How Can Exercise Affect the Wellbeing of Clients with Diabetes?

This blog was written in partnership with Anthony Crozier MSc (Health and Wellbeing Specialist at Future Fit Training and creator of the Level 4 Obesity and Diabetes Management Course) as part of a 3-part series of blogs surrounding Diabetes and Personal Training. Anthony has over 20 years of experience in community and clinical exercise provision as a rehabilitation practitioner with the NHS, various local authorities, and the private sector.

Exercise is often understood to be one of the best ways to assist in managing type 2 diabetes. However, it is also beneficial for managing type 1 as it can improve heart health and insulin sensitivity.

“This is because exercise has an insulin-like effect that enhances the uptake of glucose into body cells, even when insulin levels are low. Additionally, for those in the pre-diabetic category, regular exercise may also reduce the risk of developing the disease and relying on clinical treatment.” Anthony Crozier, Health and Wellbeing Specialist

Following on from our last blog about the key statistics and facts surrounding how personal trainers can help clients manage diabetes, this blog will cover how exercise can improve diabetic clients physical, mental, and social health. As the sector moves towards a holistic approach to fitness and wellness, viewing the client as a whole rather than merely physical fitness is essential when training diabetic clients.

This blog will cover how exercise affects the health of diabetic clients:

• Physically
• Mentally
• Socially
• Important considerations and cautions for exercise (written by Anthony Crozier)

How Does Exercise Impact Physical Health for Diabetic Clients?

Exercise can have a profound impact on clients’ physical health. As stated on Diabetes.org.uk, movement can:

• Help maintain a healthy weight
• Improve cholesterol levels
• Help you look after your blood pressure
• Increase insulin sensitivity

For clients who are not used to regular activity, it's essential that the functional exercises are similar to those that mimic everyday life.

The aim should be to improve their quality of life by developing areas that they struggle with. Anthony has suggested that trainers consider the following when exercising clients:

• Avoid too intense or high impact activity that could worsen diabetic complications, such as eye damage or foot damage.
• Monitor them throughout the session
• Give rationale about the exercises to help clients understand, and then take the knowledge with them into their daily lives for self-awareness when being physically active.
• Explain the need for them to monitor their blood sugars when they begin exercising to see how they react. This could help them realise how intensity or duration affects blood glucose levels.

Does Exercise Impact the Mental Health of Diabetic Clients?

If your clients are not used to regular exercise, then having the confidence to begin training, and stick to their goals, can be challenging.

As shown in a study in 2018, exercise has been incredibly beneficial to boosting the mental health of clients with diabetes and reducing levels of stress. Being mindful of a client’s confidence and self-esteem will significantly impact how they respond to the workouts.

It’s important that your clients understand why the exercises are right for them and that they won’t aggravate any existing injuries or health conditions associated with diabetes or obesity.

How Does Exercise Impact the Social Health of Diabetic Clients?

Even when social distancing, having a sense of community will significantly impact your client’s training. Everyone works out differently but staying connected to other clients who have diabetes and giving them a place to communicate and support one another can be very beneficial.

“This may sound strange, but I can guarantee that people never used to come to my classes in the local church because they loved the exercise part! What they loved was the interaction that they had with similar aged, similar conditioned and like-minded others – it gave people a reason for attending and enhanced adherence. I am a big advocate of group-based activity if it is functional and well planned." Anthony Crozier

This can still be achieved to a greater extent throughout online community workouts with time after for discussion, as well as through outdoor, socially distanced exercise classes.

Important Cautions for Exercise – by Anthony Crozier

“Although exercise is recommended, we need to retain our professionalism and screen patients vigilantly before exercising.

There are lots of reasons why we should not exercise all the time. These reasons are called ‘contraindications to exercise’, where activity at that time could make a client’s condition worse.

Examples you may be able to verbally screen for before a session could be:

• Are they ill, or have they got an infection?
• Is their blood glucose level above 13 mmol/L (patients could test if new to exercise)?
• Is their blood glucose level below four mmol/L (risk of hypoglycaemia)?
• Has the patient recently had treatment for retinopathy, such as laser therapy?
• Is the client unstable (newly diagnosed or newly medicated within four weeks)?
• Any signs of uncontrolled Cardiovascular Disease such as angina or shortness of breath?
• Existing open wounds such as ulcers on feet?

Once you have screened the patient, you can start with some exercise. Although there are recommended guidelines for diabetic clients from sources such as the American College of Sports Medicine (ACSM), it is important that you treat ALL patients individually and work to their abilities.”

To Conclude

While exercise and diabetes are highly complex, the need to understand how to train clients with diabetes and other metabolic conditions has never been greater. Being able to significantly impact your client’s mental, physical, and social health will see you grow in confidence as a trainer and develop essential skills.

“There are no shortcuts to gaining knowledge and experience. If you want to work within this field of expertise, I recommend that exercise professionals find a well-recognised, accredited qualification, observe clinical services in practice, and speak to as many people as possible who are specialists within this area of care.” Anthony Crozier

To help trainers gain these vital skills, we have created a new Level 4 Obesity and Diabetes Management course. To find out more about how you can sign up, speak to one of our advisors on 0800 458 1388 or through the website here.