Ep 5: Small Steps, Big Changes: Preventing Type 2 Diabetes with Exercise and Sleep

[00:00:02] Dr. Bayo Curry-Winchell: Receiving a diagnosis of prediabetes can be scary, but it's also a chance to take action. Making changes to how you live can actually help prevent type 2 diabetes. And when speaking to experts about ways to avoid developing type 2 diabetes, there is one word that pops up again and again. 

[00:00:19] Ryan Aiazzi: Exercise.

[00:00:20] Adrienne Maye: Exercise. 

[00:00:21] Oscar Camejo: Exercise. 

[00:00:22] Dr. Bayo Curry-Winchell: Yes, exercise. In this episode of the Preventing Type 2 Diabetes Podcast, we'll talk about why exercise is important for people diagnosed with prediabetes. 

[00:00:33] Grace Silverio: There's evidence that shows with exercise that you can prevent or delay the onset. 

[00:00:39] Dr. Bayo Curry-Winchell: We'll cover tips and tricks to start and maintain an exercise plan that works for you.

[00:00:43] Ryan Aiazzi: If you're just starting, do 10 or 15 minutes. 

[00:00:46] Dr. Bayo Curry-Winchell: Plus we'll talk about ways to reduce stress and improve sleep, which can reduce the risk of developing type 2 diabetes. Welcome back to the Preventing Type 2 Diabetes Podcast. I'm your host, Dr. BCW. 

The Preventing Type 2 Diabetes Podcast is a production of Mission Based Media and was made possible with support from the American Pharmacists Association Foundation.

This series is for educational purposes only. It is not a substitute for formal medical advice, diagnosis, or treatment. So if you have questions about your health, please talk to a qualified healthcare provider. In the first episode of our series, we learned that being physically inactive, overweight or obese, are all risk factors for developing prediabetes and type 2 diabetes.

As we've already discussed, making healthy food choices is one important part of losing weight and getting blood sugar levels under control. But exercise is also really important. Exercise helps lower cholesterol and blood pressure, which reduces the risk of heart disease and other health complications.

Exercise can also help with both losing weight and maintaining healthy blood sugar levels. In the United States, 42% of adults are classed as being obese, and another 30% are considered overweight. That's according to the National Institute of Health. You may be wondering, what's the difference between being overweight and being obese?

Being overweight and being obese are both related to having an excess amount of body weight. And one way to measure this is based on what's called a body mass index, or BMI for short. BMI is calculated by taking your weight in kilograms and dividing it by height in meters squared. If you'd like to know your BMI, we have a link to some websites where you can calculate it.

An individual is considered obese if their BMI is above 30. A score above 25 is considered to be overweight. That means you can be overweight but not obese. But if you're obese, you're also overweight. BMI is a widely used measurement for assessing weight status. It also has some limitations, particularly because it doesn't account for factors like muscle mass or body composition.

So, it's just one tool among many that healthcare professionals use to evaluate a person's weight and overall health. Either way, losing just about 5-7% of your initial body weight can help avoid or delay developing type 2 diabetes. So for example, if you weigh 200 pounds, that means losing about 10 to 14 pounds. That's about the size of a bag of potatoes. Even small changes can make a big difference in staying healthy. 

So if you receive a diagnosis of prediabetes and your healthcare provider says you need to exercise, what exactly does that mean and how should you get started? 

[00:03:45] Sandra Leal: When you start telling people, hey, go out and exercise, that can be very daunting.

[00:03:50] Dr. Bayo Curry-Winchell: That's Sandra Leal, a pharmacist and a former president of the American Pharmacists Association. If you don't have a lot of experience with exercise and you don't know where to begin, you're not alone. And the good news is exercise can be really simple. 

[00:04:04] Sandra Leal: Truly it can mean something as simple as walking 30 minutes a day, five days a week. So trying to get some more activity, walking a little bit further than you would have walked before. 

[00:04:17] Dr. Bayo Curry-Winchell: And there are small changes we can all make in our daily lives. 

