Healthy Habits - Managing Diabetes

 April was Defeat Diabetes Month. Initiated by the Defeat Diabetes Foundation (D.D.F), it helps to raise awareness about the preventable nature of Type 2 diabetes and focuses on the multitude of lifestyle and dietary changes that can be implemented to minimize the chances of contracting the disease.

I had a chance to interview Justin Kompf, Ph.D., author of Health Habits for Diabetes, about diabetes and wellness.

What is the role of exercise in managing diabetes?

 

Exercise plays an important role in diabetes management. First, evidence suggests that exercise can improve fasting glucose, HBa1c levels, and can aid in weight loss. Next, some exercises like resistance training can contribute to increases in lean muscle mass which can also help with glucose regulation.

 

 

What is some of the latest research in managing diabetes?

 

Probably the research on obesity fighting medications. These were originally used for diabetics at lower doses. The most recent research is on semaglutide with higher doses than those traditionally used for diabetes (Ozempic and Wegovy are the brand names). People lost about 15% of their body weight using these medications over the course of a little more than a year. These drugs also have positive effects on metabolic health. Keep an eye out for research using tirzepatide (brand name Mounjaro) as well. Recent research looks like it may be more effective than semaglutide (https://www.nejm.org/doi/full/10.1056/NEJMoa2206038). Weight loss is crucial for managing diabetes so look for future research that includes detailed explanations of lifestyle interventions along with the use of these drugs for weight loss maintenance.

 

What are some self-motivation techniques for creating and maintaining healthy habits?

 

This is a good question, because a lot of people want to change their habits. If we think of behavior as occurring with the dichotomous outcome of yes it occurred or no it did not occur, we need to think about three things. First is the difficulty of the task, next is the level of motivation the person has, and the third is the prompt to act.

 

I’ll start with the last point. No prompt to act or no plan to act almost always means a person won’t act. This is an easy one to address. Always make sure you have a plan in place. Sometimes low motivation masks itself as just not having a plan of action.

 

Next, if the task demand is too high and motivation is too low people don’t act. So that leaves us with two options. The first is my favorite, just make the task easier. I’d have to be really motivated to solve a complex math problem but if you asked me to do some simple multiplication it wouldn’t really matter how motivated I was, I’d just be able to do it because it’s easy. In my consultations with people (https://www.joinsequence.com/) at Sequence, a medical weight loss company, I tell people that habit and routine doesn’t care about intensity or duration, just about action. When people are trying to build a habit, just make sure you take action in the beginning. For example, if I was going to do a 30-minute strength training workout on Wednesday at noon but didn’t feel like it, I could always just do one set of all of my exercises instead of three. I’m still building a habit. But miss a planned routine and you break the habit. So, the second point is to make it easy.

 

The harder thing to do is to boost your motivation. But it can be done. I tell people to find ways to make it enjoyable. Maybe that means listen to your favorite podcast on a walk or watch your favorite show on the treadmill. I try to get people to connect their goals to something with deeper meaning. For example, to be a good role model to your children. In that case, each time you exercise it is in service to some value that you deeply care about. Then I tell people to focus on outcomes they can control. Are you getting more technically competent with your exercises, are you improving your aerobic fitness or strength.

 

 

How can people create - and stick to - new lifestyle habits?

 

I think I might have hit this above but in my book, Health Habits for Diabetes, I talk about how good intentions cannot overcome a bad system. I think this is important. Your system is all the sources of influence in your life. It’s your own thoughts and feelings, your social networks, your environment. I believe these things need to be in place to be successful

1.    Pick an exercise routine you feel capable of doing – don’t make it too challenging off the bat. My motto is consistency before intensity

2.    Plan, plan, and then plan some more. Block your exercise time out in your calendar and guard that time

3.    Make sure your options for exercise are convenient. Have equipment at home. Make sure your outdoor shoes are visible.

4.    Recruit social support- exercise with friends

5.    Focus on becoming- if we get to a point where all the evidence suggests that we are a person who exercises we really don’t need to rely on willpower anymore. To get there, focus on how exercise or your new healthy habit connects with your values. Find places to be healthy where you feel a sense of community (maybe that is a gym studio, a support group). Focus on skill improvement. Can I make more complex health dinners? Can I do more complex exercises? 

Justin Kompf, PhD, has worked in the fitness industry since 2009 as a college strength and conditioning coach and personal trainer. He has an MS in Exercise Science and has a PhD in Exercise and Health Sciences with a focus on Health Behavior Change from the University of Massachusetts at Boston. Justin has taught at the State University of New York at Cortland and also at the University of Massachusetts at Boston. He has published work in the Strength and Conditioning Journal, Sports Medicine, the Journal of Physical Activity and Health, and the American Journal of Lifestyle Medicine. He has contributed his expertise in health behavior change to personal training certifications and nutrition certifications with the National Academy of Sports Medicine.