Guest Article: Diabetes and Exercise

Andrea Myers, Co-Owner Compass Fitness

We all know that exercise and physical activity is a crucial part of a healthy long life. This couldn’t be more true than for people living with diabetes. As rates of type II diabetes continue to increase, physical activity continues to be a fundamental form of therapy for people who are diabetic and pre-diabetic.
Despite the increasing amount of evidence that shows the benefits of exercise, this form of prevention and treatment continues to be underused and priority is often given to medication and diet. Although a lack of knowledge of the benefits of exercise or lack of motivation contributes to this underuse, often a lack of clear guidelines is also an important factor. In this article we will discuss why exercise is so important for people living with diabetes as well as some guidelines on how to introduce exercise into your lifestyle and how to do so safely by making rewarding and long-term lifestyle changes.

Benefits of Exercise for People with Diabetes

Physical activity, including appropriate endurance and resistance training, is an important way to help manage type II diabetes and has been shown consistently to improve insulin action and several cardiovascular disease risk factors. Physical exercise, on a day by day basis, has a clear hypoglycemic effect and performed on a regular basis at a sufficient level, has many favourable benefits, including improved glycemic control (HbA1c) and insulin sensitivity, and improved blood lipid profiles (cholesterol), blood pressure, and resting heart rates. In addition, it can also help patients to lose weight, improve muscle strength and endurance, decrease visceral fat, increase muscle mass, and enhance flexibility and body composition. The psychological benefits of exercise may be just as important as the physical benefits and include improved mood and regulation of mood disorders, a feeling of control over your own health, and increased self-esteem and self-confidence.

How Much Exercise is Needed and What Types?

For health benefits, current guidelines recommend that aerobic activity should be performed for at least 30 minutes at a moderate intensity on most, if not all days of the week with no more than 72 hours between exercise sessions. This is because it has been shown that the positive effects of exercise on insulin levels only last up to 72 hours. It is further recommended that two or more resistance training sessions are completed per week. This includes weight training, resistance band and body weight exercises, and provided there are no contraindications, heavy resistance training targeting all major muscle groups should be included. This form of exercise should consist of heavy loads lifted 8-10 times, progressing to 2-4 sets for each exercise.
We also recommend a 1-2 minute break between sets to start and then decreasing this rest time as your level of fitness increases. Regardless of exercise intensity, it is crucial that good exercise technique is used throughout the program to reduce the risk of injury and maximize health outcomes.

The best exercises for most people to begin with are called the ‘primal movements’ and include many different variations of squatting, lunging, pushing, pulling, twisting and bending. Yoga, Thai Chi and Qi-gong have also been shown to be very beneficial for people with diabetes as they improve physical fitness as well as aid with stress management and mind-body awareness.

Talk to a professional

Before starting out in a new fitness and exercise program it is important to be assessed for a variety of factors. Your doctor can assess you for cardiovascular disease risk factors and other conditions that may need special attention during exercise. Your doctor will also screen you for symptoms of cardiovascular disease including unusual shortness of breath, chest pain with exertion, dizziness, light-headedness, swelling of the ankles and pain in the calves that is not associated with muscle pain. They will also assess blood pressure, cholesterol and lipid profiles, resting heart rate, weight, body mass index, waist circumference, family history and previous cardiac history. However, even if you do have some of these issues it does not mean that you shouldn’t undertake a new and exciting exercise program. Screening just provides a useful tool to guide exercise prescription and to identify those who should undergo cardiac stress testing before starting to exercise.

Once you have been cleared by your doctor a certified personal trainer can assess you for muscle imbalances, level of current physical fitness, range of motion, balance, flexibility and strength with simple body weight exercises and stretches. They can then use your doctor’s assessment in conjunction with their own assessment and create a program tailored to each individual that progresses as your level of fitness improves.

Tips for Exercising safely with diabetes

The following list outlines 7 simple ways to stay safe when starting a new exercise program:

1. Ask for help Talk to your doctor and talk to a personal trainer or other fitness professional. They can help you get started on the right foot safely and effectively.

2. Start slowly. If you are new to exercise, start with a low-impact activity like walking, swimming, or bicycling. Gradually increase your daily exercise.

3. Time it right. The best time to exercise is an hour or so after eating, when your blood sugar is likely to be a bit higher.

4. Know your limits. Check your blood sugar before and after exercise to see how your body responds to exertion.

5. Protect your feet and eyes. Make sure your shoes fit well so you don’t get blisters, which can lead to skin ulcers. If you have nerve pain or loss of sensation (neuropathy), avoid activities that could cause pressure ulcers or stress fractures. If you have developed blood-vessel abnormalities in one or both eyes (diabetic retinopathy), stay away from lifting heavy weights or other activities that cause a sudden increase in blood pressure that can trigger bleeding in the eye. Lifting light weights is fine — just don’t hold your breath while lifting.

6. Be prepared. Have water and snacks handy when you exercise. Especially important are carbohydrate-rich snacks that can quickly boost your blood sugar if it gets too low. Even carry glucose tablets or gel just in case.

7. Sound the alert. Wear a medical identification bracelet or necklace that says you have diabetes just in case you get into trouble.

For people with diabetes, the overall benefits of exercise are significant. Work together with your doctor and a fitness professional to maximize these benefits while minimizing risks for negative consequences. Simply identifying and preventing potential problems beforehand can reduce adverse outcomes and help you start living an active healthy lifestyle and take control of your diabetes and your overall health.