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Life is busy! When there are competing demands on my time, here four strategies I use to prioritize exercise:

Identify the Optimal Workout Time

Right now 6:15 AM is my time. Early morning works for me because (for the most part) the rest of my life doesn’t get in the way. If something does interfere, I can often manage to squeeze in a little exercise later in the day (multiple short walks, evening run, etc.). Another huge motivator - I can dial back the insulin for a couple hours afterward.

Leverage Technology

With so many tech tools designed explicitly to support the pursuit of a healthy lifestyle, why not give some a try? Here’s what I’m using right now:

  • Garmin Connect logo Connect App Garmin Vívofit  – A birthday gift from my family.
  •  5K Runner App Logo 5kRunner App – With this $3 investment I got in shape for my first 5k.
  •  audible logo Audible.com – I got a Groupon for a 3-month trial and liked the service so much, I extended my membership. The trick? I don’t let myself listen to a book unless I’m out for a run.
  • Podcasts – Sometimes I change it up and listen to podcasts while I run. Current favorites include: The Moth, This American Life, New Yorker Fiction.
Recruit Friends and Family

I don't know about you, but I don't get to see enough of the people I care about. So here’s what I did:

  • I got a pedometer for my husband and challenged him to a steps competition. While I know the 10,000 steps are arbitrary, they still serve as a useful milestone. In fact, it was those 10,000 steps that inspired me to start running - because I didn’t have time to walk them all 10,000 of them.)
  • I invited friends to walk and/or run with me. It’s good for us all, right?
  • I invited a few other friends to go to Zumba with me. Just $5 a class at our local rec center. Great music, great company.
  • I signed up for a neighborhood 5k. Did I mention that I am was not a runner? (See what I did there? Now I am a runner.)
  • I invited my 11-year old to run with me on the weekends. (We take turns playing favorite songs for each other. I love learning what she’s into!)
  • I realized that my neighbor and I have memberships at the same gym. Now we go to the gym together.
Vary the Activities

Admittedly, I like routines, and I have to work at introducing variety. Here's what I'm doing now:

  • Cardio and weight lifting (2x/week)
  • Yoga (1x/week)
  • Running (2x/week)
  • Fast-walking (1x/week) or Hiking

How about you? How do you stay committed to exercise?Logo for 7th Annual Diabetes Blog Week

This post is part of Diabetes Blog Week.
The Prompt: Diabetes tips and diabetes tricks.
For more perspectives on this topic, click here.

OscarBanner

Have you heard about Oscar? Oscar is a “start-up” health insurer that launched in 2013 and serves consumers in New York and New Jersey. The company aspires to leverage technology, data and design to improve customers' engagement and experience with health care. I like these goals, so when Oscar invited me to write post to help spread awareness about diabetes, I was happy to oblige. Oscar’s campaign is designed to highlight how people live unique lives through common approaches to diabetes.

What type am I? I'm a walker…

I have had diabetes for over 25 years. I’m an active person - I jog, swim, life weights, practice yoga and Pilates, play volleyball, etc. But hands-down, what works best for me for staying healthy is walking. Among the known benefits for people with diabetes, walking:

  • Lowers blood glucose levels
  • Improves the body's ability to use insulin
  • Lowers stress levels
  • Raises “good” (HDL) cholesterol levels while lowering “bad” (LDL) levels
  • Reduces risk of heart disease and stroke

I aim to walk 12,000 steps a day (roughly 6 miles). Finding time for those 12,000 steps takes some planning. Here’s what works for me:

  • Instead of catching up with friends at a coffee shop, we get our coffees to go and walk around a park.
  • Whenever possible, I schedule “walking meetings” during the workday. (Not a good option for meetings with lots of note taking, but this format works great for strategy and big-picture planning meetings.)
  • I do a lot of walking errands. Since I happen to live close to a grocery store (6,500 steps) and a library (5,000 steps), these errands contribute significantly to my daily goal.
  • I opt for the stairs instead of the elevator.
  • When really pressed for time, I jog some of my steps. (The efficiency of jogging is hard to beat.)

