Phil Johnston's has highlighted sections relating to exercise and physical activity, with occasional comments from:

How is Diabetes managed?

Along with regular measuring of blood glucose levels, a healthy diet, exercise and, where necessary, medication, form the basis of a Diabetes management plan.

The latest research shows the best ways to help control Diabetes are to:

• lead a healthy lifestyle including healthy eating and exercise, and have regular checks of your eyes and feet.

Looking at your diet, smoking status and exercise levels can also help assess risk. Having these checks can help prevent further problems, especially with the feet and eyes.

Hyperglycaemia is when blood glucose levels are too high, especially when over 11mmol/L (millimoles per litre) if measured at any time of the day, or 7mmol/L if tested after fasting.

The symptoms of hyperglycaemia include some or all of the following:

• excessive thirst;

• frequent urination;

• fatigue;

• unexplained weight loss;

• vision problems, such as blurring; and/or

• increased susceptibility to infections such as thrush.

Without treatment, hyperglycaemia can lead to serious damage of organs including the kidneys, eyes and nerves. It is also a significant risk factor for coronary artery heart disease and other blood vessel diseases.

High levels of blood glucose may result if:

• you have missed your dose of insulin or Diabetes tablets or have changed your eating pattern;

• you have an illness or infection;

• you are taking medications like cortisone injections or tablets;

• you are under emotional stress;

• you have been inactive;

• your Diabetes medication/insulin needs review; and/or

• your medication dose does not match your diet and your activity, given the level of illness you may have.

If you have hyperglycaemia, test your blood glucose frequently, keep taking your Diabetes medication and try to maintain food and fluid intake. If hyperglycaemia persists, make sure you contact your doctor, as you almost certainly need to change your medication or management program and manage your nutrition and activity accordingly.

Achieving the heart health targets often involves addressing your diet, exercise levels and smoking status.

Try to be active every single day – that doesn’t necessarily mean going to the gym or running. Just brisk walking for 30 minutes a day can give health benefits. You can even divide this into three lots of ten minutes if that’s easier. Garden, ride a bike, play with the children, walk the dog – just get moving.

Always remember that some activity is better than none and more is better than a little. You should see your doctor before beginning an exercise program, especially if you are overweight, have health concerns or have not exercised for a period of time.

Depression is reported to be two to three times higher in people with Diabetes than in those without. Learn to actively manage worry, stress and anxiety and try to avoid burn out in your working life. Complementary therapies such as remedial massage, reflexology, acupuncture and the Alexander technique can help control stress for some people. Other herbal and naturopathy therapies might also have benefits but you should check with your doctor before you decide to use them. If depression is an issue for you, please see your doctor for help.  NO MENTION OF THE MERIT OF RIGOROUS, CHALLENGING EXERCISE TO COUNTER DEPRESSION.

• Regardless of the type of Diabetes you have, medication is only one part of the overall management picture. Following a healthy eating plan and a regular activity program is just as important for maintaining your long-term good health and wellbeing.

Research has shown that Diabetes has a hereditary component.

Those with several close family members with Diabetes tend to develop the condition themselves at an earlier age.  If Type 2 Diabetes is in your family, adopting a healthy lifestyle can be your best defence to delay the onset of Diabetes or its severity. It’s important to know that evidence suggests that obesity and physical inactivity are the most important risk factors, so make addressing these a priority.

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As yet there is no cure for chronic back pain, however, there are many ways to manage the pain and reduce the impact of back pain on your life. A combination of medical advice, medication, physical exercise, therapies and a positive mindset can help you deal with back pain effectively.

Yoga*

Yoga teaches us the importance of slowing down and listening to the body’s messages. Through postures and slow movements, yoga can help back pain sufferers by stretching and strengthening key muscle groups. Yoga promotes wellbeing by helping the body unwind, stilling the mind and helping to achieve mental focus. It also enhances awareness of the ways we may be contributing to our own pain.  ALTHOUGH AVOID SALUTE TO THE SUN

Walking and swimming are good choices. Talk with your doctor about which activities are best for you. It is important to exercise regularly because an inactive lifestyle contributes to lower back pain. Abdominal and back strengthening exercises help condition the muscles so they work together like a natural ‘corset’ for your back. AGREED

Plan

Tighten your stomach muscles. VERY IMPORTANT

Position

Lift with your legs, not your back. Bend your knees until you are in a squatting position and then straighten at the knees – don’t bend at the waist.

Avoid

Avoid trying to lift something that is too heavy or an awkward shape on your own. Seek help.  Avoid twisting your body. Instead, point your toes in the direction you want to move in and pivot in that direction.

3.      Your guide to positively managing congestive heart failure

an MBF Congestive Heart Failure Action Plan that you can take to your doctor or cardiac rehabilitation specialist to complete (you will find it at the back of this guide). It will help you set physical activity goals and stay on track with your medication. You can learn how to monitor your everyday health and know when to seek help;

Medical evidence has proven that people with heart failure can reduce the risk of further heart disease with a combination of a heart healthy diet, physical activity and the right medication.

Congestive Heart Failure is also known as CHF, Congestive Cardiac Failure (CCF) and Chronic Heart Failure.

