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August 2, 2007

This is from the weekly " Diabetes In Control " magazine I get on E-mail.

Exercising with Complications: Eye and Kidney Disease

Dr. Sheri Colberg, author of The 7 Step Diabetes Fitness Plan: Living

Well and Being Fit with Diabetes, has the more help with your patients

who need exercise.

Exercising with Complications: Eyes and Kidneys This is a good one to

print out add to your handouts.

Exercising with Complications: Eye and Kidney Disease

By Sheri Colberg, Ph.D., FACSM

Diabetic Eye Disease

People with diabetes are prone to developing all sorts of eye

complications, including cataracts and retinopathy. While cataracts can

obscure your vision

and make participation in certain activities (such as cycling outdoors)

more dangerous, they're not usually considered a barrier to

participation in physical

pursuits. On the other hand, more severe forms of eye disease, such as

proliferative diabetic retinopathy, cause your eyes to form weak,

abnormal blood

vessels in the back of the eye (the retina) that can break, tear, or

bleed into the vitreous fluid in the center of your eye, filling it with

blood that

can obscure vision temporarily or permanently. If you have severe eye

disease, you will need to make greater changes to your exercise regimen

to prevent

bleeding into your eye.

While exercise itself has not been shown to accelerate the proliferative

process, certain precautions may be needed to prevent intra-ocular

hemorrhages

or retinal tears. If your eye disease is only mild or moderate, with no

active bleeds, then you should simply avoid activities that dramatically

increase

the blood pressure inside your eyes, such as heavy weight lifting or

activities during which your head is lower than your heart. If you have

moderate to

severe diabetic eye disease, you'll want to avoid all jumping, jarring,

or breath-holding activities, as they increase the pressure inside your

eyes and

can cause more bleeding and increase your risk of retinal tears or

retinal detachment. Activities best avoided include boxing, competitive

contact sports

(such as basketball and football), jogging, high-impact aerobics, most

racket sports, and heavy weight lifting. If you have an active retinal

hemorrhage

or notice sudden, dramatic changes in your sight, stop any activity you

are doing immediately and check with your eye doctor for further

guidance.

Diabetic Kidney Disease

Luckily, exercise does not appear to worsen nephropathy--otherwise known

as kidney disease-- common to diabetes. Intense or prolonged exercise

would not

usually be recommended for you if you have overt kidney disease, but

only because your exercise capacity is likely to be limited. Light to

moderate exercise

is fine, though, and even patients requiring dialysis can exercise--even

during their dialysis treatments, if they want to--with no ill effects.

If you

are undergoing dialysis, exercise would only be advised against if the

levels of certain substances in your blood (hematocrit, calcium, or

potassium) become

unbalanced as a result of the treatments. People who have undergone

kidney transplants due to end-stage kidney disease can safely exercise

six to eight

weeks after surgery, once they are stable and free of signs of rejection

of the new kidney.

You may not be aware that exercise itself can increase the excretion in

your urine of protein and/or microalbumin, which are traditionally used

by your

doctor as indicators of kidney problems. For your peace of mind, and to

prevent false conclusions, abstain from exercising on any day that you

are collecting

your urine for either of these tests so that your results will not be

erroneously skewed and misinterpreted as evidence of kidney damage or

disease progression.

In two weeks, I will share more tips and ideas from my latest book, The

7 Step Diabetes Fitness Plan: Living Well and Being Fit with Diabetes,

No Matter

Your Weight (2006). Information about all of my books, my many

articles, my research, and more is available on my web site:

www.SheriColberg.com.

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