious. I learnt that knowing what my blood glucose is doing gives me power. Power to make adjustments and changes. Power to deal with highs and lows. And peace of mind.

this is the meter I had to use back in the day! Pic via Pinterest and originally via http://americanhistory.si.edu/collections/search/object/nmah_738655

I never go out without it but lately have had a few cases of losing my machine and it was very scary and stressful. I realised how much I rely on this little machine each and every day. The last time I lost one was a few weeks ago. I was an hour away from home and there was nobody to help me. I could not find it anywhere in my bag. I drove home totally stressed about not knowing what my levels were, made worse by the fact I had high levels on arrival at the person I was visiting and had a bolus of insulin, so needed to track the fall. I got home and pulled the house apart to find my back up machine. Later the person I was visiting found it on the road, fallen out from my car.

It was not a case of losing my machine but forgetting it, that caused me more stress this week. I was out for a lunch time run and went to check my levels…..no machine. I NEVER exercise without it and always check during my run as I can drop fast. My parents were away and my husband at work. There was nobody to bring my machine to me. I made the call to cut the run short and head home. Luckily, as I was 4 mmol on arrival at home. It was a stressful run back and it struck me how much it sucks to have type 1 diabetes and not even be able to do a simple thing like going for a run without all this stress…..

Don’t you hate it when diabetes stops you doing something so simple? And the reliance on that machine is both wonderful that we have them, and terrible that we have to be so dependent on them. That’s the prick of a thing about blood glucose monitors.

Have you had a similar experience? Would love to hear

I am off for a finger prick!

Helen

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Exercise and diabetes part 6: Relapse

September 16, 2014 by Imagine_David Leave a Comment

Don't wait for your wheels to fall off..... restart YOUR Plan today. — Don’t wait for your wheels to fall off….. restart YOUR Plan today.

RELAPSE (Fall from grace)

This stage is not explained in the original article. It is a form of regression to previous stages.

It refers to falling back to the old behaviors after going through other stages.

Regression occurs when individuals revert to an earlier stage of change.

Relapses are common, and are a part of the process of making a lifelong change.

Relapse is common during lifestyle changes. It is important to realise that even though a relapse has occurred, you have learned something new about yourself and about the process of changing behavior.

Consider focusing on the successful part of the plan (“You did it for six days; what made that work?”) and shift the focus from ‘failure’, to ‘success’.

Getting support from your friends may help lower the risk of relapse

John Lennon; “Life is what happens while you are busy making other plans”

Strategies

Revisit your goals
Plan when to restart.
Talk with your support person about the things they can do for / with you

Tools (to share with your team)

1. Please place a check mark next to the ONE statement below that BEST pertains to you right now

EXERCISE
	I do not plan to make changes in my *exercise* in the next 6 months	PC
	I do plan to make changes in my exercise in the next 6 months.	C
	I do plan to make changes in my *exercise* in the next month.	P
	I have already made positive changes in my *exercise* for at least the last 6 months.	A
	I have followed my *exercise* for more than 6 months.	M
	I have followed my *exercise for* more than 6 months, but then stopped following it.	R

2A. Readiness-to-Change Lifestyle Questionnaire

Name:___________________

Date: ___________________

Cardiovascular Risk Reduction Program Readiness-to-Change Lifestyle Behaviour

Indicate the readiness of the patient towards making changes/improvements in the lifestyle behaviours listed below by using this 5-point scale.



Rating	Readiness-to-change

5	No interest in this lifestyle behavior at this time
4	Thinking about implementing this lifestyle behavior sometime in the next few months
3	Plan to implement this lifestyle behavior sometime in the next month
2	Recently (within the previous 6 months) began this lifestyle behavior
1	Have been maintaining this lifestyle behavior for 6+ months

Rating	Lifestyle behavior

—	Purposeful exercise at least 5 times per week
—	Incorporate “extra” physical activity throughout the daily routine (“extra” = taking stairs rather than elevator, walking pets, parking further away in parking lot, etc.)
—	Participate in sporting activity at least 1-2 times weekly (e.g., golf, volleyball, basketball, tennis)
—	Eat 5 or more servings of fruits and vegetables daily
—	Consistently choose foods with whole grains
—	Choose foods high in fiber
—	Lose or maintain body weight
—	Avoid smoking or tobacco use
—	Implementing specific strategies to help with lifestyle modifications
—	Live an overall healthy lifestyle.

