Exercise plays a crucial role in sustaining a healthy life. For people with diabetes, exercise is important for managing blood glucose and preventing long-term health complications. Physical exercise enables insulin to work more efficiently, resulting in better diabetes management. It also helps to lower cholesterol, reduce blood pressure, improve heart health and sleep, and control body weight.
Aerobic exercise and resistance training are proven effective interventions for the management of type 2 diabetes and its complications. When both these forms of exercise are combined, they have a significant positive outcome.
Aerobic exercise, also known as cardiovascular exercise, is a type of low to high-intensity physical activity involving the use of oxygen to generate energy. Such exercises raise the heart rate and breathing. There is a steady but elevated breathing rate, and one can sustain the activity for extended periods. When doing aerobic exercise, glucose from the blood is used as fuel. This lowers the level of blood sugar when the exercise is done consistently for 30 minutes.
A few quick and easy ways to incorporate aerobic exercise are:
- Brisk walking
- Jogging or running
- Cycling / stationary cycling
- Climbing stairs
One should aim for 150 minutes of aerobic exercise per week. Initially, people with diabetes can perform the exercise for 5 to 10 minutes per day and then can gradually increase to 30 minutes. Also, the exercises can be performed in multiple shorter sessions of 10 minutes each.
What is interval aerobic training?
Interval aerobic training refers to short periods of vigorous aerobic exercise with alternating intervals of short recovery periods. Vigorous exercise can be running or cycling with recovery periods of low-to-moderate intensity or rest for about 30 seconds to 3 minutes. In people with type 2 diabetes, interval aerobic training is found to be highly effective. It also reduces the risk of hypoglycemia (low blood sugar) in people with type 1 diabetes.
Resistance training or anaerobic exercise does not require oxygen to generate energy, as in the case of aerobic exercise. These are more intense activities that can be performed for a short period with repetitive sessions. During resistance training, the muscles use stored glycogen as fuel instead of using glucose from the blood. Resistance training is simply any exercise which uses an external resistance (e.g. dumbbells, bricks) to make the muscles contract, and can be done easily at home or the gym.
A few quick and easy ways to incorporate resistance exercise include:
- Free weights (e.g., dumbbells)
- Weight machines
- Resistance bands
- Stretching exercises
- Muscle-building exercise
A great set of simple but effective resistance exercises has been recommended by Diabetes Canada.
One should aim to perform resistance exercises 2 to 3 times a week. Before starting with resistance training, it is recommended to get instructions from a qualified trainer or a physical therapist.
Which exercise is ideal for diabetic people?
As per the American Diabetes Association, a combination of aerobic exercise and resistance training is beneficial for people with diabetes. Doctors recommend at least 150 minutes of aerobic exercise (30 minutes, five days a week) and 2-3 sessions of resistance exercise like lifting weights, spread over a week.
People who did a combination of aerobic and resistance exercises showed significant improvement in blood sugar than those who performed only one of them. Also, studies show that these exercises lower HbA1c levels only when carried out together. It is important to note that when performing a combination of these exercises, one should begin with resistance training as it leads to less decline in blood glucose levels.
In addition, other helpful exercises for better balance and flexibility are recommended for people with diabetes. Yoga and Tai chi are excellent forms of physical activity that known to create positive outcomes in a number of people dealing with blood sugar challenges.
It is important to note that not all people respond to exercise the same way, and a certain degree of customization may be required depending on the individual case. Several factors need to be taken into account, especially for people on insulin or those with type 1 diabetes. For gestational diabetes too, the exercises recommended could be completely different from the ones recommended for other types. Before starting on a new exercise regimen, it is always a good idea to discuss options and develop a plan, together with your doctor and diabetes educator.