Diabetes, Exercise, Living with Diabetes

Exercise and Diabetes


Why and How to Exercise For Diabetes

When you have diabetes, exercise is one of the most important considerations to prevent the progression of diabetes.  Exercise also reduces the number of medication burden. Your doctor tells you that you need to be more active, right? What does he or she really mean? How does exercise play a role in diabetes? What type of exercise is best to improve diabetes? There are many aspects of exercise that one should consider before starting an exercise program.

Many Americans do not meet the recommended guidelines for physical activity.  Just 39% of adults with diabetes are physically active. We define exercise as moderate or vigorous activity. This activity should last for at least 30 minutes, 3 times per week.  

For most people with any type of diabetes, exercise can be undertaken safely. Patients can manage blood glucose levels effectively. Consider being under supervision by doctor specialists and diabetes coaches. SugarMDs team is experienced to guide you through the process for a newer, healthier you. Lets dive deeper into exercise and diabetes details. 

Physical activity and exercise are important. It is important for both the prevention and the treatment of type 2 diabetes. Blood glucose management with exercise as in type 1 diabetes can be more challenging.  But, most of the same benefits are very possible for type 1 diabetic patients as well.

Benefits of Physical activity


diabetes and exercise
diabetes and exercise

Regular physical activity can prevent or delay the onset of type 2 diabetes.  As a result reduce its complications. Studies proved that physical activity can be even better than taking a medication. A large trial reported that intensive lifestyle intervention decreased the incidence of type 2 diabetes by 58%. Compare this with 31% in the group taking metformin. Impressive hah?  Increased physical activity can also be important to sustain weight loss. 

How does exercise help diabetes?

Current evidence suggests physical activity improves insulin action. Exercise also lowers blood glucose levels, improves body mass index (BMI), and reduces several risk factors for cardiovascular disease.

Transitioning from being sedentary to an exercise routine

We recommend moderate- to vigorous-intensity physical activity. This type of exercise for diabetes helps achieve aerobic and metabolic improvements.  Yet, safe exercise participation can be complicated by the presence of diabetes-related health issues. These issues could be cardiovascular disease, hypertension, neuropathy, etc. For individuals who wish to participate in low- intensity activities like walking, doctors at sugarmds.com can help. They will use clinical judgment in deciding whether to recommend pre-exercise testing. They may recommend tests such as ECG or cardiac stress testing before starting exerise if necessary. 

Medical evaluation prior to exercise for diabetes

Before undertaking higher intensity physical activity, patients should undergo a detailed medical evaluation. It is important to account for blood glucose levels, physical limitations, medications. Doctors will search for history or signs vascular problems. Vascular problems include problems in heart, blood vessels, eyes, kidneys, feet, and nervous system.

On the other hand, asymptomatic individuals who are receiving a good diabetes care are lucky. If they wish to begin low- or moderate-intensity physical activity, they can. Although, It should not exceed the demands of brisk walking or everyday living. If that is the case there is no for need medical clearance. So, it is very important to be evaluated by a diabetes expert such as the ones at SugarMDs. This is to ensure you are treated with best practices as well as fit to engage in physical activity. 

Developing a Structured Diabetes Exercise Program 

Structured exercise sessions generally have 3 parts: 

  1. Warm-up
  2. Conditioning
  3. Cool-down 

The warm-up phase includes doing 5 to 10 minutes of activity at a slower speed or lower intensity. Warming up before moderate- or vigorous-intensity aerobic activity allows a gradual increase in heart rate. It also help catching your breath at the start of the exercise.

The conditioning phase includes activities to enhance cardiac and respiratory fitness, muscle strength, and endurance, or flexibility.

The cool-down phase is  at least 3 to 5 minutes. It inlvoves a lower intensity activity to help the body gradually recover from the exercise. It also help to transition safely back to a resting state. Doing so helps prevent blood from pooling in the arms and legs and removes metabolic waste immediately after exercise. Doing so will reduce fatige after exercise.

Types of exercises that are helpful for patients with diabetes

Aerobic Exercise: ​

Aerobic exercise is defined as a continuous, dynamic exercise. With aerobic exercise patients use large muscle groups. Examples include walking, jogging, biking, swimming. If you are interested you can do water aerobics, cycling, rollerblading, and cross- country skiing. Aerobic exercise is most common prescription for diabetes management and prevention. 

Resistance/strength training:

Resistance exercise or strength training also help to improve musculoskeletal health. It helps an individual maintain independence in performing daily activities . It also reduces the possibility of injury. Properly designed resistance programs may improve heart function, glucose levels, and strength. 

Individuals with unstable diabetic eye disease should avoid activities that dramatically elevate blood pressure. These activities include intense resistance training such as heavy lifting. You should also avoid jumping, jarring, head- down, or breath-holding activities with unstable eye disease. Before starting resistance training, individuals with diabetes and heart disease need to have an ejection fraction >45% and a fitness level of 7 METs. Do not do resistance training if you have serious ECG changes or serious arrhythmias, or symptoms of serious heart disease.


