People with type 2 diabetes need to exercise

For people who live with type 2 diabetes, exercise is one of the foundations of good health.

For everyone, exercise helps control weight, lowers blood pressure, lowers harmful LDL cholesterol and triglycerides, raises healthy HDL cholesterol, strengthens muscles and bones, reduces anxiety, and improves your general well-being.

There are added benefits for people with type 2 diabetes, including lowering lowering blood glucose levels, boosting the body’s sensitivity to insulin and countering insulin resistance.

 Highlights of research

Many studies underscore these and other benefits from exercise. Following are some highlights of that research:

Exercise lowered HbA1c values by 0.7 percentage point in people of different ethnic groups with diabetes who were taking different medications and following a variety of diet. This improvement occurred even if they didn’t lose weight.

  • All forms of exercise – aerobic, resistance, or doing both – were equally good at lowering HbA1c values in people with diabetes.
  • Resistance training and aerobic exercise both helped to lower insulin resistance in previously sedentary older adults with abdominal obesity at risk for diabetes. Combining the two types of exercise proved more beneficial than doing either one alone.
  • People with diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counterparts, and those who exercised three to four hours a week cut their risk even more.
  • Women with diabetes who spent at least four hours a week doing moderate exercise (including walking) or vigorous exercise had a 40 per cent lower risk of developing heart disease than those who didn’t exercise. These benefits persisted even after researchers adjusted for confounding factors, including BMI, smoking, and other heart disease risk factors.

The best time to exercise

You will hear many different suggestions about what is the best time to exercise.

From us here at Diabetes Queensland our advice is: The best time to exercise is when it works for you. When you can fit it into your day, you’re more likely to do it. We suggest you find 30 minutes each day to get active because the benefits for your body are real.

Resistance exercise (such as weights, yoga and Pilates) causes the liver to release glucose so blood glucose levels (BGLs) initially increase. They decrease many hours later as the body “pays the liver back”.

Aerobic exercise (including walking, running and cycling) reduces BGLs. Mixed exercise (eg High Intensity Interval Training or HIIT classes) has varying effects on BGLs, and Queensland scientists are at the forefront of furthering research into HIIT as an effective tool to manage type 2.

All of these exercises will help your health in the long term.

If using insulin, check glucose levels pre, during and post exercise. Keep a record of the following information and review your individual responses:

  • Glucose levels – pre, during and post exercise
  • Carb intake – pre, during and post exercise
  • Insulin adjustments and active insulin at the start of exercise
  • Duration, type and intensity of your exercise session
  • How you felt during the session

 Anyone who is on sulfonylureas should also note glucose levels and take note of how different activities affect them so they can plan for future activity.

BGL before exercising

If you use insulin, it’s important to check your blood glucose before exercising. If the level before exercise is between 5-6.9mmol/L then have 10-15g of carb such as a piece of fruit or 200g yoghurt. If you’re doing resistance exercise then you can start straight away but if you wish to do aerobic exercise wait until you’re BGLs are more than 7mmol/L before starting.

Carrying some high glycaemic index carbohydrate as a hypo treatment, such as jelly beans or glucose tablets, is advised for those who use insulin or sulfonylurea family of medications.

It’s also a good idea to check your blood glucose after any particularly gruelling workout or activity. If you’re taking insulin, your risk of developing hypoglycaemia may be highest six to 12 hours after exercising.

Experts also caution against exercising if your blood glucose is too high (over 15mmol/L), because exercise can sometimes raise blood glucose even higher.

Consider wearing a medical alert bracelet indicating that you live with diabetes. People on insulin or sulfonylurea medications are most at risk of a hypo.

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