Taking Control of Your Diabetes features a team of experts giving you the inside scoop on diabetes. Today, meet fitness expert and host of our exercise segment “Get Your Move On,” Larry Verity.

UCSD-TV: How has being a diabetic influenced your life and career?

Larry Verity: I was diagnosed with type 1 diabetes when I was 22 years old and just beginning my Masters degree in Sports Medicine at the University of Virginia. At the time, I was working at Virginia Military Institute and commuting to UV for classes. When I was diagnosed, I honestly thought I was going to be just like a college-mate named Richie. He would have severe insulin reactions. Needless to say, I have learned that diabetes is quite heterogenous and everyone has their own little quirks regarding strategies for managing their diabetes.

When I was diagnosed type 1 diabetic, the best bit of information I could have been given (at the time) was by the nurse at Stonewall Jackson hospital. Her advice was “read all you can about your disease – it may be helpful!” Knowing how diligent my friend Richie was in trying to manage his diabetes, along with being told to read about diabetes, spurned my desire to know all I could about my disease.

After earning my Masters degree, I worked at the University of Lowell as the head athletic trainer; however, I continued to read whatever I could. I guess I really wanted to go back to school to learn more about my disease, but also about exercise physiology. So…I went to Purdue University to study exercise physiology and developed a keen desire to do research in diabetes. There I realized that type 2 diabetes was far more capable of being favorably modified via regular exercise than was type 1 diabetes. From this point, I began to use exercise and type 2 diabetes as my primary focus of research and ultimately completed my doctorate dissertation on “The Biochemical, Physiological, and Psychological Effects of Exercise in Type 2 Diabetes.”

From Purdue University, I went to San Diego State University and have mostly looked at exercise and type 2 diabetes.  I honestly believe that being diagnosed type 1 diabetic shaped my professional life and my academic career. Although it’s been devoted principally to type 2 diabetes, I still understand and am fairly well-versed in type 1 diabetes.

UCSD-TV: Why is exercise such an important tool for diabetics?

LV: Exercise is an incredibly important tool for all persons with or without diabetes. In 1996, the US Surgeon General released a report on Physical Activity and Health, with the “take home” message of IF you can’t find time for exercise, you will HAVE to find time for disease. Most of the disease onset identified were strongly related to lifestyle (e.g., cardiovascular disease; hypertension; peripheral vascular disease; stroke), and exercise was shown to have significant effects to favorably modify an assortment of risk factors linked with the onset of disease.

Those diagnosed with diabetes are 2-4 times more likely than those without to suffer from the diseases identified above. Moreover, the risk factors linked with the disease onset are favorably modified through exercise (e.g. cholesterol transport – HDL; blood pressure reduced; body fat + weight and composition management; etc.). So at the outset, diabetics have a tremendous amount to gain from engaging in regular exercise from a disease onset perspective.

Additionally, physical activity helps to make insulin more effective (whether type 1 or type 2 diabetic), which has a direct impact on how well the muscle uses glucose. Although pre-exercise glucose levels may influence the favorable lowering of glucose during exercise, the large majority of “benefit” of exercise is to enhance the skeletal muscle “machinery” (intramuscular processes by which muscle uses glucose), improve insulin action (sensitivity), and potential lowering of blood glucose. It must be recognized that “lowering of blood glucose” is not necessarily the most important benefit of exercise (although it can be one of the outcomes).

The improvement in metabolic functions is one of the most important outcomes of exercise. Improved work capacity, lowering of blood pressure, and facilitating improved mental and psychological health are real cornerstones of regular physical activity.

UCSD-TV: A busy schedule is the easiest excuse for not making time to exercise. What are some ways that people can incorporate exercise into their hectic lives?

LV: We all are willing to “schedule” a business meeting, client, or other professional aspect because it is an important part of one’s job!? Well…exercise needs to be scheduled, as well!! It is for maintaining physiological and psychological health. Setting oneself as a “higher” priority is paramount AND it takes a lot of effort. Sometimes it may be thought that “selfish behavior” is a negative thing; however, in this case, it is very important.

For diabetics, incorporating physical activity of some type into their daily lifestyle is essential, AND being selfish about yourself is A-Okay! Now, being able to schedule means you have to have a plan that works for you AND stick with the plan – even when it seems that “skipping” the workout would be fine. Remember: we don’t plan to fail; we just fail to plan our livelihood – especially the “activity” part!

Physical activity doesn’t always have to be planned – it can be obtained through activity like housework or yard work! Whether at home or on a trip (business or vacation), plan to take a walk and explore an area that you like, or have never seen. Using a pedometer can provide beginners and “veterans” with immediate feedback on how much activity they have performed too! I think the bottom line is: Diabetics need an activity toolbox and the above-mentioned “things” are essential ingredients for everyone’s toolbox!!

UCSD-TV: As a college professor, you work with the next generation of nutritionists, trainers, and health care providers. What lessons do you hope they take with them about exercise and diabetes?

LV: In my teaching, I always put forth the “reality” of diabetes – a disease that has significant impact on disease-risk and complications. HOWEVER, it is a disease that can be managed (versus a disease like cancer, where one with cancer may have very little ability to manage it). Understanding self-management and good control are the most important aspects when working with diabetics. Diabetes requires a “team” of professionals because of the many “issues” to address in the health of a diabetic.

For health-care practitioners to recommend exercise to anyone with diabetes, it is critical that the diabetic understand his/her disease AND is able to manage his/her disease reasonably well. OTHERWISE, it is best to incorporate exercise after these “skill sets” have been improved upon.

Another of my sayings – exercise is like aspirin (medicine) – IF you don’t take enough aspirin, your headache may not be lessened, whereas IF you take the entire bottle, you can die. Exercise is medicine and health-care professionals must know how to use or implement a program so that it is safe, effective, reasonable, and prudent! (IF you adhere to these last four elements, the health-care practitioner will have very low likelihood of ever having a litigious issue come to fruition!)

Finally, I always make sure that they know whether their client has any type of co-existing disease(s) or complications. If so, it is always wise for their diabetic client to undergo further evaluation to identify more specifically “what” this diabetic can perform – safely!! Last but not least – always make sure that the diabetic carries identification (bracelet or necklace); has some source of immediate carbohydrate in case of an insulin reaction; has their glucometer with them (if at the gym) to monitor blood glucose before and after exercise.

UCSD-TV: What do you hope viewers will gain by watching the TCOYD series?

LV: I hope that viewers will gain an appreciation for the simple things that can help improve the livelihoods of those with diabetes. Simple things like healthier eating, losing/managing weight, being physically active, monitoring blood glucose, and understanding how daily events influence glucose levels. I also hope that viewers become motivated to help themselves or others who have diabetes. From an activity perspective, I hope that viewers gain an appreciation for the small things that they can do to help improve physical function and health.