2B. Confidence-to-Change Lifestyle Questionnaire

Name:_______________________

Date: _______________________

Cardiovascular Risk Reduction Program Confidence-to-Change Lifestyle Behavior

Rate the following statements based on the 3-point scale below.



Rating	Confidence-to-change

3	Very confident
2	Somewhat confident
1	Not very confident

Rating	Lifestyle Behavior

—	Purposeful exercise at least 5 times per week
—	Incorporate “extra” physical activity throughout the daily routine (“extra” = taking stairs rather than elevator, walking pets, parking further away in parking lot, etc.)
—	Participate in sporting activity at least 1-2 times weekly (e.g., golf, volleyball, basketball, tennis)
—	Eat 5 or more servings of fruits and vegetables daily
—	Consistently choose foods with whole grains
—	Choose foods high in fiber
—	Lose or maintain body weight
—	Avoid smoking or tobacco use
—	Implementing specific strategies to help with lifestyle modifications
—	Live an overall healthy lifestyle

Research:

“This study compared diabetes Treatment As Usual (TAU) with Pathways To Change (PTC), an intervention developed from the Trans-theoretical Model of Change (TTM), to determine whether the PTC intervention would result in greater readiness to change, greater increases in self-care, and improved diabetes control. The Pathways To Change intervention has the capacity to deliver effective interventions to a large number of people. By helping people through the pre-contemplation and contemplation stages in a timely fashion, we may be able to redirect our efforts to diabetes care and education strategies that will have a positive impact on the prevention of long-term complications of diabetes, reducing the subsequent human and health care costs. Clearly, this study supports a new, innovative approach to this major health problem.” http://care.diabetesjournals.org/content/26/3/732.full

“To summarize, a relatively inexpensive, mail-delivered, self-instructional intervention based on the `active living message’ is an effective method of assisting sedentary young adults to progress through the SOC construct of the TM of behavior change. This research also highlights the importance of targeting specific change strategies for assisting sedentary individuals to become more physically active. It suggests intervention design for the adoption of a positive behavior should be based on different processes of change than have previously been advocated for the cessation of a negative addiction.” http://her.oxfordjournals.org/content/17/4/451.long

Video Resources:

Stages of Change: https://www.youtube.com/watch?v=oO80XyBDrl0

James Prochaska: Lengthy but very good. The developer of the transtheoretical stages of change model

https://www.youtube.com/watch?v=8XUaq2iqzA0

It's unlikely that you will get a hole in one i.e not relapse, but consider your goal, and start again when you do. — **It’s unlikely that you will get a hole in one i.e not relapse at some point; , but consider your goal – and start again**

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Juggling Wellness and Diabetes

September 15, 2014 by Sally Leave a Comment

I’m writing this personal kind of blog on a Saturday. I love Saturdays. They encompass lots of things I love to do which all contribute to my wellbeing. This morning I was out on my run and because it’s Saturday and lovely Spring weather lots of my neighbours were also out and about. Nearly everyone I ‘ran’ into made the comment about how well I looked. I had at least 3 such comments this morning and they inspired me to share with you what I believe to be the key to being well with diabetes, or what works for me anyway.

This is important to me because I have diabetes and I’m turning 50 next year, so I know that if I don’t focus on being well myself I’m in a higher risk group to lose my wellness that is so important to me. I want to do all I can to hold onto it for as long as I can, so I can enjoy more of this wonderful life. I’m also passionate about helping others to be well too to the best of their ability, so here goes!