The best news? The benefits of walking are good for everyone - not just people with diabetes. So, it’s pretty easy to recruit others to join in the fun!

I ran my first 5k yesterday.

I've never been much of a runner. So I downloaded a running app and started training the next day. I registered for a local race (Denver’s Adelante! 5k). Then I recruited a few pals to run with me once a week. The other days I ran on my own. In time, I began to look forward to the trainings as a way to spend time with people I don’t see often enough or to just zone out and listen to music.

With 7 weeks of training under my belt, I was feeling reasonably prepared on the day of the race. I ate an apple, drank some water, and stashed a juice box in my jacket pocket, just in case. My family came with me to cheer me on (it being Mothers’ Day, what choice had they?). I ran most of the way. And since I wasn’t running for any particular time, I was happy to complete the course in 36:12.

The numbers I care more about are the ones on my meter. And I was less happy with those yesterday. Given that I’d been testing and adjusting for weeks to determine a sensible strategy for the run, I was vexed by my body's response. Here’s what the day looked like in diabetes terms:

7:15 Test: 89mg/DL
8:15 Test: 81mg/DL
Eat apple (skip bolus) Preventively, to avoid mid-race low.
8:45 Decrease basal rate by 20% Again, preventively.
9:00 Run (mostly) for 36 min.
9:55 Test: 176mg/DL Woah…
Check site (it’s fine).
Bolus 2.5 units Hope that’s not too aggressive.
Hydrate.
10:10 Test: 172mg/DL Really?
Ponder test strip inaccuracy.
Verify recent changes to pump settings.
Second-guess skipping the apple bolus.
Second-guess the 20% basal decrease.
10:20 Test: 164mg/DL Still?
Bolus 1 more unit.
Head home.
Change site.
Spot a few air bubbles in line. Maybe?
Open new vial of insulin. It’s time anyway.
Continue to bolus against a stubborn high for most of the day. Sheesh.

It’s difficult to convey how damn squirrely diabetes is to people who don’t live with it every day. The best-laid plans often deliver uncertain results. It can be super frustrating. And yet, diabetes didn’t spoil yesterday; my first 5k was rewarding and fun.

Diabetes Blog Week 2014

This post was written for Diabetes Blog Week.
The prompt
(suggested by Kim of Texting my Pancreas): Change the World.  

logoJust in time for the holidays, November is National Diabetes Month. Who cares? You might. According to the National Diabetes Education Program:

  • Approx. 26 million Americans have diabetes.
  • An additional 79 million adults in the US have prediabetes.
  • The total direct medical cost of diagnosed diabetes in 2012 was $176 billion.

Two diabetes awareness campaigns caught my attention this year:

  1. Lee Ann Thill created the World Diabetes Day Postcard Exchange to "promote healing through creativity, connection and activism." Participants in the Exchange send and receive handmade postcards that incorporate the blue circle (the international symbol of diabetes) in their design. Great idea - I'm mailing my cards today.
  2. The Big Blue Test is designed to help people notice the impact of small changes. Through November 14, for every 10 Big Blue Test results that are logged, Diabetes Hands Foundation grants $5 to support people with diabetes.
    You don't have to have diabetes to participate, and the benefits of exercise are yours to keep. Here's what to do:

1) Test your blood sugar (if you have diabetes)
2) Move your body (at least 14-20 mins)
3) Test again (if you have diabetes)
4) Share your results on bigbluetest.org

I've been logging my big-blue data since the start of the campaign. Each time, my blood glucose has dropped 20-30 points following 60 minutes of moderate-to-vigorous exercise. Plus, I use 15% less basal insulin for the ensuing 4 hours.
That's some solid motivation right there.

