You may have heard that an estimated 300,000 Americans die each year from sedentary lifestyles and poor eating habits. But did you know that exercise is the best medicine that you will ever come across to prevent this – and, unlike many prescription medications, exercise has no bad side effects? If you have diabetes, physical activity enhances the action of insulin (the hormone that lowers your blood sugar), usually resulting in better blood sugar control. In fact, it is better to be overweight and fit than a lean “couch potato” from a metabolic standpoint because many chronic diseases are related to ineffective insulin action in your body, including heart disease.
Frequent, regular exercise is key to good blood sugar control if you have any type of diabetes. The glucose-lowering effects of exercise are mainly due to a heightened sensitivity to insulin in exercised muscle, an effect that persists for 1-2 days following the activity. In order to maximize exercise’s positive effects, you have to exercise regularly. The recommendation for everyone is 30 to 60 minutes of aerobic exercise a minimum of 3 to 5 days per week (walking, jogging, cycling, swimming, etc.). With type 2 and gestational diabetes, daily or near daily activities are better for optimizing blood sugar control and weight maintenance or loss. With type 1 diabetes, regular, scheduled exercise makes blood sugars easier to predict and manage. With regular blood glucose monitoring, you can control your blood sugars with any exercise program, but it’s easiest when your activity is regular.
Getting started is simpler than you think. First off, it’s important that you realize that all the exercise you accumulate during the day counts. Until recently, vigorous exercise (done at greater than 60 percent of maximal aerobic capacity, like jogging) was thought to be necessary for optimal health and fitness. However, recent studies found that engaging in almost any activity (including golfing, gardening, mowing the lawn, walking, etc.) for 30 to 45 minutes per day is beneficial to health, even if overall fitness is not increased as much. Furthermore, these lower-intensity exercises are beneficial even if done for only 10 minutes at a time.
Strategies for increasing your activity level
So, your new goal is simply to be as physically active as possible during the day to maximize caloric expenditure and blood sugar use, and you don’t necessarily have to join the nearest gym! Instead, just take the stairs instead of the elevator (and do this several times a day), park your car at the far end of the lot from where you’re headed, walk in place during all the TV commercials, and then take the dog out for a walk! For motivation, you may want to invest in an inexpensive pedometer (step counter) and try to add at least 2,000 steps a day to your current activity level. By all means, if you would like to do more “structured” exercise, such as using a treadmill, stationary cycle, rower, or other aerobic workout machine, feel free! Start out slowly, exercising a minimum of three days a week for 20-30 minutes a day, and gradually work up to 45-60 minutes per day and/or five days per week.
You may not know that resistance (weight) training is just as important as aerobic exercise for diabetes control. Such training can increase insulin sensitivity, as well as lower your risk for thinning bones and loss of muscle mass with aging. The current recommendation is to train 2-3 nonconsecutive days per week and include all the major muscle groups of the body. Some examples of exercises are bicep curls, abdominal crunches, bench presses, leg presses, lunges, and calf raises. 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. If all you can manage to fit in is one set once a week, don’t despair – you’ll still experience some strength gains. You can also fit in some “unstructured” weight training by lifting items around the house (including kids and grandkids). Include stretching exercises a minimum of two days per week to maximize strength gains and minimize the loss of flexibility caused by aging and accelerated by diabetes.
Finally, keep in mind that 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, consider switching to 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, drink plenty of fluids during and after exercise to prevent dehydration. If you are having problems with diabetic eye disease, avoid jumping, jarring, or breath-holding activities. When in doubt, talk to your doctor and follow the exercise guidelines published by the American Diabetes Association, and remember to include proper warm-up and cool-down periods (3-5 minutes 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 popping a pill or two to control your diabetes, it is well worth the effort. Just start by being as active as you can each and every day – and start reaping health and fitness benefits!