Hiking with Diabetes – 7 Steps to Ensure a Great Experience

When I was in my early 20s a friend of mine told me he was going backpacking in the Jefferson Wilderness Area located in Oregon and asked if I would like to go. The trail he was hiking would lead to Marion Lake, not far from Mount Jefferson. Living in Salem Oregon at the time and only a two-hour drive, I accepted. I had never backpacked before but it all sounded fun. I borrowed a backpack from a neighbor and filled it up with camping gear. I had the time of my life! Later I would head into the Jefferson Wilderness Area, hiking the Pacific Crest Trail, and camping several nights under the star filled sky listening only to the slight breeze and small animals that walked around at night searching for a meal. I had the best times of my life there. I even took my children hiking and camping as early as 5 years old. But mostly I went by myself.

Ten years later I found out I had diabetes and I was told that I could no longer hike several days because it was hard to manage my glucose level. If something went wrong I could die. Which can be true if you are not very careful. That did not stop me. I CONTROL MY DIABETES. IT DOESN’T CONTROL ME. At 54 years old, I still backpack and I still love doing it. If you have diabetes and you love the outdoors like I do, here are a few things you should do to make sure your visit is worry free.

1.     I must keep my insulin cold. Instead of taking freezer packs with me that are heave and eventually thaw out, I use Frio Cooling Products. These work great when you are gone for several days and need to keep your insulin cold. I use them all the time.

2.     Always, always take candy, trail mix, and or a powdered sugar supplement you add to water with you. Hiking burns a lot of carbohydrates. Even if you have diabetes and are not on insulin you can get hypoglycemia (low blood sugar). Take plenty with you. There have been many times I have needed it. If you are hiking in the wilderness there isn’t anyone to help you if you pass out due to hypoglycemia.

3.     Test your glucose level often. Every one-to-two hours. If it starts to get low, eat something.

4.     Don’t over eat! Sometimes when we are burning carbohydrates we tend to over eat. Yes, you will need to eat more because you are burning more. But overeating isn’t good either.  Again, test often. Keep you glucose level as close to normal as you can.

5.     Let your doctor know you are hiking. He can give you medical advise tailored to your health.

6.     If you hike alone (and I do) let someone close to you know when you are leaving, where you are going, and when you will return. I give my wife a map and highlight the trails I will be on. She drops me off and picks me up. There is rarely cell phone service so far away from civilization. Someone needs to know when to call for help and know where you are hiking so someone can find you in case everything goes wrong. Which leads me to my last point…

7.     When I give my wife a map highlighting the trails I will be hiking, I do not stray from those trails. If something goes wrong my wife and emergency personnel need to know where to find me. If I stray from my original plan, I may wind up dead and no one will know where I am.

I love hiking. I love the wilderness. Being careful and following these steps is the difference between a great backpacking trip and a dangerous one. Be safe. Hiking with diabetes isn’t for everyone. If you like to hike it is not over if you develop diabetes. It just means you have to be better prepared and more cautious.

Can Exercise be Dangerous for Type 2 Diabetes?

The answer to this is yes, IF you do not manage your glucose levels. Dr. Ben Stutchbury, of the University of Manchester, states that exercise in patients with diabetes is very important but too much can be dangerous (The British Journal Of General Practice, August, 2016). This is due to hypoglycemia, or low blood sugar. Often times I work out in the yard and suddenly I begin to shake and feel faint. I head inside the house and check my glucose level and its below 50. I quickly drink a glass of orange juice then wait 20 minutes for my glucose level to return to normal (between 70 and 120). Then I go back out and work in the yard again. I try to prevent this from happening but sometimes I don’t know I am doing something strenuous until I am. For example, working in the yard. There are times when I do not intend to work in the yard. I go outside to check the mail and I see a weed in the flowerbed. So, I pull it. Then I see another one. Then another. Then I get the yard container and pull weeds. Then I am raking. Then mowing… Then my glucose level drops and I need to eat or drink something… quickly. Below are five steps you can follow to make sure you are exercising but not to the point that your glucose level drops below normal. These five steps have helped me tremendously.

  1. Check your glucose level before doing anything strenuous.

If your glucose is normal drink a glass of juice or eat a bit if candy before doing something strenuous. Don’t over-do it! A little sugar goes a long way. An 8-10 ounce glass of juice or a half of a candy bar may be plenty. You just need enough to get through the activity.

  1. Check your glucose level throughout the activity.

If it is starting to get low, eat or drink something. I check my glucose level at least four times a day. More if I am exercising or doing something more strenuous. It’s never a bad idea to check your glucose level several times a day. During the summer I often put on a backpack and hike 2 to 3 days in the Cascade Mountains along the Pacific Crest Trail. I check my glucose level every two to three hours to make sure my glucose is stable and I bring carbs with me incase My glucose level drops.

  1. Work with your doctor

Dr. Stutchbury states that “the risks can be minimized or completely avoided by doctors, nurses, and patients working together to construct a plan of diabetes management before, during, and after the activity.” Communicating with your health professionals is the best way to manage exercise and strenuous activities. Your doctor may advise you to take less medication if you know you are going to do something strenuous.

  1. Keep an emergency supply of carbohydrates close.

My wife has a container in the house with a supply of candy in it and we always have orange juice in the refrigerator. It’s only for me and I only use it when I need it. It is not there as a late-night snack. It is for emergencies. If we are running errands I take something with me. We often get side tracked so if my glucose level starts getting low I have something to tie me over until we eat.

