Exercise for Diabetes: How and What to do?

How Does Exercise Help in Managing Diabetes?

Diabetes mellitus is a chronic condition that affects your body's ability to produce (Type 1 Diabetes) or use a hormone called insulin or both (Type 2 Diabetes), resulting in high blood glucose (sugar) levels. 

Any kind of exercise or physical activity, when done consistently, can have several benefits for your health. Exercise is a key component of lifestyle modification for the prevention and treatment of diabetes. It helps control your blood glucose levels and manage diabetes as it:

Improves the insulin sensitivity of cells

The food you consume is broken down into glucose units by your body. Excess glucose is stored in the form of glycogen (a stored form of sugar in the cells) in the liver and muscle cells. 

During high-intensity exercise, your body converts the stored glycogen into energy. To compensate for the shortage of glycogen, the muscle cells take up glucose from the bloodstream. 

Insulin facilitates the transport of glucose into the cells, where it is stored and converted into energy when required by the body. The increased utilisation of glucose due to exercise increases the insulin sensitivity of the cells and decreases blood glucose levels.

Contributes to healthy weight loss 

Obesity is one of the biggest risk factors for Type 2 Diabetes. Studies suggest that in obese individuals, the fat cells in the abdomen release pro-inflammatory proteins such as interleukins and tumour necrosis factors, which interfere with the body's ability to respond to insulin (insulin resistance).

Obesity also has an impact on the body’s metabolism. It causes fat tissue to release fat molecules into the bloodstream, which can affect insulin-responsive cells and lead to reduced insulin sensitivity. This elevates blood glucose levels.

Exercise helps reduce the excess fat in the body and counteracts the effects of fat on blood glucose levels.

Reduces the risk of diabetes-related complications 

High blood glucose levels are known to damage your blood vessels over extended periods. This results in insufficient blood supply to your vital organs and thus, damage to your eyes, heart, brain, feet, and kidneys. 

Exercise is known to regulate blood glucose levels by improving the insulin sensitivity of the cells. Thus, it helps manage diabetes and reduces the risk of related complications. 

Maintains muscle strength

Insufficient action of insulin leads to reduced growth and multiplication of muscle cells, resulting in a decline in skeletal muscle mass. Exercise aids in improving insulin levels in the body and helps maintain muscle strength. 

What are the Best Exercises for Diabetes?

Walking

Whether you have Type 1 or Type 2 Diabetes, walking is the simplest way to keep yourself physically active. Take a brisk walk for at least 30 minutes a day for 5 days a week. Walking has several benefits:

• It is easy on your joints. It improves your stamina and helps burn excess fat.
• It can help your body produce and use insulin more effectively.
• It can reduce stress and prevent the release of stress hormones. These hormones disrupt the function of insulin-producing cells in the pancreas and decrease the production of insulin required to regulate blood glucose levels.
• A lack of sleep of fewer than 7 hours can increase insulin resistance. Walking helps you get better sleep and thus aids in regulating blood glucose levels.

Dancing

Dancing is a fun way of exercising. It increases physical activity, improves flexibility, promotes weight loss, lowers blood glucose levels, and reduces stress. Dancing for 30 minutes at least 3 days a week can help burn calories and manage diabetes.

Swimming

Aquatic physical activities involve the upper and lower parts of the body and do not strain your joints unnecessarily. Swimming burns calories, stretches and relaxes your muscles, and improves muscle strength. It is also known to lower stress, reduce blood glucose and cholesterol levels, and enhance the health of your heart and lungs. 

Yoga

Yoga involves breathing techniques and movements performed methodically. Specific yoga poses such as Surya namaskar (sun salutation), Dhanurasana (bow pose), Bhujangasana (cobra pose), and Shavasana (corpse pose) may help lower blood sugar levels and also improve blood circulation. 

Yoga may also help reduce the risk for diabetes-related complications, including heart disease. It is ideal to practise yoga under the supervision of a trained professional. 

Tai Chi

Tai Chi is an ancient Chinese practice of gentle physical exercise and stretching. Studies suggest that gentle exercise has been shown to prevent diabetes. 

Stress may also be a contributing factor to the worsening of diabetes. Tai Chi helps reduce stress and encourages mental relaxation. 

Tai Chi focuses on building strength, balance and flexibility through slow and fluid movements combined with deep breathing. Research suggests that Tai Chi has beneficial effects on cardio-respiratory fitness, muscular strength, balance, and peripheral circulation. Thus, it can help minimise the complications of diabetes.

Strength Training

Strength or resistance training includes exercises that help in improving strength and endurance. It is performed with free weights or resistance bands.

