According to the Centers for Disease Control and Prevention (CDC), over 29 million people in the United States have diabetes - a condition where the body either doesn't make enough insulin (type 1 diabetes), or is unable to use insulin properly (type 2 diabetes).
Insulin is a hormone, made in the pancreas, which regulates blood sugar (glucose) levels, and allows the body to use glucose for energy.
Exercise can help reduce complications of diabetes including:
A further 86 million people have prediabetes - a health condition that increases their risk of developing type 2 diabetes and other illnesses.
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Preventing the onset of diabetes for those with prediabetes, or managing symptoms for those who already have the condition, is crucial to maintain health and prevent complications. Exercise is one proven way to help manage diabetes.
According to a joint position statement by The American College of Sports Medicine and the American Diabetes Association, exercise:
Staying physically active also helps prevent diabetes-related health complications and improves overall quality of life.
Exercise is useful for those with diabetes because it improves insulin sensitivity by helping the cells of the body use available insulin. Physical activity also stimulates a separate mechanism, unrelated to insulin, to allow the cells to use glucose for energy, thereby regulating blood glucose levels.
The American Diabetes Association recommends two types of physical activity for those with diabetes: Aerobic exercise and strength training.
Also known as cardiovascular exercise, aerobic activity helps the body use insulin more effectively. It brings other benefits too, including:
Examples of aerobic exercises include:
The President's Council on Fitness, Sports and Nutrition recommends:
This recommendation is for adults aged 18-64. Adults with diabetes should also aim to meet this target.
Those with a busy schedule may find it helpful to do several shorter workouts totaling 30 minutes daily - research suggests that the benefits received are similar to those associated with one longer workout.
Strength training, or resistance training, helps lower blood sugar levels and increases insulin sensitivity. In addition, it increases resting metabolism and builds stronger bones and muscles, reducing the risk of osteoporosis.
Examples of strength training include:
Strength training should be undertaken at least twice a week, in addition to the recommended amount of aerobic activity.
Stretching exercises are important for everyone, including those with diabetes. Stretching:
It can be useful to consider incidental physical activity - everyday activities that aren't classed as exercise but involve movement. Some research suggests that such activities can contribute to improved fitness.
Types of incidental physical activities include:
To exercise safely, many people with diabetes - particularly those with type 1 diabetes or those on diabetes medications - may need to check their blood glucose levels before, during, and after exercise.
This indicates how well the body is responding to exercise, and may help avoid blood sugar fluctuations, which can be dangerous.
Blood sugar levels should be tested 30 minutes before exercise. If they are:
During exercise, particularly long workouts or new activities, blood sugar levels should be tested every 30 minutes. Stop exercising if any of the following signs are there:
After exercise, check blood sugar levels immediately. Recheck levels several times over the following day - physical activity can lower blood glucose for up to 24 hours.
If hypoglycemia (low blood sugar) is experienced during or after a workout, it should be treated immediately. This involves taking at least 15-20 grams of fast-acting carbohydrate such as:
Blood glucose levels should be tested after 20 minutes, and the treatment repeated if they haven't returned to normal. Follow the fast-acting carbohydrates with a protein such as peanut butter and crackers. Do not resume exercise until blood glucose returns to above 100 mg/dL.
If hypoglycemia occurs regularly during exercise, it may be necessary to adjust medications or the exercise regimen, or to simply eat a small snack before working out. Skipping meals, strenuous exercise, or prolonged workouts can all cause hypoglycemia.
It should be noted that people with type 1 diabetes are more likely to experience hypoglycemia during or after exercising, although people with type 2 diabetes may have issues if they are on medication for their condition.
It is advisable to consult a doctor before beginning any new workout program.
A doctor can advise on the impact of medications on blood sugar levels during activities, and can provide a target range for blood glucose levels during workouts. They may give advice on the best time to exercise, based on the patient's individual schedule, meal plan, and medications.
A doctor may also perform a physical check-up, looking at:
Depending on these complications, it may be advisable to avoid strenuous activities, or specific sports.
It is also important to consult a doctor if hypoglycemia is experienced regularly during or after exercise, or if any other undesirable side effects are experienced.
Beginning an exercise plan can be daunting. It is important to:
Written by Jayne Leonard
Disclaimer: This informational section on Medical News Today is regularly reviewed and updated, and provided for general information purposes only. The materials contained within this guide do not constitute medical or pharmaceutical advice, which should be sought from qualified medical and pharmaceutical advisers.
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