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Question:

From Oklahoma, USA:

I have been a Type 1 diabetic for 19 years. I am now 31 years old and I have a weight problem. No matter what I do I can not lose weight. What can I do short of not eating to lose weight? I already eat right, exercise and take my medicine properly.

Answer:

First of all, I trust that you are in good metabolic control and that you check your blood glucose before and after exercise and if need be during. The key to losing weight is knowing the total amount of calories you take in and the total amount of calories that you expend. If you take in more calories than you expend you will gain weight. If you take in the same amount of calories you expend you will maintain weight. A simple rule of thumb, and one that most people know, is that weight loss occurs when energy expenditure exceeds energy intage (negative energy balance). Make sure you are correctly calculating the total energy you are eating with regard to total caloric intake.

The second part of the equation is exercise. The type of activity you need to be engaging in should be aerobic in nature. This means you are using large muscle groups, the activity needs to be continual and rhythmical in nature. (brisk walking, bike riding, rollerblading).

Being fit involves:
 
Frequency: How many days a week do I need to engage in aerobic activity? (5 to 6 days a week)
Intensity: How hard do I need to work at this aerobic activity? (Low to moderate intensity) 13 to 15 on the Rate of Perceived Exertion Scale
Rate of Perceived Exertion (RPE):
6 14
7 Very, very light15 Hard
816
9 Very light17 Very hard
1018
11 Fairly light19 Very, very hard
1220
13 Somewhat hard 
(From Borg, GA: Med Sci Sports Exerc, 14:377 - 387, 1982)
Duration: How long do I need to engage in this aerobic activity? (45 to 60 minutes a session)

Before you start to make changes in your lifestyle, sit down with your physician, endocrinologist and/or diabetes team and discuss your plans for exercise. You physician may want you to have a stress test before you engage in any structured exercise/physical activity program.

PL

Original posting 28 Sep 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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