Getting the Right Diabetes Support 8 Tips for Managing Diabetes with a Personal Trainer and Nutritionist

When it comes to diabetes control, personal dietitians and trainers can whip your diet and exercise routine into shape. Whether you’re newly diagnosed or a longtime patient needing a lifestyle tune-up, managing diabetes might be just a matter of getting informed and organized. Read on to find out how the right professionals can help with diabetes support... It’s no secret that a sedentary lifestyle, obesity, high blood pressure and high cholesterol increase the chances of developing diabetes complications, and that getting fit and eating right reduce those risks. “A healthy diet and exercise should be part of every diabetes treatment program,” advises Naheed Ali, M.D., author of Diabetes and You: A Comprehensive, Holistic Approach (Rowman & Littlefield Publishers). “Together, they can reduce symptoms of diabetes, such as lack of energy, weight gain, and more importantly, sugar-control issues,” he says. But it’s difficult to start an exercise or diet routine when you’re also watching glucose and insulin levels and coping with medication side effects or painful nerve problems. Plus, you may not know how to use gym machines or calculate carbohydrate loads in a meal. “It can be overwhelming to figure out [on your own],” agrees Nessie Ferguson, R.D., certified diabetic educator at Nebraska Medical Center’s Diabetes Center in Omaha. Here’s how to find the best specialists to help with your diabetes support. Find the Right Personal Trainer If you have no idea how to heft a dumbbell or use the Stairmaster or elliptical machine, a personal trainer can teach you proper form so you’ll make the most of each move and prevent injuries. They can also keep an eye out for dangerous blood sugar dips. People with type 2 diabetes must monitor glucose before and after exercise, according to American Council on Exercise. “I have a diabetic client whose blood sugar level will drop nearly 100 points during an hour-long workout,” says certified personal trainer Nick Irons, owner of a fitness studio in Bethesda, Md. “So she has to make sure her blood sugar is high enough before the session to prepare for that sudden drop.” That’s why you need to choose a trainer for diabetes support as carefully as you’d select your physician or endocrinologist. There are no national standards, licenses or minimum requirements for personal trainers, and some people who claim to be “certified trainers” may have just taken a few home-study courses, warns Janet Sunderland, a fitness and Pilates instructor in Richmond, Wash. Start by verifying your trainer is certified by a nationally recognized and accredited organization, such as the American Council on Exercise, the American College of Sports Medicine, or the National Strength and Conditioning Association. These organizations offer referrals on their websites. When interviewing trainers, “ask about education, certifications and training that qualify them to work with clients [with] specific health concerns like diabetes,” Sunderland adds. Ideally, your trainer will have formal academic training in exercise science, kinesiology, biomechanics, nutrition, human anatomy, exercise physiology or physical education. Look for “chemistry” with your trainer Your trainer’s personality, communication skills and workout style are as important as their credentials when offering diabetes support. “Your trainer should teach in a way you relate to,” says Shirley Archer, a NSCA-certified personal trainer and author of Fitness 9-5: Easy Exercises for the Working Week (Chronicle Books). “Most trainers specialize in a specific type of client: older adult, beginning exerciser, youth, teen athlete, competitive athlete or pre-menopausal or post-menopausal women,” she says. If a trainer works only with free weights and you prefer machines, you may not feel comfortable, which makes it easier to drop out. If you’re an at-home exerciser who loves resistance bands and balls and the trainer only works with heavy-duty gym equipment, you also may have a hard time following through. Consider the trainer’s style If the trainer doubles as a drill sergeant and you prefer a laid-back style, keep searching. A trainer should motivate and offer diabetes support without pushing too hard, Ali says. “Your personal trainer shouldn’t force you into rigorous activity right away,” he says. “As a diabetic, your goal should be staying healthy – not instantly building muscle mass.” If you’re not having a good time getting into shape, you’re more likely to give up and drop out. “The training relationship should be positive and fun,” Archer says. Bottom line: You should feel comfortable, not intimidated; motivated, not forced; enthusiastic, not fearful. Tailor your workout to your health issues When developing a fitness and diet routine for diabetes support, a personal trainer should factor in your overall health and diabetes treatment, such as medications. “I make sure my clients with diabetes ask their doctors how and if their medication