Exercise is Medicine: Diabetes Management and Physical Activity

Although everyone can benefit from physical activity, individuals with diabetes can significantly improve their overall health by exercising regularly. Studies have shown that exercise can actually reduce the impact of diabetes on the body and prevent diabetes-related disease and death. Because diabetes is such a prevalent and impactful disease, it is important for people diagnosed with diabetes to understand the power of exercise in reducing the impact of this disease.

What are the benefits of exercise for people with diabetes?

Because diabetes patients have reduced sensitivity to insulin or no insulin present in their bodies, this causes the body to produce an excess amount of glucose, resulting in hyperglycemia (high blood sugar). During exercise, the body’s blood glucose level naturally reduces, even without insulin in the body1. This is because physical activity stimulates the cells to take up glucose for energy. After just one exercise session, blood glucose levels decrease for up to 24 hours1. For diabetics who exercise regularly, this can result in an A1C reduction of up to 1%3. Although this may seem like a small reduction, a 1% drop in A1C is what many doctors hope to achieve with an oral or injectable medication. Therefore, this proves that exercise is an effective tool for the treatment of diabetes.

Other benefits of exercise for diabetes patients include:

  • Improved blood glucose control4
  • Reduced obesity and improved body image4
  • Reduced diabetes-related medical complications
  • Increased vitality, fitness, and overall health

What is the best type of exercise for people with diabetes?

Ultimately, the best kind of exercise is the type that motivates you to get active and improve your overall health. Although all types of exercise and physical activity improve your health, some forms of exercise produce greater benefits for diabetes patients.

Below are the types of exercise that have been scientifically tested and proven to benefit individuals with diabetes:

  • Aerobic Exercise: This type of exercise improves function of the heart, lungs, and blood vessels.

    • Moderate Aerobic Exercise Benefits (fast-paced walking or jogging, swimming, physical chores)
      • Blood pressure reduction and maintenance
      • Reduced risk of cardiovascular disease
    • High Volume Aerobic Exercise Benefits (running, high intensity interval training, jumping rope, hiking)
      • Weight loss
      • Improved glycemic control and lipid profile
      • Greater insulin sensitivity in type 2 diabetes patients
      • Increased glucose uptake in the skeletal muscle
      • Improved fasting blood glucose levels
      • Restoration of blood vessel function
  • Resistance Exercise Benefits (weightlifting, bodyweight exercises such as pushups and squats): This type of exercise involves the use of resistance (in the form of bodyweight,
    weights, or other equipment) to perform exercises that strengthen the bones and muscles of the body.

    • Safe and effective at any age
    • Improved insulin sensitivity in type 2 diabetes patients
    • Larger energy expenditure (calorie burn)
    • Increased muscle strength, lean muscle mass, and bone density
    • Reduced risk of bone and muscle tissue loss
    • Improved quality of life

 

 

  • Other Types: Other types of exercise that have been tested for diabetes patients include endurance training (distance running, swimming, cycling), passive exercise (range of motion, rehabilitation exercises) and yoga. Although these exercise types have not been studied as extensively as aerobic and resistance training, they nonetheless contribute to improved health. Benefits of these types of exercise include reduced postprandial hyperglycemia, improved glycemic control, and improved insulin sensitivity2.

Although each individual type of training is beneficial, a combination of resistance, aerobic, and other training is far more effective than a single type of exercise3.  When choosing your exercise regimen, it is important to set goals, regardless of the types of exercise you choose. To explain, studies show that diabetics who set specific fitness goals have better results than those who don’t3. If you struggle to incorporate daily exercise into your life, it is important to at least strive to be active every day3. Never underestimate the power of chores and daily activities- even simple daily tasks such as cleaning, walking, and standing can be beneficial.

How often should I exercise?

According to the American Diabetes Association, individuals with diabetes should exercise for about 30 minutes at least five days per week. However, newly diagnosed diabetics or individuals who have never exercised should start slow and progress as they grow stronger3. It is also important to be aware of how your exercise frequency and intensity affects your blood sugar as you adopt an exercise regimen.

Should I change my medications or food intake with exercise?

 Naturally, the balance of medications prescribed to each person is highly individualized. Therefore, it is important to communicate with your doctors if you are considering incorporating regular exercise. Based on the type and intensity of exercise training, your doctor may change or adjust medications as needed.

With regard to food intake, most diabetics do not need to make significant changes to their meal plan. Some people may need to add extra carbohydrates to account for increased energy use. However, if you are trying to lose weight, adding extra food may not be necessary1.  In general, focus on making healthy food choices to maximize your exercise regimen. Incorporating a balance of vegetables, fruit, whole grains, dairy, healthy fats, and lean protein will maximize health benefits and reduce the impact of diabetes on your body. If you are unsure of how to choose a balance of foods that is best for you, seek the help of a dietitian. Dietitians are certified experts who are qualified to educate you on healthy eating, meal planning, and chronic disease prevention through nutrition.

Does exercise cause any safety risks?

It is important to understand how your body and blood glucose levels respond to exercise. You should use a blood glucose monitor to determine your body’s response to physical activity and identify patterns that may contribute to hyper- or hypoglycemia. Low blood sugar (below 70 mg/dL) is common during and after exercise in diabetics. Because this can result in dangerous health risks, such as mental confusion, seizures, and unconsciousness, prevention of exercise-induced hypoglycemia is very important.

If hypoglycemia occurs during or after exercise, immediately respond by:

  • Taking a break from exercise to treat the problem
  • Following the “Rule of 15” – consume 15 g of a fast-acting carbohydrate (glucose tablets, juice, gels), wait 15-20 minutes, and check your blood glucose again. If your levels are still low, repeat the process until normal levels are restored.
  • Eating regular meals and snacks following the event to keep the blood glucose normal

If your blood glucose levels regularly interfere with your ability to exercise, talk to your doctor, Certified Diabetes Educator, or dietitian. He or she may suggest an adjustment to your medications or pre-workout snack1.

How do I start?

If you would like to begin an exercise regimen, meet with your doctor to determine the safest way to incorporate activity into your daily life. Also, you may benefit from meeting with a personal trainer or dietitian to discuss your fitness goals and receive professional guidance.

Are you interested in improving your fitness through exercise and healthy eating? The Elite Nutrition and Performance team would love to help! Contact us to schedule a FREE No-Obligation Consultation and achieve your personal fitness goals!

Sources:

  1. American Diabetes Association. (1995). Blood glucose control and exercise. Retrieved February 20, 2017, from American Diabetes Association, http://www.diabetes.org/food-and-fitness/fitness/get-started-safely/blood-glucose-control-and-exercise.html?referrer=https://www.google.com/
  2. Das, S., Thent, C. Z., & Henry, L. J. (2013). Role of exercise in the management of diabetes Mellitus: The global scenario. PLoS ONE, 8(11), e80436. doi:10.1371/journal.pone.0080436
  3. (2016, July 20). How much exercise is enough if you have type 2 diabetes? Retrieved February 20, 2017, from Health, http://www.health.com/health/condition-article/0,,20188785,00.html
  4. Mayo Foundation (2013). Living with Diabetes. Mayoclinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/diabetes/expert-blog/insulin-and-exercise/bgp-20056553

 

Sarah Roof, Elite Nutrition and Performance Intern

University of South Carolina Honors College–Exercise Science

Certified Personal Trainer

 

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