The term ‘failure’ refers to the difficulty or inability of the heart to do the job of pumping blood around the body as it needs to do. The ‘congestion’ is the build up of fluid in the lungs or typically, in the feet. If you have heart failure, it means that your heart doesn’t pump blood around your body as effectively as it should.

Instead, it stays in your body. This is known as ‘fluid retention’.  The fluid may stay around your heart and lungs, causing further breathing difficulty and discomfort. The force of gravity can cause fluid to stay down in your lower limbs, in the feet, ankles and calves, causing puffiness, swelling and sometimes tight, irritated skin. This type of swelling is known as ‘oedema’.

Sometimes it can even accumulate in your hands and wrists, or in your lower back if you have to spend a lot of time in bed.

CHF is the result of damage, overwork and/or scarring of the heart. The most common reasons for this damage are coronary heart disease, often after past heart attacks and high blood pressure, which is not well controlled so that the heart has to work against abnormally high pressures in your arteries.

Other causes are heart valve disease and congenital heart problems that you are born with.

We all know the value of a healthy diet and getting enough physical activity or exercise. If you have heart failure, this has never been more important. It is an essential requirement to stay as fit and well as you can. Studies have shown that for people with heart failure there is a close relationship between nutrition, weight, the amount of physical activity and the risk of further cardiovascular disease.

An important part of staying in control of your heart condition is to exercise your heart safely and have excellent nutrition because the vitamins and minerals you take in are important in making sure your cells work to the optimum.

Physical activity of any kind, from walking or gentle stretching to lifting lightweights or cycling is also vital for your heart health and for helping you maintain a healthy weight.

As a general rule:

• try to get active every day;

• do what you can without getting breathless or over-tired – you should be able to talk easily as you do it;

• if you can’t manage one longer session of activity, divide your activity into two or three shorter sessions; and

• avoid strenuous activities that make you breathless unless your doctor has approved them.

It’s important to understand that depression can be treated.

However, if your depression continues for more than two weeks, and your low mood is affecting your ability to carry out your normal routine, it’s best to see your doctor. Dealing with these feelings is part of the path to greater control of your physical condition and your CHF.

Cardiac rehabilitation is an individually tailored program designed to optimise your health and help you carry out your day-to-day activities. Initially the healthcare team (which could include doctors, nurses, physiotherapists, exercise specialists and dieticians) will perform an assessment and create a program especially tailored for you. The program may include exercise training, nutritional advice and education about your condition.

Exercise is also helpful in the management of diabetes, but it may require a different program, so check with your diabetes specialist as to the sorts of exercise you may need to include in the program.

Keep a positive mindset

Keep focused on a positive outcome

4.    Your guide to positively managing diabetes

1. Type 1 Diabetes, also known as insulin dependent Diabetes, occurs when the cells that produce insulin are destroyed or don’t work. It usually affects children and young adults and accounts for 10–15% of all Diabetes cases. With this Diabetes, the exact cause is unknown, but it has a strong family link.  Sometimes a viral infection triggers the immune system to destroy the insulin-making cells in the pancreas. This is called an autoimmune reaction.  While the cause is not related to lifestyle, a healthy lifestyle is very important in helping to manage Type 1 Diabetes.

Along with regular measuring of blood glucose levels, a healthy diet, exercise and, where necessary, medication, form the basis of a Diabetes management plan.

The latest research shows the best ways to help control Diabetes are to:

• lead a healthy lifestyle including healthy eating and exercise, and have regular checks of your eyes and feet.

If you have hyperglycaemia, test your blood glucose frequently, keep taking your Diabetes medication and try to maintain food and fluid intake. If hyperglycaemia persists, make sure you contact your doctor, as you almost certainly need to change your medication or management program and manage your nutrition and activity accordingly.

Try to be active every single day – that doesn’t necessarily mean going to the gym or running. Just brisk walking for 30 minutes a day can give health benefits. You can even divide this into three lots of ten minutes if that’s easier. Garden, ride a bike, play with the children, walk the dog – just get moving.

Always remember that some activity is better than none and more is better than a little. You should see your doctor before beginning an exercise program, especially if you are overweight, have health concerns or have not exercised for a period of time.

Depression is reported to be two to three times higher in people with Diabetes than in those without. Learn to actively manage worry, stress and anxiety and try to avoid burn out in your working life. Complementary therapies such as remedial massage, reflexology, acupuncture and the Alexander technique can help control stress for some people. Other herbal and naturopathy therapies might also have benefits but you should check with your doctor before you decide to use them. If depression is an issue for you, please see your doctor for help.  NO MENTION OF THE MERIT OF RIGOROUS, CHALLENGING EXERCISE TO COUNTER DEPRESSION.

• Regardless of the type of Diabetes you have, medication is only one part of the overall management picture. Following a healthy eating plan and a regular activity program is just as important for maintaining your long-term good health and wellbeing.

Those with several close family members with Diabetes tend to develop the condition themselves at an earlier age.  If Type 2 Diabetes is in your family, adopting a healthy lifestyle can be your best defence to delay the onset of Diabetes or its severity. It’s important to know that evidence suggests that obesity and physical inactivity are the most important risk factors, so make addressing these a priority.