blog detail banner

Diabetes and Exercise

How Does Exercise Help Diabetes

Dec 15, 2016

How Does Exercise Help Diabetes?

“How Does Exercise Help Diabetes?” is one of the most common questions among diabetic patients. Exercise is one of the best ways to improve your overall health. Research has repeatedly shown that it can help diabetics bring their diabetes under control through a variety of body mechanisms. There is also a deep connection between exercise and type 2 diabetes prevention as a fit and healthy body isn’t prone to lifestyle disorders like diabetes.

Experts agree that to move the needle on diabetes through exercise, you need do either do:

  • Thirty minutes of ‘moderate intensity’ aerobic activity (i.e. “cardio”), five days a week,

Or

  • ‘Vigorous intensity’ aerobic activity, 20 minutes or more a day, 3-5 days a week.

 In addition to this, you should add flexibility and strength training to your routine:

  • Flexibility activities 5-7 days a week.
  • Strength training: 8-10 exercises, 10-15 repetitions of each exercise, 2-3 days a week.

Controlling Type 2 Diabetes With Exercise

Work with your diabetes educator or your doctor to create a plan that works for you. Here are some ideas of activities that could fall in different categories:

  • Moderately intense physical activity means you are working hard enough to raise your heart rate and break a sweat, but are still able to talk (but not sing).
  • Vigorously intense aerobic activity means you are breathing hard and fast, and your heart rate has increased quite a bit. You won’t be able to say more than a few words without pausing for a breath.
  • Lifestyle activities mean small activities that are part of day-to-day life. They seem small, but can quietly add up to a nice bonus in terms of blood sugar control.

Moderately Intense Aerobic Activities

  • Brisk walk: One and three quarter miles in 35 minutes (pace of around 20 minutes per mile) or 2 miles in 30 minutes (15 minutes per mile).
  • Ride a bike on level ground or with a few hills, 4-6 miles in 30 minutes.
  • Swim or do water aerobics.
  • Push a lawn mower.

Vigorously Intense Aerobic Activities

  • Jog or run (One and a half 2 miles in 15 minutes – so that’s 10 min/mile).
  • Ride a bike fast or up a hill.
  • Play singles tennis or basketball, for 30 minutes.
  • Swim laps briskly, for 15-20 minutes.
  • Jump rope, for 15 minutes.
  • Dance fast, for 30 minutes.
  • An aerobics class
  • Push a stroller one and a half miles, in 30 minutes.
  • Skate, for 30-40 minutes.
  • Try a follow-along vigorous exercise video at home.

Lifestyle Activities

Getting started is the important thing—any exercise is better than no activity! Here are a few ideas that are easy to incorporate into your daily life and can go a long way to helping you achieve your goals.

  • Plan active weekends.
  • Take the stairs instead of the elevator.
  • Park at the far end of the parking lot and walk to the office or store.
  • Walk a few blocks before getting on the bus, and get off a few blocks before your stop.
  • Pace when waiting for a bus or subway.
  • Get up from your desk during the day to stretch and walk around.
  • Carry your own groceries.
  • Take a brisk walk for 10 minutes before lunch.
  • Walk your dog.
  • Trade in your electric mower for a push model, rake your leaves, or wash your car by hand.
  • Reduce your TV and computer time.
  • Get up from the sofa and stretch for a few minutes every hour.
  • Incorporate yoga exercise for diabetes in your daily regimen

How Long Should I Exercise?

The U.S. Surgeon General’s report recommends that most people accumulate at least 30 min of moderate-intensity activity on most, ideally all, days of the week. However, many people find it easier to schedule fewer longer sessions rather than five or more weekly shorter sessions. Ideally, there should not be more than two consecutive days without aerobic physical activity.

What If I Exercise Longer Than 30 Minutes?

  • Longer or more intense exercise can help you improve your diabetes parameters even more; but it could also cause your blood glucose to drop more than shorter or easier exercise. You may need to have a carbohydrate snack after 20-30 minutes of intense exercise.
  • Blood glucose may continue to drop for several hours after activity. Monitor it, especially in the earlier stages.

Could I Be “Sensitive” to Exercise?

Being sensitive to exercise means that your blood glucose has a tendency to drop suddenly when you exercise and your insulin sensitivity improves. You could feel any of these symptoms, suddenly. 

  • If you feel that you are sensitive to exercise, your doctor or diabetes educator may suggest that you lower your pre-exercise insulin dose.
  • If you do not adjust your insulin before you exercise, eat or drink 15 grams of carbohydrate for every 20 minutes of physical activity.

When Is The Best Time of Day to Exercise?

How does exercise help diabetes

How does exercise help diabetes

Any time is a good time! You will get healthy and fit no matter when you work out, but here are some important things to consider:

  • Research shows that exercising in the morning may cause your blood glucose to drop lesser than if you exercised later in the day.
  • If you are on insulin or taking meds that work by making your body secrete more insulin, evening exercise may result in low blood glucose levels while you sleep, so be aware of this and exercise care.

