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Diabetes & Exercise Solutions – No Time, Too Expensive, Painful, Boring, Unmotivated

by Adam Brown

twitter summary: 21 strategies to overcome key #diabetes #exercise barriers – no time, inconvenient, $, boredom, discomfort, and low motivation

Adam Brown headshot

“Well, I know I should exercise, but ____.”

The brain is an excuse machine – give it an inch and it will take a mile. I’ve found this is especially true with exercise, where there always seems to be a darn good reason to skip it. This article is the first of a two-part series on the biggest barriers I’ve encountered when it comes to exercising with diabetes. Below are some of my personal strategies for dealing with (i) time/convenience/cost; (ii) boredom/mental or physical discomfort; and (iii) low motivation. Of course, what I do may not work for everyone. Diabetes is all about personal problem solving, and you have to figure out what works for you! As always, I emphasize that I’m not a healthcare provider – just someone with diabetes that is passionate about exercise, diet, and wellness.

This article is intended for everyone – even if you do NO exercise right now. I hope it shares some helpful solutions or, at minimum, gets you thinking about your own barriers to exercise. Please let me know what you think by email or on Twitter. Part two of this column will discuss hypoglycemia, hyperglycemia, and tiredness.

I. TIME/CONVENIENCE/COST

I’ve grouped these three barriers together, since I’ve found the solutions align:

Make exercise a priority

Getting some activity is in my top five priorities every day, along with spending time with my favorite people, giving something, learning something new, and eating well.

Schedule exercise into my daily routine

Exercising in the morning is essential for me. Once the workday begins, it’s so much harder to pull away and get activity in. As the late leadership thinker Stephen Covey said, “The key is not to prioritize what’s on your schedule, but to schedule your priorities.” Morning exercise is also a terrific insulin-free way to correct a high, improves my daytime blood sugars, and makes overnight hypoglycemia far less likely.

Riding my bike

Buying a road bike is one of the single best purchases I’ve ever made, and aside from regular maintenance, it costs nothing to use. I grab it and walk out my front door – the ultimate convenient workout! Riding regularly brings me endless happiness, along with lower blood pressure and body weight.

Walking

As I discussed in a previous column, I shoot for 10,000 steps per day (as measured via a Fitbit). Even if I can’t get a real “workout” in, I know that getting 10,000 steps per day is enough to meet the CDC’s recommended levels of activity. Over the past year, I’ve logged 3.69 million steps (10,109/day - no coincidence!), far more than if I hadn’t tracked it.

Use an app

My go-to exercise apps (in order of frequency):
- Strava
- Fitbit
- myWOD (great timers; Apple, Android)
- Yoga Studio (incredible app for Apple devices)
- 7 Minute Workout (gorgeous design and endless exercise variety for all skill levels, no equipment required)

Other popular apps: RunKeeper, MapMyRun, Full Fitness, Fitstar, Fitness Buddy, hundredpushups.com, Training Peaks

Create my own “home gym”

Instead of paying $50+ per month to join a gym here in San Francisco, I made my own setup at home:
- Pullup bar (~$25 on Amazon)
- Kettlebell (~$10-$50 on Amazon)
- Resistance Band (~$15 on Amazon)
- Dumbbells (~$2-$30+ on Amazon)
- Yoga mat (~$20 on Amazon)

These tools offer an endless range of exercise options. Though I don’t have the complete variety a fully equipped gym offers, I can generally get 90% of the workout quality with 10% of the cost in my own home!

Use interval training

Alternating bursts of activity with short rest periods crams more work into less time – and studies show it can be just as effective as much longer exercise sessions!
- On a bike, walking, or running, do a maximum effort for 30 seconds; rest for 60 seconds. Repeat 4-6 times. [Other options are 20 secs/40 secs or 1 minute/2 minutes]
- Tabatas: 20 seconds of one exercise + 10 seconds rest x 8 = 4 minutes (one interval). It’s best to alternate between different exercises: 20 seconds of pushups, 10 seconds of rest, 20 seconds of squats, 10 seconds of rest, repeat 4 times. I invent workouts with tabatas that choose from different exercises: kettlebell swings, pushups, pull-ups, band crunches, planks, jumping jacks, etc.

II. BOREDOM/MENTAL OR PHYSICAL DISCOMFORT

One thing I’ve learned about exercise is that it’s a game of psychological warfare – with myself! I often have to trick or distract my mind to ignore how I feel and prevent an endless stream of complaints.

Find activities I like (ideally outside)

Like anything else in life, if exercise feels like a chore, it’s really hard to stick with it. But when exercise is fun, I actually look forward to it. For me, being outside makes a huge difference: strength training on my back porch, cycling, tennis, hiking, and yoga.

Smile!