Sleep

Every Saturday I get to sleep in. Yay! To catch up on a few hours I may have missed through the busy-ness of my week. Time to give my body a chance to repair and relax. I usually get to sleep in until around 8am, which is a big improvement on my 6-6.30am starts on other days of the week. The only thing that stops me from doing this is waking early with a hypo, but this morning my BGLs behaved themselves. This week I found an awesome article in The Conversation on the importance of sleep which I encourage you to read. It’s just so important for our wellbeing, and especially so for us with diabetes.

Eating Well

As a dietitian you would know that I am particularly passionate on this topic! This is the only topic in today’s blog that I’m qualified to talk about as a health professional, and it’s such an important one! The Australian Dietary Guidelines that we follow actually makes the comment, “Diet is arguably the single most important behavioural risk factor that can be improved to have a significant impact on health.” It is something that I think about, read up on and focus on every day.

Today I started with my fibre rich, low-GI and high nutrient breakfast, a combination of two cereals that enjoy eating together topped with skim milk. I had a banana for morning tea and a delicious bowl of vegetable and low-GI carb rich Minestrone soup. This afternoon I’ll probably have a snack of a handful of nuts and another piece of fruit. We have a delicious lean meat and vegetable rich stir-fry planned which we’ll serve with plain Basmati rice, and I’ve marked out my favourite Black Cherry yogurt for dessert.

I know that I’m getting the nutrients I need to be well each day, and I’m sure it must also reflect in my outward appearance when I’m out on my run, makeup free in my daggy running shorts too lol

Regular Exercise

Nice segway to the exercise! Also lots of evidence here to support wellbeing, reducing inflammation, improving mental health and keeping our BGLs more stable. You may know that I’m a golfer. I try to play 18 holes in a comp twice a week, and 9 holes if I have time as a break in my day on a Friday. On the days I’m not golfing I do my best to get in at least the minimum recommended 30 minutes of moderate physical activity. Usually I try for 45 minutes. Since I’ve been doing this I have noticed a big improvement in the stability of my glycemic control as my fitness has improved. It’s so worth the effort even when you don’t really feel like it!

Family Time/Love

I’m incredibly fortunate to have so much love and support from my family, but I guess it works both ways in that I also love and support them! I believe that love and giving love is an important part of wellbeing. We hug each other a lot in our household, and in the wider family too. Have you hugged someone today and told them you love them?

Being sociable

Although I was out on my run, I enjoy stopping along the way on a Saturday as I have more time available to me to chat with my lovely neighbours in the suburb I live in. I chat with the children, and the parents, and the older people, and the neighbours who are my friends. To me this is important as I feel loved within my community too, and I know that I’m helping some of these people to feel loved too <3

Hard Work

I enjoy working. It keeps my brain active. It gives me a purpose and keeps me inspired each day to stay well and make the most of my life. The lovely Helen Wilde called me a workaholic this week, which made me think. You know I probably am a workaholic, but that’s because I love what I do and it makes me happy to help other people to be well. But I honestly try very hard to keep a balance with the other important factors in my life.

For those of you who are lucky to be retired or not have to ‘work’ as such I would encourage some kind of volunteer role as it can really be so rewarding and contribute to your wellness. We have some awesome volunteers who help us out at Diabetes Counselling Online. You can read more about our team and some of our ambassadors here. They’re so important in making our charitable organisation what it is.

Keeping the Balance

Of course, being Saturday, I also have household chores to do, preparation cooking for the week ahead, and I might even fit in a quiet hour of reading a book. It’s always a good day, and means I really relax and enjoy myself on my day of rest (and golf) Sunday.

If you try to imagine all these aspects (including any others you may have yourself) as a number of balls that you’re juggling, I believe that remaining well is all about keeping a balance amongst them. Sometimes you need to drop one ball to keep the others going smoothly, but don’t forget it and go back to collect it as soon as you can. I don’t see diabetes as one of those balls – it’s just part of me and often influences how I manage some of those balls/aspects.