What If I Have Already Had Episodes of Low Blood Glucose Levels?

  • If so, you are more likely to develop symptoms of low blood glucose after exercise.
  • If you exercise in the evening, you may need to have a carbohydrate snack before going to bed to prevent a low blood glucose reaction while you sleep.
  • If you’re on insulin and you exercise at night, you may need to take a lower dose at bedtime. Do check with your doctor to monitor/fine tune your dose.

Aerobic Exercise to Help Diabetes Or Strength Training (Using Weights)?

Aerobic training involves continuous activity of multiple large muscle groups, whereas strength training involves isolated, brief activity of single muscle groups. All of the activities we have suggested above are aerobic activities. The first exercise advice that most doctors give you is usually aerobic exercise related. This is because it also increases cardio-respiratory fitness and has been proven over the years to reduce diabetes lab markers, including HbA1c and cholesterol in various studies.

Strength training increases muscle strength and endurance. For the point of view of diabetes, it is also equally effective in reducing the very same lab markers – HbA1c, bad cholesterol, etc. Insulin resistance responds well to strength training or using weights. The reason this kind of exercise is not easily recommended by your doctor is because if you have never done it in your life, it is better done under supervision to avoid injuries. Not everyone has access to a trainer or can afford one, so it is not freely recommended to diabetics.

A meta study (a study of other research studies on the subject) of the effects of exercise on diabetes was conducted by the American Diabetes Association in 2006. It showed that the combined effect of using aerobic exercise and resistance training in combination may well be the best of both worlds for diabetics. So, if you are someone who is either familiar with exercising with weights or have access to a local gym or center where someone can teach you the correct form, you should consider adding it to your routine twice a week. High Intensity Interval Training (HIIT) using weights can really help you hasten your progress on diabetes.

Using Weights: How to Go About it

  • High-resistance exercise using weights may be more acceptable to younger people with diabetes; if you feel you don’t fall in this category, seek expert help to help you pick what works for you.
  • Unless contraindicated by expert medical opinion, most people are fit enough to perform resistance exercises, using light weights and high repetitions, targeting all major muscle groups, three times a week. Ensure you do the exercises correctly; do them strictly under the supervision of a trainer or at least learn them with one.
  • Have periodic reassessments done by a qualified exercise specialist. This will maximize health benefits, and minimize the risk of injury.
  • Always start low and slowly build up your strength, with resistance training or weight training. You can see our sample Strength Training Table for the sorts of weight training exercises you can do, using different muscle groups on different days of the week.

Here are some examples of strength training activities you could do

  • Weight machines or free weights at the gym
  • Using resistance bands
  • Lifting light weights or objects like canned goods or water bottles at home
  • Calisthenics or exercises that use your own body weight to work your muscles (examples are pushups, sit ups, squats, lunges, wall-sits and planks)
  • Classes that involve strength training
  • Other activities that build and maintain muscles, like heavy gardening

All Set? Here’s A Plan to Follow!

Put your weekly goals in writing! Experts recommend that you write down your weekly goals and immediately reschedule any sessions that you miss.  Keeping to a schedule and tracking your progress is a huge factor to success. As always, be sure to check with your doctor before you begin exercising.

A Sample Diabetes Exercise Plan

Day Activity Suggested Time of Day Amount
Monday Walk after lunch Noon 20 minutes
Tuesday Stretch Before dinner 10 minutes
Strength Training 15 minutes
Wednesday Stretch class 12:30 pm 45 minutes
Thursday Stretch Before bed 10 minutes
Strength Training 15 minutes
Friday Stretch 5:00 pm 10 minutes
Walk home 45 minutes
Saturday Walk to Grocery Store
Wash Car
Sunday Stretch 9:30 am 10 minutes
Walk in park 30 minutes

 

Type of exercise Intensity Duration / week Frequency
Resistance (multi joint exercises,

progressive, large muscle groups)

Moderate to vigorous

8–10 exercises

2–4 sets

8–10 repetitions

1–2 min rest intervals

60 min 2 or more times/week
  FREE WEIGHT MACHINE BASED BODY WEIGHT
Chest Supine bench press Seated chess press Push ups
Back Bent-over Barbell rows Lat pulldown Pull ups
Shoulders Dumbbells lateral raise Shoulder press Arm circles
Biceps Barbell / dumbbell curls Cable curls Reverse grill pull ups
Triceps Dumbbell kickbacks Press downs Dips
Abdomen Weighted crunches Seated “Abs” machines Crunches, prone planks
Quadriceps Back squats Leg Extension Body weight lunges
Hamstrings Stiff-leg deadlifts Leg Curls Hip ups

An Important Point About Diet

For the items marked as “Strength Training” in the table above, you can pick from the exercises below. Experts advice that it is best to start with the larger muscle groups (stronger) such as your chest, legs, etc. and then rotate among the muscle groups, for best results.