 

I promised to share how LiveWell's Get Movin' Challenge is working for me.
It's been great so far! Since August 1, I have engaged in the following activities:

check-markenjoyed volleyball & picnic in the park with other families
check-markparticipated in the super fun Viva Streets (Coloradans, join me next year!)
check-markplayed tag at a park with my children
check-markswam while my kids had swim lessons
check-markbounced with my kids at an indoor trampoline park
check-markworked out at the gym 3-4 times per week
check-markhiked with my family
check-marktook my children to a roller rink and skated with them

Most days I exercised for more than 45 minutes. I found that even when I had met my daily exercise goal, I continued to seek additional opportunities to be active.

On the other hand, there were days - three of them - that I didn't squeeze in my 30 minutes. I made up for it by exercising twice as long the next day.

Since part of the goal I had set for myself was to try new forms of exercise, and I still haven't got to everything on my list, I'm taking the challenge into September.
Here's what's on deck:

  • go on a bike date with my husband
  • commit to one car-free (or walk-only or bike-only) day in September
  • add one class to my fitness routine (cycle or power yoga)
  • take my family on a hike
  • learn to swim better - take a lesson!

(As an added benefit, I have lost one pound.)

SaveSave

Dancing Dude

I just signed up for LiveWell Colorado's Get Movin’ Challenge. For those who are unfamiliar with it, LiveWell Colorado is a nonprofit organization committed to reducing obesity in our state. The challenge invites Coloradans to commit to one month of physical activity – at least 30 minutes a day every day – during the month of August.

As it happens, my kids are enrolled this week in a sports-oriented camp.
A typical day looks like this:

8:15-9:00     -    Open Recreation  (Basketball, Soccer, Corn Hole, Twister, etc)
9:00-9:45     -    Rules, Stretching, Name Games & Morning Snack
9:45-11:15     -    Dance/Cheer OR Soccer
11:15 -12:15   -    Lunch
12:15-1:00     -    Lacrosse
1:00-2:00     -     Ice Skating
2:00-3:00     -    Climbing Wall
3:00-3:30     -    Afternoon Snack
3:30-4:30     -    Ultimate Frisbee

I would not have described either of my children as particularly sporty. And yet, they  return home from camp each day raving about how much fun they had scaling the climbing wall and learning to play lacrosse.
That got me thinking – I should make my workout more fun. Here’s how I'm going to do that during the Get Movin’ Challenge:

  • add two classes to my fitness routine (I picked spin and power yoga)
  • take my family hiking twice over the next 5 weeks
  • schedule an evening soccer or volleyball game in the park with other families
  • commit to two car-free (walk- or bike-only days) in August
  • go on a bike date with my husband
  • take another Will Power and Grace class with my friend
  • participate in Viva Streets in Denver on August 11th
  • play tag at a park with my kids
  • swim for 30 minutes during my children's swim lessons

I like this plan. August is going to be really fun.

The 2012 Colorado Health Report Card was released last week. The Report Card tracks 38 health indicators across five life stages to provide a snapshot of Coloradans' state of health. This year's picture is not as promising as might be expected from the healthiest state in the nation.

“Even in the areas where we are doing ‘well’ compared to the rest of the country, some troubling trends loom on the horizon,” the report states. “Putting (adult obesity) figures in perspective, Colorado currently may be the leanest state, but if we reported those numbers in 1995, we’d be the heaviest.” The picture is particularly dim in the areas of prenatal care and childhood health, and leads me to reflect on my eight-year old's most recent pediatric wellness visit.

The pediatrician spent some time reviewing G's growth chart, and then announced that her weight-to-height ratio was "optimal." He said so twice.
Why the emphasis, I asked?
He responded that slender eight-year olds are far less common in the U.S. than they used to be and because of that Americans are inclined to perceive wiry pre-teens as underweight. He added, "I want you to have this in your mind because people are going to tell you that she's too thin. The reality is that she does not need to gain weight. Her weight is ideal and I want you to feel very secure about that."

I wasn't concerned about G's weight, but I did appreciate the pediatrician's perspective. It's interesting, isn't it, how we're subtly influenced by our surroundings? The conversation reminded me of LiveWell Colorado's 2011 obesity awakening campaign which sought to re-set Coloradans' perception of what constitutes a healthy weight. The campaign's  obesity quiz caught my attention when I scored poorly on it, failing to correctly identify a featured actor as "overweight."