Hopefully some of this will inspire you to focus on keeping your balls in the juggle, and know where you can make some positive changes to improve your own wellness. Diabetes Counselling Online actually has a whole section on the website on Diabetes & Wellbeing. Check it out!

You know we’re here to help. With love, Sally.

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a list of all Sally’s Diabetes Counselling Online blogs here.

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Exercise Part 3: Preparation Stage

August 19, 2014 by Imagine_David 1 Comment

Exercise is also an essential part of treating your diabetes safely and effectively. Medicaton alone is never sufficient to achieve maximum health.

“The Transtheorectical Model (TTM) offers guidance for people at all stages of readiness for change.

Using this model to its fullest involves matching intervention approaches to a person’s current stage of change, as well as other components of the TTM: decisional balance, situational self-efficacy/temptations, and the process of change.

The integrated application of all of the components of the TTM can help health care providers tailor behaviour change interventions to maximise successful outcomes for individuals with diabetes.” from Diabetes Spectrum

PREPARATION STAGE

During the preparation stage, people prepare to make a specific change.

They may experiment with small changes as their determination to change increases.

For example, borrowing a friends bike may be an experimentation with or a move toward buying your own bike and start a cycling program.

You’re not completely decided but you’re heading in the direction of change.

You’re making plans but obstacles keep popping up.

If you’re going to start working with an exercise physiologist, maybe making the time becomes an obstacle. Or you can’t find the right gym. You’re not clear on the details.

Writing out your intentions may be more helpful than talking about it.

Outline the specific steps you need to take and what you can do to make each step easier.

Break it into smaller parts. For example, instead of targeting a weekly 3 hour bush walk , plan actionable steps you can control along the way.

Each time you exercise should be considered a ‘win’ along the way. Even for only 10 minutes.

Preparation is all about keeping it simple.

**Weighing up the pros and cons of participating in some regular exercise: talk with your health care team.**

Too often people will want to change too many behaviors at once or try to change their behavior without a clear and focused plan.

Instead, develop a clear and simple goal that is easy to track.

For example, rather than writing out a vague goal of I will exercise more, establish a clear goal – something like:

“I will exercise three times a week for 15 minutes for 4 weeks , then increase to 20 minutes for four weeks, then increase to 30 minutes”

Goals

Having a clear goal will get you started on the right foot and allow you to tweak the plan later on.

If you miss a days exercise have a backup plan. Example: If I miss my exercise on any day I shall make time to do it another day.

Behavioural / Doing Strategies

	Consider These Strategies in Your Planning
Substituting alternatives	Seeking ways of being physically active when encountering barriers of time etc.
Enlisting social support	Seek support from others for your physical activity efforts.
Rewarding yourself	Praise and reward yourself, in a healthy way, for making successful efforts in physical activity.
Committing yourself	Make plans and commitments for physical activity.
Reminding Yourself	Establish reminders and prompts for physical activity, such as diary time slots and making equipment easily available.

Situational Self-Efficacy—Gaining the Confidence Needed to Be Successful  

It may be helpful to work with your counselor or psychologist also in the preparation stage, with an aim to building confidence and strategies to avoid temptations in different situations e.g. taking time to shop or clean or transport family members instead of participate in your planned exercise.

Also to diminish any negative beliefs that what you plan to do is not possible.

Research has shown a specific pattern of changes in self-confidence and temptations across the stages of change.

Specifically, people report greater temptations and less confidence in the early stages, and this pattern reverses itself in the later stages where people feel less temptation and more confidence.