[00:04:21] Sandra Leal: Park a little bit further from the front of the store, walk up the stairs a couple of flights instead of taking the elevator. It's things like that that you can start incorporating into your lifestyle to start bringing that additional activity.

[00:04:33] Dr. Bayo Curry-Winchell: You don't need to come up with a whole routine to see the benefits of exercise. You can start by being mindful about how much you move throughout the day, and find little ways to move more and more. And you can start slow. Don't expect to instantly go from not exercising at all, to the recommended level of moving your body for 30 minutes, 5 times a week.

[00:04:53] Ryan Aiazzi: If you're just starting, do 10 or 15 minutes. You don't have to jump right to the 30 or 40 minutes because you're probably going to burn yourself out and stop. 

[00:05:00] Dr. Bayo Curry-Winchell: Ryan Aiazzi is a family nurse practitioner, and he likes to remind his patients that any amount of physical activity is better than none. And it starts by finding a form of movement you actually enjoy.

[00:05:12] Ryan Aiazzi: If you hate running, don't run. If you love riding bikes, ride bikes. If you like boxing, do some kickboxing classes. 

[00:05:18] Dr. Bayo Curry-Winchell: So think about the activities you like most and make them a part of your weekly routine. It will help you stick to your exercise goals. When we think of exercise, many people think this means going to a gym. But for some people like Jessica, gyms can be intimidating places, especially if you're feeling a bit uneasy about your weight. 

[00:05:39] Jessica Patrick: When you're carrying that weight and you go into a gym and you're huffing and puffing in the back of the gym, praying that nobody's watching you, you don't stick with that. There's something to be said about that fear of judgment. 

[00:05:53] Dr. Bayo Curry-Winchell: One of the great things about exercise is that you can do it almost anywhere. In fact, you don't even need to leave your house. When Grace Silverio was diagnosed with prediabetes, it was during the COVID 19 pandemic, so she couldn't go to the gym.

[00:06:09] Grace Silverio: You can find several different ways to do exercise in the comfort of your home in the living room. Do you have some milk jugs that you can save and put some water in and use that as a hand weight? Do you have some canned foods? 

[00:06:24] Dr. Bayo Curry-Winchell: You can also do exercises that don't require any equipment at home, like push-ups and squats and taking a walk. And there are plenty of resources available online to give you ideas and plans for what to do at home.

[00:06:38] Grace Silverio: There's free apps on either smartphones or even televisions. 

[00:06:43] Ryan Aiazzi: You can find exercise anywhere, Apple TV, YouTube...

[00:06:48] Dr. Bayo Curry-Winchell: We'll put links to some free exercise apps on our website at healthunmuted.com/resources, along with other information that's specifically for people living with prediabetes and type 2 diabetes.

Of course, if one of your goals is to exercise at the gym, Oscar Camejo recommends you go easy on yourself and don't be tempted to compare yourself to others. 

[00:07:12] Oscar Camejo: You're dealing with anxiety. Don't get caught up on what somebody else is doing. Don't make someone else's goals your goals because they're working on something different.

[00:07:21] Dr. Bayo Curry-Winchell: Oscar was active as a teenager.

[00:07:24] Oscar Camejo: I wasn't overweight my entire life. You know what I mean? I had somewhat of an athletic build growing up. 

[00:07:32] Dr. Bayo Curry-Winchell: By his mid-to-late forties, he found himself overweight and feeling sluggish and tired. When he was diagnosed with type 2 diabetes, it was a wakeup call for him to change his lifestyle. So he went back to the gym but found it overwhelming. 

[00:07:46] Oscar Camejo: And my first day in the gym, I remember walking in, not knowing what to do. I would get on a machine, well, how many reps am I supposed to do? I did not have a plan whatsoever. So that first workout was very strenuous. 

[00:08:03] Dr. Bayo Curry-Winchell: Most gyms have professional trainers who can help you come up with an exercise plan that works for you based on your preferences, goals, and needs. Your trainer can also coach you through workouts to make sure you're using good form and not at risk of injuring yourself. But you don't need a gym and a personal trainer to exercise. As Grace and Ryan mentioned, there are many online apps and resources that can help and many are available for free.

