Should I Exercise with Diabetes?

by: Lisa Ritchie

The latest exercise guidelines  for people with diabetes are likely to shock some, yet for those that follow them, they may help prevent or manage Type 2 diabetes, improve overall health and boost quality of life. A panel of nine experts developed the recommendations, published in Medicine & Science in Sports & Exercise®, the official journal of the American College of Sports Medicine (ACSM) and the American Diabetes Association.

Cardio Recommendations

Research has already established the importance of physical activity for all individuals. These new guidelines provide specific advice for those whose diabetes may limit vigorous exercise. The recommendations call for at least 150 minutes a week of moderate-to-vigorous aerobic exercise spread out over at least three days of the week, with no more than two consecutive days between sessions.  "Many people with type 2 diabetes are elderly and/or don’t have sufficient aerobic capacity to undertake sustained vigorous activity for that weekly duration. They may also have orthopedic or other health limitations," says Sheri R. Colberg, Ph.D., FACSM, who chaired the writing group.  If the 150 minute recommendation is broken down into smaller moderate sessions, most could reach the recommended guidelines, for example, walking for thirty minutes, five times a week, or even break that down to 15 minute sessions  twice a day.

Physicians should prescribe exercise

Many physicians appear unwilling or cautious about prescribing exercise to individuals with type 2 diabetes for a variety of reasons, such as excessive body weight or the presence of health-related complications. However, the majority of people with type 2 diabetes can exercise safely, as long as certain precautions are taken. The presence of diabetes complications should not be used as an excuse to avoid participation in physical activity. In keeping with the philosophy of ACSM's Exercise is Medicine® initiative, Colberg urges that physical activity be a conscious part of every person's health plan, as appropriate for age and physical condition.

Strength training, too

Aerobic activity alone cannot give the full benefit of exercise to diabetic individuals, say the experts. Recent research has shown that resistance exercise (strength training) is as important as aerobic training in diabetes management. The latest studies have reinforced the additional benefit of combining aerobic and resistance training for people with diabetes. The amount of insulin circulating in the bloodstream during exercise is critical in determining performance and preventing fatigue from setting in early from hypoglycemia (low-blood sugar). Insulin levels in the blood drop during exercise, and the rise in glucagon released from the pancreas stimulates the liver to produce more glucose (sugar). If insulin is injected, however, the body is unable to lower the circulating levels when starting exercise. Having too much

insulin under those circumstances is bad news because it stimulates muscles to take up glucose from your bloodstream. Muscle contractions do the same thing, so people with diabetes who are injecting insulin must be careful to test their levels frequently. In people with type 2 diabetes who have moderate hyperglycemia, glucose concentrations can be decreased with moderate-intensity exercise, an important health benefit of exercise.

What About Type 1 Diabetics?

If you are a type 1 diabetic either injecting insulin or wearing an insulin pump, consistent exercise is also highly recommended to help control weight and blood sugar, but certain precautions must be taken. Try to inject the insulin into a site where the muscle underneath will not be utilized. For example, if you are injecting in your thigh a bike ride is probably not a good idea. The increased muscle use and circulation can cause the insulin to spike prematurely. In addition, your blood sugar should be tested before, during and after your workout, and a convenient carbohydrate snack should be handy. You shouldn’t exercise if your blood sugar is over 300 because the presence of ketones may be worsened by exercise. This can present a serious condition called ketoacidosis which may result in coma. Weight lifters need to be careful not to hold their breath, and always keep the head above the heart as this can cause an increase in blood pressure or pressure in the eyes leading to retinopathy, a diabetic condition where tiny blood vessels burst in the eye.

The Future

Predictions that one in three Americans will have diabetes by 2050 (Centers for Disease Control and Prevention) are accompanied by estimates that diabetes and prediabetes in the U.S. will cost almost $500 billion a year by 2020 (United Health Group, Inc.). As individuals, and as a community, we must do all we can to promote a healthy lifestyle and prevent the onset and complications from this disease.



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These statements have not been evaluated by the food and drug administration.  The preceding information and/or products are for educational purposes only and are not meant to diagnose, prescribe, or treat illness. Please consult your doctor before making any changes or before starting ANY exercise or nutritional supplement program or before using this information or any product during pregnancy or if you have a serious medical condition.

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