should be changed due to exercise,” Sunderland says. If you have eye, feet, kidney or heart complications, you may need to exercise less intensely, or make other modifications to your workout, Ali says. “I also ask if they’re having any secondary complications, such as peripheral neuropathy, or if their feet are affected, so I can adjust their workout program accordingly,” Sunderland adds. For example, she may avoid weight-bearing exercises for people with foot issues or ask them to wear shoes and socks while doing Pilates (which is typically done barefoot or in socks). Ask about fitness alternatives Your training session doesn’t have to be confined to one-on-one sessions on the gym’s weight floor. Ask your trainer about these new ways to get fit, suggests the American Council on Exercise. Fusion fitness: Many trainers are blending yoga, Pilates and other mind/body routines with traditional strengthening or cardio exercises. Shorter workouts: Crunched for time? Ask your trainer to create 30-minute “circuit” workouts that incorporate several machines you work for just minutes at a time. Wellness coaching: Some trainers double as wellness or lifestyle coaches, guiding clients holistically in all aspects of daily life. Small-group training: Your trainer may allow you to work out with friends. You’ll save money and be motivated by others, but get less individual attention. Functional fitness: Your trainer may teach you to exercise several muscles and joints at once to enhance coordination, strength and endurance in everyday activities. “I encourage people with diabetes to look beyond traditional weight-lifting and cardio machines,” Sunderland says. “The best exercise is one you’ll keep doing because you enjoy it.” Find the Right Nutritionist Nutrition professionals, such as registered dietitians (R.D.) or certified diabetes educators (C.D.E), can offer diabetes support by creating meal plans that fit your tastes and lifestyle. “A nutritionist serves as a support system for diabetics when it comes to diet,” Ali says. “A doctor will provide suggestions, but a nutritionist will motivate you and oversee your diet regimens in more detail.” Both R.D.s and C.D.E.s provide meal plans, tips, guidance, diabetes support and motivation, but they have different backgrounds and areas of emphasis. Registered dietitians must have completed coursework approved by the American Dietetic Association (ADA) and a bachelor’s degree – typically in food and nutrition sciences, sociology, physiology or biochemistry. They must also complete an accredited practice program similar to an internship, pass a national exam and take continuing education courses throughout their careers. Many specialize in diabetes and often work with physicians to determine how dietary needs and medications should intertwine. A certified diabetes educator must be a health-care professional, such as a medical doctor (M.D.), registered nurse (R.N.), psychologist, physical therapist, social worker or R.D. They also have to complete 1,000 hours of diabetes education, pass an exam by the Board of Certified Diabetes Educators and take continuing education courses for re-certification every five years. To find a C.D.E., check with the American Diabetes Association. For an R.D., visit the American Dietetic Association website. Consider group nutrition classes Both R.D.s and C.D.E.s offer group classes for diabetes support, as well as individual sessions, to help you understand the big picture and details of your diabetes treatment. These provide you with tools for managing diabetes through diet, and evaluate current sugar levels, medications and foods you’ve been eating. Prepare for the consultation Your first meeting – whether a group class or individual session – will probably cover the basics: how to check your glucose levels, the basics of meal planning and an exercise plan. To get the most out of that first meeting, take: Your blood glucose monitor to check that it’s working properly Your blood glucose log book with your recent recorded levels A list of medications you’re on A food diary listing what you ate for the past week A list of questions you may have about diabetes “We also encourage patients to bring their family members to classes,” says Ferguson (R.D). Not only can your family help with diabetes support, but if they also make lifestyle changes with you they may be able to avoid diabetes in the future. A nutritionist may suggest specific recipes that match your tastes and create grocery lists that even include fast foods for when there’s no time to cook. “We’re not the ‘food police,’” Ferguson says. “I would never tell my patients they can’t eat their favorite foods. We just have to create an individualized meal plan that works for them.” For more expert advice and information, visit our Diabetes Type II Health Center. Myth vs. Fact: How Much Do You Know About Diabetes? In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about diabetes is rampant – and mixing up the facts about this disease can have dire consequences. Are you confused about diabetes?