As your body undergoes strength training, it uses the stored muscle glycogen for energy. Once this stored muscle glycogen runs out, the body starts to mobilise extra glycogen from the liver and blood. This leads to a decrease in blood glucose levels and stored muscle and liver glycogen reserves. 

Further, strength-trained muscle has a higher capacity to store blood glucose in the form of glycogen, leading to a reduction in blood glucose levels and easier glucose management.

Apart from burning calories during the workout, strength training promotes fat loss by increasing levels of lean muscle mass. Thus, your muscle is metabolically active and continues to burn calories even when the body is at total rest. 

Abdominal (visceral) fat aggravates insulin resistance and complicates blood glucose management. High-intensity resistance training is more effective than cardiovascular exercise at reducing abdominal fat levels and managing blood glucose in people with insulin resistance. 

Lastly, strength training helps prevent Type 2 Diabetes complications through various mechanisms, including: 

• Improving insulin health
• Lowering high blood glucose levels
• Increasing HDL (high-density lipoprotein) or “good” cholesterol levels
• Decreasing LDL (low-density lipoprotein) or “bad” cholesterol levels
• Improving bone density
• Preventing age-related muscle loss
• Reducing the risk of peripheral neuropathy and vision loss 

Gardening

Gardening is one of the best exercises for diabetics who love spending their time in nature. If other exercises seem complicated or cumbersome, gardening is a very simple physical activity that involves walking, kneeling, and bending. 

Gardening can lower your blood glucose levels. It is an excellent cardiovascular workout and protects you against heart disease, which is one of the most common diabetic complications. 

Lastly, gardening helps you beat stress. Stress hormones increase the demand for insulin in your body, which puts more pressure on your pancreas. Hence, gardening can help manage stress and diabetes. 

Cycling

Cycling is a low-impact aerobic exercise that can easily be incorporated into your daily life. Studies suggest that cycling results in an improvement in glucose tolerance, insulin resistance, and insulin secretion. 

It may prevent the development of Type 2 Diabetes by improving glucose metabolism, maintaining blood glucose within normal ranges, and lowering body fat and cholesterol levels.

Stairs climbing

Climbing stairs is the easiest way to burn calories. You do not need any special equipment for this exercise. Just wear a sturdy pair of shoes and minimise the risk of falling. 

According to a study, Type 2 Diabetes patients had lower post-meal blood glucose levels after climbing stairs for three minutes, one or two hours after having a meal.

What is the Best Time to Exercise for Diabetes?

The best time to exercise for diabetes is within 30 min to 2 hours after eating when your blood sugar levels are higher. 

Glucose levels are at their highest within 90 minutes of eating a meal. Individuals with Type 2 Diabetes are advised to keep blood glucose levels at 160 mg/dL within two hours of a meal. Exercising soon after eating reduces blood glucose concentrations. 

Remember to measure your blood sugar levels before you start exercising. This is because your blood sugar levels can rise briefly when you start exercising, owing to the release of stress hormones in your body. It might be harmful to your health if you start exercising with very high blood sugar levels. 

If you are on insulin therapy, check your blood sugar levels after performing any exercise to ensure that your blood glucose is not too low. 

How Much Exercise is Enough in Diabetes?

As per the American Diabetes Association (ADA), most adults with diabetes should aim to get at least 150 min of moderate-to-vigorous intensity activity in a week. The physical activity should be spread over at least 3 days per week, with no more than 2 consecutive days without activity. 

For younger and more physically fit individuals, a minimum of 75 min of vigorous-intensity exercise per week may be sufficient. Consult your doctor about the type and extent of exercise you can undertake as a diabetic. 

If you are just starting to get physically active, start with 5 to 10 minutes at a time and build up over time. Gradually increasing exercise to 30 minutes a day for 5 days a week may help lower your blood sugar level, reduce weight, improve blood circulation, and maintain your overall health.

What are the Safety Measures to Follow for Exercise in Diabetes?

• Before starting any exercise, consult your doctor and discuss whether the exercise of choice is suitable for you. 
• Check your blood glucose levels before and after exercise. If your blood glucose level is less than 100 mg/dL before exercise, eat a carbohydrate snack before your begin.
• Always keep a source of fast-acting carbohydrates such as glucose tablets with you to counter episodes of low blood glucose levels (hypoglycemia) after you exercise.
•  Drink plenty of water before, during, and after exercise to keep yourself hydrated.
• Avoid exercising in extreme hot and cold temperatures. Warm up before exercising as the heat generated will improve blood flow to your muscles and make movement easier.
• Avoid exercising if you experience shortness of breath and dizziness.
• If you exercise outdoors, wear some form of identification that indicates you have diabetes so others can help you. 
• Do not exercise if you are unwell, such as with flu or an infection. 
• Wear comfortable and well-fitting shoes and socks.