**Planning: Ask a friend or family member to support you.**

For help setting up your exercise self care plan submit a request for eCounselling HERE

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Life..’More than #diabetes’ Ups & Downs

July 28, 2014 by helwild 7 Comments

How much does diabetes dominate your life? It is a health condition which, because it is related to food and exercise, can seem like the most difficult health condition you could possibly have, doesn’t it? And because the symptoms are not always obvious or noticeable, it can seem that if you ignore it, it will just go away, or not be true.That you will ‘get away with it’, if you ignore it, or make a ‘token effort’. Even people with type 1 diabetes can at times feel that they can ‘stretch’ the ‘rules’, not take their insulin, or use insulin to allow themselves to ‘indulge’ in ‘favourite’ foods; or ‘allow’ themselves to ‘run high’ to avoid hypos. The insulin pump combined with the modern blood glucose meters, cgm’s, allows such fine control, approximates more closely than anything else the action of the pancreas in releasing insulin; yet in its very existence such biotechnology is a constant reminder of life with diabetes.

As the parent of a child diagnosed with type 1 diabetes, there were times when it seemed there would never be anything else that mattered in life, other than diabetes. When my daughter grew up & left our home in a tiny rural town to go to the City to study at University, things in some ways got easier; but in other ways, things got harder. I was a young Mum, and I was only 32 years old when my beautiful healthy girl was diagnosed. I was 37 when she left home. It was hard knowing she was 250 km away, and relying on others, who were not me, as her ‘backup’ person. Every night that we slept under the same roof, I got up to sit with her through her hypos. The click of a light switch, or the click of the toaster, would wake me. This continued through her teen years; her pregnancies; her own years mothering babies; travelling with her for Diabetes related professional reasons as colleague, & as her ‘back up person’ for her diabetes management, on trips overseas & interstate ; and on family holidays. Even now, if we are sleeping under the same roof, if I’m sleeping within hearing distance, something wakes me, and I can’t lie in bed knowing she’s out of bed & feeling bad.

I do have other things in my life: work, sport, friends, family: causes to do with the environment and the earth. I have grown tree seedlings for Trees for Life, collected for the Heart foundation, travelled. I’ve volunteered at Film Festivals, Arts Festivals, tutored at the U3A. But beating away like another heartbeat is my daughter’s diabetes. I work and volunteer in Diabetes. I practice Mindfulness. Being her parent will always be a part of who I am. Of course, it is much, much more intense for her. Every minute of every day and night, no respite. I do get to take breaks, she doesn’t.

My life changed 15 years ago. My husband retired, and I got a job in the city, so we moved house. Over the past 15 years, my life has expanded to include assisting my mother in dealing with changes that came about in her life, first with my father’s diagnosis of dementia. In the beginning, I was working in a highly responsible & challenging job. My help was as practical as I could manage, also fitting in supporting both my daughters with pregnancies & babies, toddlers & growing children. With my father’s death, assisting Mum meant helping her manage her own health & living arrangements, & eventually her own dementia.

That time also came to include my own diagnosis of diabetes. Because of my daughter’s diabetes, I came to the diagnosis with a shorter period of ‘denial’ than some experience; and with very little anger. I do feel some negative emotions, of course; but I know that it’s possible to live a good life with diabetes. My fear of diabetes related complications is much less than my fear of dementia.

I hadn’t meant to write about difficult experiences in my life, but yes: they are also part of life, and many of them have nothing to do with diabetes. The past 15 years have included weddings, births, joys: wonderful family Christmases, when Mum played ‘Mother Christmas’ to our large family: visits from overseas relatives, contact through Social media with relatives, friends, strangers. Yes food is pleasure, but there are other pleasures. Exercise is pleasure. Doing things for others is pleasure. Growing things, writing, taking photos, playing with children, doing good work, talking with friends from all over the world, these are all pleasurable.

Life is Good. Life is a river, it flows. Life is truly a journey, with opportunities for rich experiences that include the difficult ones, and the easy ones: spontaneous ones and planned ones. Seize the moment, take opportunities when they arise. Life is more than diabetes: it includes things that are harder, and worse: and things that are easier, & better..Life is for the Living.

Helen Wilde

carpe diem

Helen is a Senior Counsellor with Diabetes Counselling Online. She is also the parent of someone diagnosed with diabetes in 1979. She has lived with type 2 diabetes herself since 2002.

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