Diabetes Forecast

Answers to Embarrassing Exercise Question

Feel a little urine release during exercise? Wondering what’s up with the red and raw skin around your groin? Experts answer these workout questions—and more

By Karen Asp , ,

Aaron Amat/Bigstock

Q: Whenever I  exercise, I pee a little. What’s the deal?  

A: Certain exercises, such as running, lifting heavy weights, and doing sit-ups, can stress your pelvic floor muscles and make leaks more likely. There are a variety of reasons this can happen. If you’re a woman who has given birth or a man with prostate problems, you may release a little urine during exercise.

Diabetes may also be a cause. It can raise your risk for autonomic neuropathy, in which the nerves that control your internal organs, including the bladder, are damaged. This can result in urinary incontinence—the loss of bladder control—which can make leaking a regular issue, says Rocio Salas-Whalen, MD, founder of New York Endocrinology in New York City and clinical instructor at NYU Langone Hospital. Managing your blood glucose is the best way to avoid diabetes-related incontinence because it reduces your risk for neuropathy, Salas-Whalen says.

If you experience regular leaks during workouts, consider using incontinence pads, which will absorb urine. And skip heavy weight lifting and other exercises that increase incontinence.

Strengthening your pelvic floor muscles can help, too. “Yoga and Pilates strengthen these muscles, as do Kegels, exercises that involve contracting those inner pelvic floor muscles,” says LaurieAnn Scher, MS, RD, CDE, a spokesperson for the American Association of Diabetes Educators and chief strategy officer and diabetes educator for Fitscript, which makes the online exercise tool GlucoseZone. To perform Kegels, contract your pelvic muscles (as if you’re trying to hold in urine), hold for a few seconds, then release and repeat.

Don’t forget common-sense principles such as allowing enough time between eating or drinking and exercising so that you give your body time to void itself, Scher says.

Some prescription drugs (such as heart meds) have been linked to incontinence. If you suspect your medications are the culprit, talk with your doctor  about switching.

Q: The skin around my groin becomes red, raw, and irritated after exercise. How can I  prevent this?

A: The areas most commonly affected by chafing—which happens when skin rubs against skin or fabric—include the thighs, underarms, nipples, and heels. While anybody who exercises can be prone to chafing, it may be more of a concern for people with diabetes for two reasons. “Your skin may be drier than somebody’s without diabetes,” says Matt Schoenherr, CDE, ACSM-CEP, a spokesperson for the American Association of Diabetes Educators and founder of Active Diabetes, a remote diabetes coaching service in San Diego. In addition, diabetes can hinder your ability to quickly heal, making it more likely  that a slight abrasion will develop into a more  serious infection. 

To avoid that, look for anti-chafing creams that you can use on areas that are most susceptible to chafing. And make sure you’re wearing the right clothing. “You want clothes that aren’t too tight but fit well and stay in place so they’re not moving around and rubbing your skin,” Scher says.  

Q: I sweat so much when I exercise that by the end of my workout I can practically wring my clothes out. Is this normal?

A: Sweating is a natural part of exercise—it’s your body’s way of cooling itself down—and everybody has different sweat rates, so what’s normal for you may not be normal for someone else doing the same workout. Weight plays a big role, says Salas-Whalen. As you lose weight, you may notice a change in how much you perspire during physical activity. To avoid letting sweat get the best of you, exercise in a cool environment or near a fan. Pick workout clothes and socks that will wick away moisture—look for the term “moisture wicking” on the label.

It’s important to know that sweating can also be a sign of low blood glucose (hypoglycemia). It’s usually not hard to distinguish between the sweat of a challenging workout and sweat from a low (hypoglycemia usually just involves clamminess), but do pay attention to other symptoms, such as shakiness, confusion, headache, dizziness, irritability, and nausea. If sweating is accompanied by symptoms of a low, stop exercising and check your blood glucose. To prevent hypoglycemia, check your blood glucose before your workout, aiming for a reading between 90 and 250 mg/dl, the target range for exercise, according to an American Diabetes Association position statement.

Q: I have fungus on my nails and feet, and I’m so self-conscious about how they look that I don’t want to go to my yoga and Pilates classes. What can I do?

A: Fungal infections in the toenails are common in people with diabetes. Blame higher blood glucose. “Bacteria and fungus feed on glucose—you’re giving them a buffet—which is why you may be more prone to infections,” says Salas-Whalen. Poor circulation and decreased immune function, more common in people with diabetes, are also culprits.
At the first sign of an infection (the nail will be thick and discolored, usually yellow) see your doctor, who may prescribe oral medications to treat the condition (over-the-counter antifungal meds won’t work). It can take three to six months to see a change.

To avoid future fungal infections, keep your feet covered during exercise and in the locker room. Yoga or Pilates socks—typically those with grips on the soles—help prevent the kind of slipping that can happen with regular socks. And make sure you bring your own mat to yoga or Pilates class, and your own cycling shoes to spin class. Slip on a pair of flip-flops for your post-workout shower at the gym.

Q: It feels like everyone else  can run for miles or lift a lot  of weight. How can I become more physically active without being embarrassed by how  little I can do?

A: People with diabetes generally have the same athletic potential as those without the condition. “Diabetes doesn’t cause you to be any weaker or have less stamina,” Schoenherr says. But inactivity can. If you haven’t exercised in a while, it’s going to take time to build your stamina. You can do that by starting slowly and progressing gradually—and there’s no shame in that. Instead, be proud of the fact that you’re making a healthy change in your physical activity habits.

Don’t feel comfortable exercising in public? Home workouts can be just as effective as going to a gym, Scher says. They can build your fitness level and confidence. Before you embark on a new fitness challenge, talk with your health care provider about strategies for managing your blood glucose before, during, and after exercise.



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