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Diabetes Forecast

The Healthy Living Magazine

Choosing the Best Personal Trainer for You

By Kimberly Goad ,

Peopleimages/iStock

Finding a personal fitness trainer is a little like dating: Looks matter more than they should.

In a study in which people were asked about their reasons for choosing a particular fitness trainer, they equated a fit, toned body with competence. None of the study participants even asked whether their trainer was certified to do the job.

Here’s why that can be a mistake if you have diabetes, and especially if you’re living with diabetes-related nerve damage: “People with diabetes are more prone to overuse injuries and can even develop undetected ulcers and other sores on their feet due to exercise,” says Sheri Colberg-Ochs, PhD, a fitness consultant with the American Diabetes Association and author of Diabetic Athlete’s Handbook: Your Guide to Peak Performance. It helps if the trainer understands more about diabetes and its potential consequences, she says.

With more than 279,000 fitness trainers in the United States, according to the Bureau of Labor Statistics, how do you figure out who is—and isn’t—legit? Answers ahead.

Find the Right Personal Trainer

Step 1: Collect Names

Ask your health care professional, as well as friends or relatives with diabetes, to recommend a personal trainer—especially if you don’t know a bench press from a bicep curl. Another good place to look: the United States Registry of Exercise Professionals (usreps.org). The national database of fitness pros lists trainers who’ve been certified by the National Commission for Certifying Agencies, considered the gold standard in the fitness world. “There isn’t a huge pool of trainers who have experience working with people who have diabetes, especially type 1,” says Cliff Scherb, an elite athlete with type 1 diabetes and founder of TriStar Athletes.

Step 2: Check Credentials

Sure, the Hugh Jackman clone at the gym looks the part, but is he qualified to be your personal trainer? “That can mean qualified by experience—they have a history of working with clients who have diabetes—or qualified by education and certification,” says Richard Cotton, national director of certification for the American College of Sports Medicine. “It’s important to look into these claims of experience.” For more info, check out “Does Your Trainer Have the Right Creds?”

Does Your Trainer Have the Right Creds?
The alphabet soup of credentials following a trainer’s name can be confusing. Look for someone who’s been certified by any of the organizations that fall under the National Commission for Certifying Agencies umbrella, including:

ACSM: American College of Sports Medicine*

NASM: National Academy of Sports Medicine

NSCA: National Strength and Conditioning Association

For a complete list, go to credentialingexcellence.org/ncca.

*Offers diabetes certification for trainers

Step 3: Ask Questions

Some examples: What’s your experience working with people who have diabetes? Were your clients diagnosed with type 1 or type 2? What’s your strategy when someone goes low during a workout? Have you ever trained someone who’s on intensive insulin therapy? Ask for the contact information of clients who share your health issues.

Other questions to ask: Are health care providers referring their patients to you? What’s your education? “If someone doesn’t have a college degree, you need to scrutinize that trainer much more carefully,” says Cotton. Here’s why: Research suggests that trainers with five years of experience under their belts but no college degree fall short on basic  fitness knowledge.

Step 4: Talk About Expectations

After a trainer has proven he or she has the credentials to work with someone who has diabetes, ask about his or her style to make sure it syncs up with yours. Does the prospect of working out regularly with a drill sergeant appeal to you? Or would a cheerleader be more motivating?

Then ask about the regimen itself. “You want to see if they can work with you given whatever physical limitations you may have,” says Colberg-Ochs. “If you have joint issues, you may not want to do heavy resistance training because that might aggravate them. Maybe you’ve got neuropathy in your feet and you can do weight-bearing stuff—but not with an unhealed ulcer. You don’t want to do anything that aggravates your joints or preexisting problems.” 


Q: What’s the difference between a personal trainer and a physical therapist?

A:A personal trainer’s job is to improve your level of fitness. A physical therapist’s mission is to rehabilitate you after an injury or a health-related condition that’s limiting your ability to perform everyday activities. Personal trainers mostly do their jobs in gyms, while physical therapists tend to work in hospitals and health care clinics. Another big difference: Sessions with a personal trainer are rarely covered by insurance, but those with a physical therapist often are.


Get Personal

Before you step foot on a treadmill, tell your trainer:

These Are My Issues.

Bring your trainer up to speed on the specifics of your condition before your first session. “There are a lot of things we take into consideration when we prescribe an exercise program for someone with diabetes,” says Jacqueline Shahar, MEd, RCEP, CDE, manager of the Clinical Exercise Physiology Department at the Joslin Diabetes Center in Boston. 

For instance, if you have an overuse injury such as tendinitis or bursitis, let your trainer know so he or she can design your workout accordingly. If you wear an insulin pump or continuous glucose monitor (CGM) sensor, explain where it’s attached so it doesn’t get in the way. And let your trainer know the potential side effects of your medications so he or she can pick up on cues if necessary. 

Gretchen Kubacky, a health psychologist in Los Angeles, was diagnosed with type 2 diabetes at age 33. She told her trainer at the outset: “I’ll always have a snack with me. If I … don’t seem quite right, you should poke me in the shoulder and tell me to eat something.”

Don’t Go (Too) Easy on Me.

You haven’t hired a trainer to coddle you. Make it clear that you can be pushed and coached just like anybody else—unless, of course, you have an injury or diabetes-related complication, such as retinopathy. With proliferative retinopathy, it’s important to avoid pressure in the retina, which can happen if your head is below your heart during exercise moves. And because “exercise increases the pressure in the retina, someone with diabetes should get clearance from an ophthalmologist before engaging in any exercise program,” says Shahar.

I Know How to Manage My Diabetes.

It’s up to you—not your trainer—to know if your blood glucose is running high or low. (The American Diabetes Association’s 2017 Standards of Medical Care in Diabetes suggests that people on intensive insulin regimens check their blood glucose before and after exercise.) Your trainer should, however, know enough about diabetes to be able to respond accordingly. “The first conversation I have with a new trainer,” says TheFitBlog.com’s Christel Oerum, “begins with: ‘I have type 1 diabetes and I manage it with insulin. That means I am at risk of going low or high when I work out, depending on the exercise. Right now, I wear a sensor on my abdominals—a CGM that measures my blood sugar continuously and sends results to my phone. That’s why I look at my phone all the time.’ ” 

 
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