Many recent studies have shown that Type 2 diabetes may actually be preventable with regular physical activity, even with only brisk walking. For all individuals with diabetes, exercise enhances your body’s sensitivity to insulin, which usually results in better blood sugar control. Recent research has shown that it is definitely better to be fat and fit than lean and sedentary from a metabolic standpoint; many chronic diseases besides Type 2 diabetes are related to insulin sensitivity, including hypertension and heart disease. Regular exercise also lowers your risk of premature death, heart disease, some cancers (colon, for example), anxiety and depression, osteoporosis (loss of bone mass), and severe arthritic symptoms.
#2: Frequent, regular exercise is key to good blood sugar control.
The glucose-lowering effects of exercise are mainly due to a heightened sensitivity to insulin in exercised muscle, an effect that persists for only 1-2 days following the activity. Therefore, in order to maximize exercise’s positive effects on blood sugar control, you have to exercise regularly. The recommendation for all individuals is a minimum of 3 to 5 days per week of aerobic exercise (walking, jogging, cycling, swimming, etc.), done for 20 to 60 minutes. With Type 2 diabetes, daily or near daily activities are recommended to optimize weight loss and blood sugar control. With Type 1, regular, predictable exercise makes blood sugars easier to manage. With practice and a blood sugar meter, you can manage your blood sugars with any exercise regimen, but regular exercise is still important for the health benefits.
#3: All exercise you accumulate during the day counts.
We used to assume that participation in intense activities (done at greater than 60% of maximal aerobic capacity, like jogging) is necessary for optimal health and fitness. However, now we know that almost any physical activity (including golfing, gardening, mowing the lawn, walking, etc.) done 30-45 minutes per day is beneficial to health, even if fitness is not increased. Furthermore, these low-intensity exercises are beneficial even if done in as short as 10-minute segments. Your daily goal should be to remain as physically active as possible during the day to maximize caloric expenditure and blood sugar use. So, take the stairs instead of the elevator (and do this several times a day)!
#4: Resistance training is as important as aerobic exercise.
More and more research is showing that resistance or weight training can increase insulin sensitivity as well as lower your risk for osteoporosis and loss of muscle mass with aging. The current recommendation is to include such training 2 to 3 days per week; your training should include all the major muscle groups of the body. Some examples of exercises are bicep curls, push-ups, abdominal crunches, bench press, and calf raises. You should pick a weight or resistance that you can lift 8-12 times and do a minimum of one set (preferably 2-3 sets) on each exercise. Also include flexibility training of all major joints a minimum of two days per week to minimize the loss of flexibility caused by aging and accelerated by diabetes.
#5: Almost everyone can exercise safely and effectively.
Diabetes bestows additional risks on exercisers; however, you can still exercise to your maximal potential as long as you respect your limitations. For example, if you have lost some of the feeling in your feet due to peripheral neuropathy, you may need to switch to non-weight-bearing activities such as swimming or stationary cycling to minimize potential trauma to your feet common with walking and jogging. If you have high blood sugars, you will have to drink plenty of fluids with exercise to prevent dehydration. If you are having problems with your eyes due to diabetic eye disease, then you will want to avoid jumping, jarring, or breath-holding activities. Follow the exercise guidelines published by the American Diabetes Association and others for safe participation. Remember to include proper warm-up and cool-down periods (at least 5 minutes of a similar aerobic activity done at a lesser intensity before and after an activity) to ease the cardiovascular transition and minimize your risk for orthopedic injuries.
Although exercise is more work than just taking medications to control your diabetes, it is well worth the effort for many health-related reasons, including psychological ones. Include moderate exercise training and frequent physical activity in your daily regimen for optimal health and fitness benefits!
If you need tips for getting started on an exercise program, check out my book entitled The 7 Step Diabetes Fitness Plan. For people with any type of diabetes who are already more active, you will benefit more from Diabetic Athlete’s Handbook. For other tips on exercise, fitness, diabetes, nutrition, and more, please visit my website and exercise blog at www.shericolberg.com.
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