Safety precautions for patients with diabetes undertaking exercise 

  1. Warm-up and cool-down. 
  2. Careful selection and progression of exercise program. 
  3. Monitor blood glucose pre-and post-exercise.
  4. During prolonged activities adjust medications and food intake to prevent hypoglycemia.
  5. Consult with healthcare personnel at www.sugarmds.com about regimen changes. 


Determining the intensity of exercise for Diabetes

Recommending a standard starting intensity range is difficult. Because deconditioned individuals can improve their cardiorespiratory fitness at lower intensities. Whereas, individuals with greater fitness typically require a higher minimum threshold. We prescribe intensity range  based certain criteria. These include one’s fitness level, duration of diabetes, degree of complications, and individual goals.

Due to the high prevalence of cardiovascular disease, We recommend caution for applying standard heart rate formulas to diabetic patient. 

The rating of perceived exertion (RPE)

The rating of perceived exertion (RPE) is another useful guide for estimating exercise intensity. 

When we use RPE we recommend patients to focus on full-body feelings of exertion and general fatigue. While performing the activity within his or her target exercise intensity, we ask them to identify feelings of exertion and fatigue.

Generally, a moderate-to-vigorous exercise intensity  RPE ranges from 12 to 16 on a scale of 6-20.  A high correlation exists between a person’s perceived exertion rating (6-20 scale) multiplied by 10 and the actual heart rate during physical activity. For example RPE rating of 13 × 10 = heart rate of approximately 130. This works best for younger individuals whose maximal heart rate (HR) is near 200 bpm. Therefore, perceived exertion may provide a fairly good estimate of actual heart rate during activity. This practice does not apply to people taking medication that affects heart rate. Most common drugs in this area are beta-blockers.  But, perceived exertion is still valid to use with caution in their case and in people with altered HR due to autonomic neuropathy. 


Determining the necessary duration of activity to harvest the benefits of exercise

You want to gain maximum caloric and glucose lowering benefit? Then, perform lower intensity exercise for longer periods of time rather than shorther higher intensity exercise. Guidelines from the American heart association are as follows. For adults and older adults they recommend 150 minutes of moderate activity (30 minutes, 5 days per week). For all other adults 60 minutes of vigorous physical activity (20 minutes on 3 days) also is acceptable. Most patients with diabetes will not be able to engage in vigorous physical activity due to physical or medical limitations. So, we recommend most individuals with type 2 diabetes at least 150 minutes of moderate to vigorous aerobic exercise per week. This helps achieve optimal cardiovascular risk reduction.

Longer less frequent versus shorter more frequent activity

Diabetic patients can do shorter exercise sessions throughout the day. Studies have shown that similar  gains occur when patients exercise throughout the day in shorter bouts (3 bouts of 10 minutes).  Similar benefit occur with a single prolonged activity session of similar duration and intensity (a 30-minute bout). So this is up to the patient and his or her lifestyle. Severely deconditioned individuals may need to exercise in multiple sessions of short duration (5-10 minutes).


How frequent should patients with diabetes exercise?

Individuals with diabetes should undertake physical activity at least 3 nonconsecutive days per week. But up to 7 sessions of moderate activity per week will likely be even more beneficial. More exercise will improve glucose control and fitness. It will help in achieving target caloric expenditure.  An exercise that is limited to 2 days per week generally does not result in significant improvements.

For individuals taking insulin, being active on a daily basis may help balance caloric needs with insulin dosing. Exercise also helps maintain higher levels of insulin sensitivity to allow for less insulin dosing.


Physical activity is a vital part of better diabetes control.

And, it has a positive effect on blood pressure and blood cholesterol. It aids in the prevention of type 2 diabetes as well. Choose an activity you enjoy! Involve family or friends in a swim class, biking or hiking trip, even some Zumba.

Contact your healthcare provider for approval of an exercise plan. Let them know if you have high blood pressure or any other complications (such as neuropathy or arthritis).

Wear diabetes identification. Test blood glucose before and after activity.

Create a network of friends and family who will support you. Ask them to keep you accountable, partner with you, and motivate you to get going. Make sure to talk to your healthcare professional team at www.sugarmds.com about your physical activity routine. Report any pain associated with it, any challenges, and the impact on your health.

Exercise with a frequency of a minimum of 3 days per week. Remember the additional benefits likely from up to 7 days.

Do not go without exercise no more than 2 consecutive days. Keep total exercise duration of a minimum of 150 minutes.  Spread exercise throughout the week. Yet, possibly a lower total time such as 60-90 min if done more intensely. Move from moderate to vigorous activity as fitness levels allow.

Strength training 2-3 times a week also helps improve diabetes control.

For resistance/strength training you can use machines, free weights, resistance bands, and/or bodyweight as resistance exercises. 8 to 10 exercises that cover all the major muscle groups. 1 to 3 sets of 8 to 15 repetitions is ideal.

Contact us

At sugarmds.com we recommend both aerobic and strength training. Of course that depends on patient’s medical and physical condition. For a more detailed evaluation and assessment contact sugarmds.com. Reach us at our website or call 1-800-644-3963 NOW. You can also email us at ask@sugarmds.com.


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