Nicole Palacios, BSc
Exercise improves the body's sensitivity to insulin and helps manage blood glucose levels. If you have diabetes, our exercise tips will help you get fit safely.
Exercise improves the body's sensitivity to insulin and helps manage blood glucose levels. If you have diabetes, our exercise tips will help you get fit safely.
My mother-in-law, aunt, and father all suffer from type 2 diabetes, a disease with signs and symptoms ranging from weight loss and fatigue to blurred vision and numbness in the hands and feet.
They are not alone; today more than 9 million Canadians have diabetes or prediabetes. And according to the Canadian Diabetes Association (CDA), the number of people with type 2 (previously termed adult onset) is increasing rapidly.
It’s no surprise that the CDA recommends fitness for those with diabetes, since regular physical activity improves the body’s sensitivity to insulin and helps manage blood glucose levels.
Getting started with a new exercise program can be a little daunting, but it doesn’t need to be. Here are some of the best ways to make the most of fitness to help prevent the complications of diabetes.
Aerobic exercise
Any type of exercise that elevates the heart rate and keeps it up for more than two minutes is considered aerobic exercise. Activities such as walking, swimming, and cycling are all great forms of aerobic exercise.
Benefits
A few of the many benefits of aerobic exercise for diabetics include improved sensitivity to insulin, better management of blood glucose levels, increased heart and lung capacity, increased muscular and cardiovascular endurance, reduced heart disease and stroke risk, increased HDL (good) cholesterol, decreased stress, increased mental health, and lowered body weight.
How much?
The ideal amount of exercise is at least 30 minutes daily. However, the CDA recommends 150 minutes per week of moderate intensity exercise, which would be about 22 minutes per day.
Realistically, fitting in three sessions a week is more likely than daily, according to a trial done with type 2 diabetics. In this 2006 trial, published in the journal Diabetes Care, people found it easier to do fewer but longer sessions than more frequent but shorter sessions.
It’s important not to let more than two days in a row go by without training, since the effect of a single bout of aerobic exercise on insulin sensitivity lasts 24 to 72 hours, depending on the duration and intensity of the activity.
What to avoid?
Depending on your overall health and fitness level, you can do any type of cardio exercise. However, hypoglycemics need to be careful during long-distance efforts, and people suffering from neuropathy (nerve dysfunction) should choose a stationary bike or water sports as opposed to exercise machines such as the StairMaster or treadmill.
Resistance exercise
Free weights, exercise machines, and resistance tubing are all modalities for training with resistance, or strength training.
Benefits
Resistance training has been shown to improve glycemic control, according to a study reported in Diabetes Care, which showed that both impaired glucose tolerance and impaired fasting glucose improved significantly when utilizing a resistance training program.
How much?
Generally, two to three sets of eight to 10 repetitions of each exercise is optimum. The CDA recommends strength training three times per week. Start out with a lighter weight and slowly build up to heavier resistance.
What to avoid?
If your feet are severely affected by neuropathy, try seated activity. Chair-based stretching and strengthening enhances everyday functioning, and when you move your feet (even in sitting), you increase circulation critical for diabetes, says Suzanne Andrews, a Canadian occupational therapist and host of Functional Fitness Exercise videos.
As well, avoid weightlifting if you have retinopathy (retinal damage due to diabetes in this case), or diabetic nephropathy, says Scott Moses, MD.
When not to exercise?
The Mayo Clinic recommends that you check your blood sugar 30 minutes before exercise. If it’s too low (less than 100 mg/dL), have a piece of fruit or whole grain crackers.
If it’s too high (more than 300 mg/dL), you may need to take prescribed medication and skip your session. Another deterrent, according to Andrews, is diminished sensation in your hands or feet. Wiggle your fingers and toes to try to regain circulation.
Aerobic exercise and strength training are both terrific ways for diabetics to take control of their health and lower their need for drugs; however, a Canadian research study done in 2007 showed that both modalities in conjunction can give diabetic exercisers even greater results.
Test subjects who trained with both forms of exercise had lower abdominal fat, body fat percentage, cholesterol, and haemoglobin levels over their counterparts who did just cardio or just strength training.
Proper eating is essential for all diabetics to help control their blood sugar; so what should you eat when you are a diabetic who is exercising?
Before, during, and following exercise you should check your blood sugar and act accordingly: too low, you need to have something with complex carbohydrates; too high, you may need to medicate.
Depending on the intensity and length of your workout, your eating requirements will change. It’s best if you keep a daily record of your blood sugar levels before and after exercise to assess your needs properly.
Fuelling your body
Before your workout
Try having a protein- and fat-based snack before working out, says Mike Demeter, senior trainer at Good Life Fitness. He says this will increase dopamine levels for performance and be ideal as a low-GI food source. Try nuts, yogourt, cheese, or hummus.
During your workout
Make sure to stay hydrated. If you feel lightheaded or dizzy, you may need to reassess your blood sugar. You should not need to ingest anything during your workout unless it exceeds one hour. However, if needed, a sport drink with 6 to 7 percent carbohydrate is recommended, according to an article in the journal Diabetes Spectrum.
Following your workout
Demeter recommends a shake with whey and glutamine after a workout: “The glutamine restores glycogen levels without the blood sugar impact of a glucose/fructose supplement.” Make sure to consume a carb/protein meal or drink within 45 minutes following exercise.
Top exercises for diabetics
The following exercises were all used in the “Effects of Aerobic Training, Resistance Training, or Both on Control of Blood Sugar in Type 2 Diabetes” study published in the September 2007 Annals of Internal Medicine.
Aerobic exercises
- stationary cycling: safe for diabetics with retinopathy or neuropathy
- treadmill walking: gradually increased intensity and duration
Resistance exercises
- leg press: builds quadriceps muscles
- leg curl: builds hamstring muscles
- seated row: builds back muscles
- chest press: builds pectoral muscles
- modified abdominal crunches: builds abdominal muscles
Prevention
Here are some risk factors for type 2 diabetes:
- genetics
- over age 45
- high triglycerides
- obesity and/or sedentary lifestyle
- high blood pressure
If you have certain risk factors, such as age or ethnicity, you can’t do anything about it. However, other risk factors—being obese or having high triglycerides—can be altered by lifestyle changes.
It’s never too late to start exercising, no matter how little you can manage. Start with at least three times a week for 20 to 30 minutes. Include cardio and weight-bearing exercises.
Changing your eating habits can also make a large impact; start with little changes and over time you can redesign your meals. Cut out sugary drinks and eat more whole grains, lean proteins, and fresh fruits and veggies.
By combining a healthy diet with cardiovascular and resistance exercises, you can assist in the management of type 2 diabetes, but you may also be able to proactively prevent it.
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