[00:08:28] Oscar Camejo: I was able to find a program that's simple to follow through the Nike Training Club app.

[00:08:35] Dr. Bayo Curry-Winchell: The Nike Training Club app is one of the apps we have listed in the show notes for this episode and on our website. And at the time of this recording, it's completely free to use. Whatever you prefer, exercising in a gym, at home, outdoors, or somewhere else, the most important thing is that this is about forming a new habit and finding some way to make exercising a part of your life. For some people that can take a short amount of time, while for others it can take months. Here are five tips to help create new habits.

Number one, set a specific achievable goal. This is where starting small is important for those of us who haven't moved much recently. 

[00:09:15] Katie Engel: It's definitely all about the small goals. You might have a larger goal at the end, which is to lose a certain number of pounds, but how you get there is through those weekly small goals. 

[00:09:29] Dr. Bayo Curry-Winchell: Number two, create a plan. Don't just say you'll do it. Make specific time on your calendar and treat it like an appointment for yourself that you have to keep. Number three. Make it fun. As Ryan said, find that activity you love and you're far more likely to keep going. 

[00:09:46] Oscar Camejo: I've lost over 80 something pounds and I've been able to maintain it through the diet and exercise and just keeping it real simple, keeping it fun, adding a variety of exercises.

[00:10:01] Dr. Bayo Curry-Winchell: Number four, be flexible. If you miss a day, you miss a day. Don't be too tough on yourself and try again tomorrow. 

[00:10:08] Sebastian Beller: There's no expectations, right? If you need to start out going to the gym for five minutes at a time, do that. 

[00:10:15] Dr. Bayo Curry-Winchell: And finally, tip number five, find some support. Exercising with someone or in a group is much more sustainable and more fun. More importantly, on those days, you really don't want to put your running shoes on, your friend can come and drag you off the sofa. The absolute key to all of this is getting started and the very best time to start was yesterday. The second-best time to start is today. 

[00:10:42] Adrienne Maye: Take a deep breath. It's not going to be perfect. You're not going to get it right every time, but just do it. You can do it. It's your journey and just stick with it.

[00:10:54] Dr. Bayo Curry-Winchell: We've talked a lot about how exercise can help you lose weight and control your blood sugar. But exercise also helps you sleep better and reduce stress. And those are important because both stress and poor sleep can affect your blood sugar. Let's talk about sleep first.

We've all had nights when we don't sleep well or don't sleep long enough. And you know that it makes you feel tired and can even cloud your thinking. But did you know that getting too little sleep can make it harder for your body to control blood sugar and even make you feel hungrier when you wake up? And when you feel hungry and tired, you may be less likely to make healthy food choices and be more tempted to reach for foods that are high in carbohydrates and sugar.

And this makes it even harder for your body to manage blood sugar levels. You may be wondering, how much sleep do I need? And the answer is, it varies. Here's registered nurse, Adrienne Maye.

[00:11:46] Adrienne Maye: For most adults, it's seven to eight hours, give or take. It's going to be different for each individual. 

[00:11:52] Dr. Bayo Curry-Winchell: But getting good sleep is about much more than how many hours you stay in bed. It's also important to make sure you get the best quality sleep. 

[00:12:01] Adrienne Maye: Sleep hygiene is one of the most important things that people overlook.

[00:21:07] Dr. Bayo Curry-Winchell: Sleep hygiene means having good habits in an environment that supports getting a good night's sleep. And there are a few things to keep in mind. Keeping your room nice and dark, avoiding screens, and avoiding caffeine and alcohol are just a few of the key recommendations to help improve your sleep.

