Contributor: Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES

As a pharmacist, I love medications. We have tons of drugs to treat diabetes, and many of the newer ones have tremendous benefits. Some of these benefits include lowering blood sugar, aiding in weight loss, reduction of heart attacks and strokes, and protection of kidneys.

I also know that despite advances in drug therapy, medications often fall short. We have simply not been able to make a pill that can replicate what physical activity does for us.

Physical activity has numerous benefits and can often lead to lower insulin doses and make it easier for people with both type 1 and type 2 diabetes to achieve blood sugar targets. For people with type 2 diabetes, physical activity often leads to a need for less medication. Listed below are many of the benefits from physical activity:

• Improvement of blood sugars
• Improvement of thinking and cognition
• Reducion in levels of anxiety and depression
• Improvement of sleep
• Weight management
• Reduction of heart attacks and stroke
• Reduction of some cancers
• Improved quality of life
• Stonger muscles and bones, reduction of bone fractures
• Less arthritis pain
• Increased chances of living longer

The latest statistics from the Centers for Disease Control and Prevention (CDC) indicate that 42.4% of people in the United States are considered obese, indicated by a body mass index over 30kg/m2. We know that obesity is a considerable risk factor for type 2 diabetes. One of the largest contributors to the obesity epidemic is lack of physical activity. The American Diabetes Association recommends 150 minutes or more of moderate to vigorous-intensity aerobic activity spread over at least three days per week and 2-3 sessions of resistance exercise.

This may sound daunting if you are currently doing very little physical activity. The good news is that physical activity doesn’t have to be a super intense gym session. It can be anything that gets you up and moving, such as taking a walk during a lunch break or walking the aisles in the grocery store. There are many free exercise videos that can be done from home, ranging from tai chi to yoga to Zumba to high-intensity interval training (HIIT). For those with physical limitations, even chair exercises, literally done from the comfort of your chair, can get your heart rate up.

In this crazy time of COVID-19, it’s more important than ever that we find ways to release our energy and get moving. And fortunately, the weather is getting nicer, and the walking trails are open.

I know there are a million reasons in the world why incorporating physical activity into life is hard. I used to struggle. I’d tell myself I’d go in the morning, but it was too dark and cold, so I’d plan to go in the evening, but then I really wanted to get home and see my kids. And I had a long commute, and well, it was just really hard…

Have you ever been on a hot streak of exercising or eating healthy, and then some life event throws you off? And then sometimes days, weeks, months, even years could go by, and it just seems so difficult to get back “on the wagon.”

Life events are bound to happen. I’m sure all of our lives are looking a lot different these days with COVID-19. I want to share four strategies that work for me and my patients.

1. Set modest goals: I tell myself that I only have to move for 10 minutes and anything I do is good. This sounds manageable. I often go for 30 minutes or more, but I never feel like I have to. For those starting out, you may start with 5 minutes or even 2 minutes, depending on your fitness level. I also aim for 4-5 days per week (not 7) because this is reasonable with my schedule.
2. Track my steps: I wear a watch that tracks my steps - many phones can do this too. I aim for 10,000 steps per day at last five days a week, and if I’m under, I am motivated to get in an extra walk or perform an additional errand during the day to get those steps.
3. Positive mindset: This is so important. On hard days I use what may sound like cheesy self-talk and repeat, “I am tough, I am strong, I can do this.” Staying positive is the secret weapon against all or nothing thinking that leads us to believe we fell off the wagon. In reality, as long as you are breathing, you’re still on the wagon. Every moment is a new opportunity.
4. Find your motivation: My kids motivate me. I want them to be healthy, and I want to lead by example. I’m also motivated by COVID-19. Preliminary evidence shows that exercise may actually be protective against deadly complications. I want to be as healthy as I can be to fight this virus if I get it.

I hope I’ve convinced you to park your car further away, take the stairs instead of the elevator, or play tag with your kids or grandkids. Please do make sure that you talk to your healthcare team if you plan to make major changes to your physical activity routine. Your medication doses may need to be adjusted, or your doctor may want to do a stress test on you first to make sure it’s safe to start exercising.

In conclusion, physical activity is truly the best medicine. I encourage you to move, move, move because we don’t have any pills that can do all the amazing things that physical activity can do.

References:

• Centers for Disease Control and Prevention: Benefits of Physical Activity https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm
• COVID-19: Exercise may protect against deadly complication https://www.eurekalert.org/pub_releases/2020-04/uovh-cem041520.php?fbclid=IwAR15mfOQyawWLOF4ucOTLEzp_pu2B6vSLwH_y3p0J49YQ6UMCyBa-WpVP08

Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES is a Clinical Pharmacist and Certified Diabetes Care and Education Specialist. Dr. Isaacs earned a Bachelor’s Degree in Chemistry from the University of Illinois at Chicago and a Doctor of Pharmacy Degree from Southern Illinois University Edwardsville. Dr. Isaacs enjoys working on an interprofessional team and has established several clinical services within the Cleveland Clinic Diabetes Center. She is the 2020 ADCES Diabetes Care and Education Specialist of the Year.