  1. Control your diabetes. Don’t let your diabetes control you.

I often do strenuous activities. Sometime it worries my spouse. But I will tell you what I tell her: ‘I cannot let this disease control me or limit my life style. I will manage my diabetes so that it does not manage me’. I diet. I exercise. I monitor my glucose levels. I manage my diabetes so I can live a long, happy life.

Source: Stutchbery, Ben, Diabetes: The Danger of Exercise, The British journal of general practice: The journal of the Royal College of General Practitioners, 2016, 66, 649, 427-427, England

 

 

Type 2 Diabetes and Exercise

PHYSICAL EXERCISE THERAPY

Diabetes is increasing at an alarming rate globally and is the major cause of death related to cardiovascular disease (Lumb, 2014). Diabetes has impacted over 300 million people in the last 30 years and is expected to hit 600 million within the next 20 years (Bloomgarden & Li, 2015). These numbers are really an educated guess because there are many people who do not know they have this disease. This is mostly due to obesity and lack of exercise, although in some cases such as mine that is not the case. By exercising, people can reduce the risk of developing diabetes by 47% to 58% (Lumb), (Bloomgarden & Li). As a matter of fact, many clinical studies have shown that diet and exercise in pre-diabetes patients can slow the onset of diabetes, and improve the control of glucose in people with diabetes (Bloomgarden). Exercise for me means less insulin and other drugs, and I can eat a little more to keep hyperglycemia from occurring.

The American Diabetes Association states that adults with diabetes should perform at least 150 minutes per week of moderate-intensity aerobic physical activity (50–70% of maximum heart rate), spread over at least 3 days per week with no more than 2 consecutive days without exercise. That’s 50 minutes of exercise every two day. If you think about it, it is not really that much and you do not have to kill yourself doing it.  Remember, this is moderate-intensity or relative intensity. Not absolute intensity. Below are some of the positive effects of exercise and diet for people with pre-diabetes and type 2 diabetes;

·      Less medication

·      Reduction of sleep apnea

·      Enhanced mobility

·      Decreased urination

·      Reduced cardiovascular risk

The problem is that people with diabetes fail exercise while self-monitoring, mainly due to lack of motivation or poor health. There is research currently being done and being considered for approval by the Food and Drug Administration called Physical Exercise Therapy (Balducci, et al, 2014) and is designed for people with diabetes to help them get the exercise they need and provide support and help while doing it. Like a pharmaceutical drug prescribed by a physician or a restricted diet by a dietician, specific exercises would be prescribed with a therapist designed to help keep glucose levels at the desired levels while being monitored not just to make sure exercises are done but also to ensure they are done correctly and that no more exercise is done than the body can physically handle. The dose and intensity of exercise would be prescribed by a doctor in conjunction with the patient.

Physical Exercise Therapy would include:

Leisure time activities – Walking in the park, gardening, sports or dance, and formal exercise training.

Absolute intensity training to get the heart rate up if the patient can do this.

Relative intensity training. This is more like warm up training but designed for patients who cannot do absolute intensity training.

Exercise training such as cardiorespiratory fitness such as walking on a treadmill or other equipment to get the heart rate up.

Muscular strength and resistance training such as lifting weights to get back muscle lost due to high glucose levels.

Flexibility training to help work on joints for mobility.

Occupational physical activity so patients can do their jobs.

Conclusion

There is a long way to go for this type of therapy to work. Question such as payment for therapy by insurance companies and exercise facilities that would allow therapists and patient to work together on exercise equipment would need to be answered.  Also, would patients need to be in therapy long term or short term with the hope that this type of therapy would eventually pave the way to self-monitoring? Cost is most certainly a factor. Clearly, fiscal exercise therapy would be helpful for the control of glucose levels in patients with type 2 diabetes.

When more information becomes public regarding physical exercise therapy it will be posted on this website. Stay tuned!

References:

Balducci, Stefano, et al, (2014) Physical exercise as therapy for type 2 diabetes mellitus: Exercise as Therapy for Type 2 Diabetes, Diabetes/Metabolism Research and Reviews, 30 (S1) Retrieved from http://el2ne5ae7f.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Physical+exercise+as+therapy+for+type+2+diabetes+mellitus&rft.jtitle=Diabetes%2FMetabolism+Research+and+Reviews&rft.au=Balducci%2C+Stefano&rft.au=Sacchetti%2C+Massimo&rft.au=Haxhi%2C+Jonida&rft.au=Orlando%2C+Giorgio&rft.date=2014-03-01&rft.issn=1520-7552&rft.eissn=1520-7560&rft.volume=30&rft.issue=S1&rft.spage=13&rft.epage=23&rft_id=info:doi/10.1002%2Fdmrr.2514&rft.externalDBID=n%2Fa&rft.externalDocID=10_1002_dmrr_2514&paramdict=en-US

Bloomgarden, Z. & Li. X (2015) Healping People with Diabetes to Exercise. Journal of Diabetes, 7(2), 150-152. Retrieved from http://web.a.ebscohost.com.contentproxy.phoenix.edu/ehost/detail/detail?sid=070092e7-a9ab-4df6-af89-556d961dac63%40sessionmgr4006&vid=0&hid=4214&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=100696491&db=a9h

Lumb, A. (2014). Diabetes and exercise. Clinical Medicine, 14(6), 673-676. Retrieved from https://search.proquest.com/docview/1635285524?accountid=458