It sounds simple, but so much research now suggests our body language influences our mental state. When exercise feels painful and I just want to quit, forcing myself to smile actually helps A LOT. I recently found out that four-time World Ironman Champion Chrissie Wellington actually writes “smile” on all her water bottles as a reminder. [On this topic, I highly recommend this tremendous TED talk on the impact of body language, as well as the book The Charisma Myth by the remarkable Olivia Fox Cabane.]

Set mini-milestones

It’s funny how easy it is to trick myself by saying, “Just ride to the top of that hill” or “Just do one more set of 10 reps.” Once I accomplish my mini-milestone, I can set another one – “Now ride to that bridge up there” or “Now just five last reps.” This strategy helps break up longer exercise sessions into bite-size chunks.

Podcasts/audiobooks/TED Talks

These are great while strength training, walking, or running. There are literally endless options out there – a true goldmine of excellent, free content. I like the podcast (Android, Apple) and TED apps (Android, Apple). [I don’t ever listen while I’m riding my bike though – that would be a major safety mistake.]

Mind wandering

Endurance exercise is a great time to think. I often let my mind wander for minutes at a time, brainstorming new ideas or thinking about challenges I’m facing in my life. Often, I get lost in thought, and 10 minutes can pass by without noticing I’m exercising. I’ve found it helpful to spend a few minutes before exercise coming up with a couple mind-wandering topics.

Counting or Focusing on my Breathing/Motion

During bike rides or strength training workouts, I will often count up to 10 and back down to 1, or simply focus on my breathing or the way my feet are moving. The focus required diverts my mind from complaining.

Mix strength and cardio

I alternate strength-training days with cycling days. The variety keeps things interesting and helps hit the CDC’s physical activity guidelines. When doing both strength and cardio in the same workout, I opt for the strength stuff first; it tends to keep my blood glucose flatter and prioritizes my energy for the muscle building work.

Find a friend

While personally I tend to like exercising alone, it’s amazing what a difference companionship makes – the time flies, activities feel so much more enjoyable, and you can hold each other accountable. It’s key to find someone at a similar skill level. 

III. NOT MOTIVATED

Here’s how I overcome low motivation to exercise:

Think of how great I will feel after I exercise

Sometimes, I wake up in the morning and the last thing I want to do is exercise. But those feelings often pass when I visualize how great I will feel after exercise. The bed may be comfortable, but I know my entire day will go better if I just get up and move.

Choose a motivating, slightly scary goal

I’ve found that the right exercise goal should be specific, measurable, and feel like a bit of a reach. This year, my cycling goals are to ride 4,000 miles for the year and do a 200-mile bike ride. These are 25% and 61% longer than last year, respectively. I’m not positive I will complete these goals, but they sure are motivating! I’m also a huge fan of signing up for exercise events, such as supported bike rides, charity events, or running races. [I loved the JDRF Lake Tahoe Ride!] I’ve seen friends experience a serious boost in motivation by signing up for their first public event, especially when they do it with a buddy.

Set short-term milestones in the context of longer-term goals

Last year, my goal was to ride my bike 3,000 miles for the year. That felt truly daunting, so I broke it down into a weekly goal of 60 miles. By focusing on the smaller goal each week, I knew I’d accomplish my grander goal for the year. The result was crossing 3,000 miles two months ahead of time in November – I was ecstatic!

It’s easy to underestimate how much I can accomplish in a year, and chipping away in small chunks works wonders.

Don’t expect results immediately

It’s tempting to look for results in a matter of days, but the body doesn’t work that way – adapting to exercise happens over a matter of weeks and months. Taking a long-term view and expecting results in 4-6 weeks helps motivate me to keep at it.

Measure progress via an app/piece of paper

Feeling a sense of progress is core to the human condition. When I measure how I’m doing through an app or device, I can celebrate improvement. It’s an awesome, addicting feeling. Strava and Fitbit do a particularly great job of awarding badges to celebrate progress. But no app is needed – a piece of paper, a calendar on the wall, a whiteboard, stickers, a scale, or pretty much anything else can also help document progress.

Remember the health benefits – for diabetes and beyond

Exercise can improve blood sugars, reduce blood pressure, lower body weight, reduce the risk of depression, and increase happiness – and that’s only a partial list. It’s like the ultimate drug!

Part two of this article will include tips on overcoming hypoglycemia, hyperglycemia, and tiredness. I love hearing from readers – please don’t hesitate to write me with feedback by email or on Twitter, especially with the strategies or resources you find most helpful.

Special thanks to designer Priscilla Leung for this article's graphic.

Adam is the Senior Editor of diaTribe and Chief of Staff at Close Concerns. He was diagnosed with type 1 diabetes at the age of 12 and has worn an insulin pump for the last 11 years and a CGM for the past three years. Most of Adam's writing for diaTribe focuses on diabetes technology, including blood glucose meters, CGMs, insulin pumps, and the artificial pancreas. Adam is passionate about exercise, nutrition, and wellness and spends his free time outdoors and staying active. 

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