BMI Visualizer

Another helpful tool in this vein is the BMI Visualizer (above), created by the Perceiving Systems Department at the Max Planck Institute for Intelligent Systems. It's deceptively simple: you input your gender, age, height and weight, and the "visualizer" calculates your BMI and generates a 3D Model to help you see the relationship of BMI to body shape, and what you would look like if you lost (or gained) weight.

I'm relieved that Colorado is embracing the spirit of our title as the "healthiest state" and am excited about the role will surely play in helping us get there.

At a recent annual physical, I was discouraged to see that despite a healthy diet and more frequent trips to the gym, I was gaining weight (the unwanted, non-muscular kind). “How could this be?” I asked my doctor.

Dr:   [glancing at medical record] Let’s see… oh, you’re turning 40 next week.
          Happy Birthday! And welcome to your 40-year-old metabolism.
Me:  For real? Doesn’t reaching my target A1c count for anything metabolically?
Dr:   Nope.
Me:  Here’s the thing: I don’t want to gain weight.
Dr:   Great! Do you count calories?
Me:  (Pause) No. I don’t count calories.
Dr:   Have you ever counted calories?”
MeNo. I count carbohydrates.

(She’s my endocrinologist. She knows I count carbohydrates. And fiber. She knows I consider exercise. And stress. And how much sleep I got last night. And what time of the day it is. And what day of the month it is. Every. Single. Time. I. Eat. Calories? Hell, no!)

DrOkay, so from now on you’ll count carbohydrates and calories.
(I’m sorry, did you not hear everything I just thought?)
Dr:  You get 1,500 calories per day. 50% carbs / 30% protein / 20% fat. Got it?

(Damn you, slowing metabolism, how dare you take more fun out of eating?
But… I don’t want to gain a pound a year either.)

Me:  Okay. I’ll do it. I’ll get an app.

That night I downloaded LIVESTRONG’s Calorie Tracker app and played with it for way longer than I should have. It's pretty cool. It incorporates a large database with nutrition info for most of the foods I eat. There’s a place to track exercise. At a glance I can see progress toward my daily calorie threshold. I like this app! It’s going to help me reach my goals. It’s even going to remind me to drink water. Awesome.

         

The following week, my schedule was dreamily predictable. I exercised, ate, worked, and slept at consistent times. I had complete control over the carbohydrates in my meals. There are were no unexpected twists, no curve balls. It was the perfect week to be a carb-and-calorie-counting diabetic.

But, really, who has weeks like that? Life is full of schedule-wreckers. Within three weeks I had fallen off the calorie-tracking wagon. And yet, I like Calorie Tracker and continue to reference it for counting carbs (and the odd calorie).

But as far as a strategy to prevent weight gain, it’s more time in the gym for me.
And maybe I'll consider drinking my coffee black.

Three mornings a week, I head to the gym, dial down my insulin, insert ear buds and spend 45 minutes ellipticizing. There's a lot of motivation: I want my clothes to fit, I'll enjoy the post-exercise calm, I want to model healthy habits for my daughters, etc. But really gets me out the door is knowing that I'll be able to dial back my insulin by about 15% for several hours following the workout.

This morning I broke from routine and attended a WillPower & Grace® class taught by my friend Jen. The class was part of the One Billion Rising movement, which is itself pretty fantastic.

I was apprehensive about trying to keep pace with the über-fit regular attendees. But the class was terrific. I worked hard, broke a sweat and stretched long-forgotten muscles.

And! Just before the class started, I saw a woman I recognized. Where did I know her from? Work? The neighborhood? Then I noticed her wrapping the plastic tubing around her insulin pump. And I remembered meeting her last summer at our kids' swim lessons.

We chatted briefly this morning after class, exchanged contact info and just appreciated the ease of connecting with someone who "gets it" without explanation.

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