LIBRARY

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THE PREGNANT CLIENT

1. Myths and facts about exercise during pregnancy

Misinformation and bad advice are still rampant when it comes to exercise advice for pregnant women. To follow are common myths, followed by facts, regarding pregnancy and exercise:

Myth 1 - Exercise should never last longer than 15 minutes.

Fact 1 - Although it’s never a bad idea to use the concept of intermittent exercise – a number of minutes exercising followed by recovery and hydration – the black and white 15-minute limit arose in the initial attempt to set conservative and safe guidelines for women who exercised throughout their pregnancies (American College of Obstetricians and Gynecologists 1985 – ACOG). More current guidelines – buoyed by research that says women with uncomplicated pregnancies can exercise with virtually the same safeguards as non-pregnant women – support that women can exercise for longer periods of time (30 minutes or longer, most if not all days of the week) as long as... click here to read the article (PDF 238KB).

2. Exercise guidelines during pregnancy

By following sensible and research-based guidelines, like these from the American College of Obstetricians and Gynecologists (ACOG - 1994, 2002), we ensure your health and safety, and that of your unborn baby.

Approval - We will always get approval from your obstetrician before beginning or continuing an exercise programme. Some medical conditions make exercise during pregnancy inadvisable or justify modifications to ensure that your programme is safe.

Plan - We will design a programme of mild to moderate intensities and avoid exercise to the point of exhaustion. Common sense and perceived exertion rule here. If you are already fit, we will only need to make small changes as your pregnancy advances. If you are new to exercise, we will begin you on a low level programme and progress you slowly.

Regular - We will use regular and moderate duration exercise sessions. You should exercise at least... click here to read the article (PDF 156KB).

3. Physiological concerns, adaptations and changes during pregnancy

Why do controversy and concern surround the issue of exercise during pregnancy? Physiological changes occur in the cardiovascular, respiratory, musculoskeletal, and gastrointestinal systems and affect the maternal response to exercise. Anatomic changes of pregnancy alter balance, flexibility, joint stability, and co-ordination (Araujo 1997). Finally, exercising during pregnancy is of concern because... click here to read the article (PDF 149KB).

4. Gestational Diabetes

Gestational diabetes mellitus, or GDM, is similar to type 2 diabetes, but it diminishes after pregnancy. This condition occurs in up to six percent of women during pregnancy. If you have GDM or are pregnant and have type 2 diabetes, your health care team must monitor your condition closely. In addition, pregnancy may hinder your action plan if you are not aware of the potential problems. Those with type 1 diabetes who become pregnant need to be monitored exceptionally closely during pregnancy and should not start any new exercise or continue physical activities without explicit clearance by a physician experienced in the field of reproductive endocrinology.

Pregnancy, especially in women with diabetes, alters glucose metabolism. Like type 2 diabetes, gestational diabetes is caused by insulin insensitivity or resistance. And just as it is in those with type 1 and type 2 diabetes, good glucose control is very important in those with gestational diabetes. But the condition for women with GDM is somewhat different... click here to read the article (PDF 135KB).

THE DIABETIC CLIENT

1. Living with diabetes

Living with diabetes isn’t easy. You know that diet and exercise are important in controlling your blood glucose, but how do you find balance in these areas without letting them take over your life? The answer lies in understanding how your body reacts to both diet and exercise, and finding the practical solutions that allow you to enjoy your life and your health.   In most cases, exercise plays a vital role in diabetes prevention and is paramount in the treatment of this condition. But, most important, exercise can play a major role in preventing complications associated with diabetes that can hinder your ability to thrive in your life.           

Diabetes and the role of exercise in the treatment of this disease may seem complicated or confusing at first. Your GP may have told you that exercise is important but may be dangerous to your health if you do not plan your exercise, medication, and meals according to a specific schedule. Or perhaps... click here to read the article (PDF 135KB).

2. Planning your lifestyle

You may already have a plan that allows you to live with diabetes. But, it’s likely that you’ve approached us at PPUK to find a better way to improve and enjoy your health. It’s no secret that planning ahead for any endeavour is crucial for success.

Lifestyle is a personal matter. It represents who you are, what you believe in, and what stage of life you are in. So why should you make plans for a new lifestyle? You already know that glucose control should be your goal. So why don’t you just go on a diet, start your own exercise programme, lose weight, and control your glucose? Well, we all know the answer: It’s easier said than done! To do all these things you must... click here to read the article (PDF 135KB).

3. Making glucose control your goal

Diabetics are characterised as having abnormally high blood glucose levels. The main difference between type 1 and type 2 diabetes is in the treatment: Individuals with type 1 diabetes require treatment with an external source of insulin, and those with type 2 diabetes are typically treated initially with a modification of their diet and exercise habits because exercise can make the body more sensitive to insulin (Devlin 1992).

However, some people with type 2 may require medication to help them produce more insulin or make them more sensitive to it. Some with type 2 may even require injections of insulin to control their glucose levels.

The main goal of treating diabetes is to prevent complications of the disease. Many studies have shown that... click here to read the articel (PDF 163KB).

4. The type 1 diabetic

The type 1 diabetic can improve cardiovascular conditioning and accrue other health-related benefits by exercising three to five days per week. Daily exercise is often unrealistic for type 1 diabetics and can increase the risk of other complications. Type 1 diabetics who have no complications can exercise at 55 to 75 percent of functional capacity or a rating of perceived exertion (RPE) of 3 to 5, using a 10-point exertion scale. Sessions will last about 20 to 30 minutes to optimise fitness and health-related returns. Using a predictable and consistent pace is highly recommended. Resistance training in type 1 diabetes is recommended in most cases. Strength training can... click here to read the article (PDF 137KB).

5. The type 2 diabetic

The focus of the type 2 diabetic’s programme is to make lifestyle changes, lose weight, and burn calories by using moderate effort. This programme resembles something akin to an overall health and weight management programme. If there are no complications, often the same type of programme can be used as that for an obese or de-conditioned exerciser.

The type 2 diabetic should endeavour to do the following:

- Lose weight and make better nutrition and food choices.

- Decrease blood pressure and eliminate cardiovascular disease risk factors.

- Increase activity that includes cardio-respiratory, resistance training, and stretching exercises.

Many type 2 diagnoses for diabetes are believed to be more related to... click here to read the article (PDF 138KB).