Diabetes is a dietary disorder and having the right diet is a huge component of being able to progress towards reversing it. While we have suggested that you keep short acting carbs handy during exercise to prevent any incidents of low blood sugar, you also need to have the right amount of proteins and good fats in your diet to make your exercise work for you. A good quality protein powder shake, with the least added sugars, can go a long way in helping you build lean muscle (that burns sugar and fat better).

Exercise Success Secrets: What Diabetic Warriors Know…

Once you start you’ll multiply your chances of success by sticking to your plan. Here are some of the best tips from the veterans.

  • Keep records of your progress.
  • Reward yourself when you achieve goals (with a movie, massage, book, or new clothes)
  • Listen to music or books on tape while you exercise so you don’t get bored.
  • Exercise with a partner to stay motivated (or alone if you prefer some time to yourself).
  • Imagine yourself exercising and “rehearse” it in your mind every day. Research shows that this can have fantastic results – both in terms of actually sticking to exercise and in terms of physical improvements!
  • Set realistic goals.
  • Seek out positive social support and avoid those who discourage you.
  • Don’t get discouraged if you don’t see immediate results.
  • Don’t give up if you miss a day; just get back on track the next day.
  • Build some rest days into your exercise schedule.
  • Keep it simple.
  • If you have trouble preventing low blood glucose, involve your doctor

So, there you have it. Everything you need to understand how does exercise help diabetes and get it under control. There is a tangible connection between exercise and diabetes sugar levels and the more active you get, the better your condition will become. Remember that everyone can share the joy of movement.  You’ll feel more alive when you’re physically active. You will have more energy, a brighter outlook and be able to join the growing band of people who understand that they can actually reverse their diabetes – through the simple acts of eating right, lowering stress, losing weight and getting the right exercise.

Ashish Sharma
Ashish holds a Masters degree in Pharmacy. He believes that solid research is the backbone of all good writing and brings this quality to his work in healthcare.
Ashish Sharma

Latest posts by Ashish Sharma (see all)

References:

1.  

Hordern Matthew D. Dunstan David W., Prins Johannes B., Baker Michael K., Singh Maria A. Fiatarone, Coombes Jeff S. Exercise prescription for patients with type 2 diabetes and pre-diabetes: A position statement from Exercise and Sport Science Australia 2. 

Tripathi K.D., Essentials of Medical Pharmacology, 6th edition. 3. 

Ronald J. Sigal, MD, MPH; Glen P. Kenny, PhD; Normand G. Boulé, PhD; George A. Wells, PhD; Denis Prud’homme, MD, MSc; Michelle Fortier, PhD; Robert D. Reid, PhD, MBA; Heather Tulloch, MSc; Douglas Coyle, PhD; Penny Phillips, MA; Alison Jennings, MA; James Jaffey, MSc: Effects of Aerobic Training, Resistance Training, or Both on Glycemic Control in Type 2 Diabetes: A Randomized Trial 4. 

American Diabetes Association: Diabetes Care 2004 Jan; Physical Activity/Exercise and Diabetes: http://care.diabetesjournals.org/content/27/suppl_1/s58. 5. 

Resistance Training and Type 2 Diabetes http://care.diabetesjournals.org/content/29/8/1933 6. 

Colberg Sheri R.  ,  Sigal Ronald J.  , Fernhall Bo , Regensteiner Judith G., Blissmer Bryan J., Rubin Richard R. , Lisa Chasan-Taber , Albright Ann L. , Braun Barry , Exercise and Type 2 Diabetes, The American College of Sports Medicine and the American Diabetes Association: joint position statement 7.  

Mohammad Asif , The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern 8. 

Tayek John A. , Is Weight Loss a Cure for Type 2 Diabetes?     9.  

Gupta Alka, Awasthi H.H., Tripathi J.S. , Relevance of yoga on type 2 diabetes mellitus, Obesity and ibs – An approach through Manipura Chakra: a review discussion 10. 

Post Robert E. , Arch G. Mainous III, King Dana E. , Simpson Kit N. , Dietary Fiber for the Treatment of Type 2 Diabetes Mellitus: A Meta-Analysis 11. 

Whitebird Robin R., Mary Jo Kreitzer, Patrick J. O’Connor, Mindfulness-Based Stress Reduction and Diabetes 12. 

Fowler Michael J., Microvascular and Macrovascular Complications of Diabetes, 13. Clinical Diabetes 2008 Apr; 26(2): 77-82. 14. 

Ibañez Javier , Izquierdo  Mikel , Argüelles Iñaki , Forga Luis , Larrión José L. , Marisol García-Unciti, Idoate Fernando , Gorostiaga  Esteban M. , Twice-Weekly Progressive Resistance Training Decreases Abdominal Fat and Improves Insulin Sensitivity in Older Men With Type 2 Diabetes 15. 

Wojtaszewski Jørgen F.P., Richter Erik A., Effects of acute exercise and training on insulin action and sensitivity: focus on molecular mechanisms in muscle, Copenhagen Muscle Research Centre, Institute of Exercise and Sport Sciences, University of Copenhagen, Denmark