Exercise and sleep have a two-way relationship. Exercise positively influences sleep quality. And sleep in turn supports recovery and performance in physical activities. Finding the right balance and timing of exercise in your routine can contribute to better sleep and overall well-being. We have links to more information about getting good quality sleep in our show notes and on our website at healthunmuted.com/resources. When we talk about exercise, it would not be complete without including the impact exercise can have on reducing your overall stress. We've all heard about and experienced stress, so let's explore what it is and your body's reaction to it. When you experience stress, your body releases the hormones adrenaline and cortisol.

Adrenaline makes your heart beat faster, and cortisol releases glucose into the bloodstream. These hormones are super useful when your body needs a sudden burst of energy and alertness. For example, if you suddenly have to jump out of the way of a moving car or run away from danger, these hormones get released to give you that extra push.

So adrenaline and cortisol are your body's emergency helpers designed to help keep you safe in those intense moments. But if you're under stress a lot, whether from work, home, or family pressures, health issues, or just life's challenges, and you're not using that extra sugar in your blood, it can crank up your blood sugar levels way too much and for too long.

And that can make it tough for insulin to do its job right, which leads to increased blood sugars. That's why exercising is like your stress busting superhero. It's a fantastic way to take on stress and keep your blood sugar in check. And exercise doesn't have to feel like exercise. It can also just feel like having some fun.

[00:14:10] Miguel Cruz: I have a 12-year-old son and we just go and play. We go outside and throw a ball. 

[00:14:15] Oscar Camejo: I love long hikes and I go out there into the woods. I love the serenity of being out in the woods. It's just a great thing for me.

[00:14:25] Dr. Bayo Curry-Winchell: Not only is walking outside good exercise, but the World Health Organization also recommends it as an effective way to reduce stress as part of your overall health plan.

And there are other strategies that can help reduce stress levels. You may have heard of people talking about mindfulness as a way of reducing stress and anxiety. Mindfulness is all about hitting the pause button and really tuning in to the here and now. It's like taking a mental chill pill and paying attention to what's happening around you and inside you.

You can start practicing mindfulness for free from almost anywhere. There are loads of handy mindfulness apps, websites, and videos, and we've linked to some in the show notes and resources. Spending just a few minutes each day doing this can be a game changer for how you handle stress. Yes, stress is a common part of most people's lives.

However, when you make and take the time for activities that bring you joy and relaxation, it can make a huge impact on your overall mental and physical health status.

[00:15:26] Grace Silverio: Be kind to yourself. Make sure that you're finding time for yourself, whether it's meditation, whether it's going for a walk by yourself, listening to some music, dancing it out. Don't be afraid to ask for help as well.

[00:15:39] Dr. Bayo Curry-Winchell: Oscar says from his experience, relying on a support network is especially important for men, because men can often feel pressure to deal with their problems on their own. 

[00:15:49] Oscar Camejo: It's okay if you're struggling to reach out to a friend or a loved one to say, hey, you know what? I need support from you. We as men don't like to go and make it known that we need help, but we need to get over that because I don't know about you, I don't want to be overweight, I don't want to have passed away early or have lost a limb. So fellas, you have the opportunity today to turn things around.

[00:16:20] Dr. Bayo Curry-Winchell: So far in this series, we've talked about how lifestyle changes like diet, exercise, sleep, and reducing stress can help people prevent type 2 diabetes. In the next episode, we'll talk about how medication can also play a role for people who are at risk of developing type 2 diabetes. 

[00:16:37] Sandra Leal: Medication for cholesterol, medications to prevent pain or depression or other things associated with diabetes, plus the diabetes medications themselves and things for high blood pressure.

[00:16:48] Dr. Bayo Curry-Winchell: We'll discuss what they are, how they work, and how to talk to your provider about them.  In the meantime, if you want to learn more about how exercise can help prevent type 2 diabetes and find resources to get started, visit our website at healthunmuted.com/resources. There you can find links to free exercise apps and useful items like the National Diabetes Prevention Program and information to enroll in a lifestyle change program.

I'm Dr. BCW and this show is a part of the Health UNMUTED Audio Library by Mission Based Media. It was created with support from the American Pharmacists Association Foundation. Follow our show on your favorite podcast player and share it with the person in your life.