Exercise's Effects on Diabetes

Exercise's Effects on Diabetes:

Moderate aerobic exercise can lower your risk for type 2 diabetes.

Exercise has positive benefits for those who have diabetes. It can lower blood sugar levels, improve insulin sensitivity, and strengthen the heart. Strength training, which increases muscle and reduces fat, may be particularly helpful for people with diabetes.

People with diabetes who begin a new or vigorous exercise program should have their eyes examined, and discuss footwear and heart risks with their physician.

Type 1 diabetes: Aerobic exercise has significant and particular benefits for people with type 1 diabetes. It increases sensitivity to insulin, lowers blood pressure, improves cholesterol levels, and decreases body fat.

For improving glycemic control, the American Diabetes Association recommends at least 150 minutes per week of moderate-intensity physical activity (50 - 70% of maximum heart rate) or at least 90 minutes per week of vigorous aerobic exercise (more than 70% of maximum heart rate). Exercise at least 3 days a week, and do not go more than 2 consecutive days without physical activity.

Strength Training. Strength training, which increases muscle and reduces fat, is also helpful for people with diabetes who are able to do this type of exercise. The American Diabetes Association recommends performing resistance exercise three times a week. Build up to three sets of 8 - 10 repetitions using weight that you cannot lift more than 8 - 10 times without developing fatigue. Be sure that your strength training targets all of the major muscle groups.

Some Precautions for People with Diabetes Who Exercise

The following are precautions for all people with diabetes, whether type 1 or 2:

• Because people with diabetes are at higher than average risk for heart disease, they should always check with their doctors before starting a demanding exercise program. For people who have been sedentary, or have other medical problems, lower-intensity exercises are recommended, using programs the patients designed with their doctors.
• Strenuous strength training or high-impact exercise is not recommended for people with uncontrolled diabetes. Such exercises can strain weakened blood vessels in the eyes of patients with retinopathy (a common diabetic complication). High-impact exercise may also injure blood vessels in the feet.

Patients who are taking medications that lower blood glucose, particularly insulin, should take special precautions before starting a workout program.

• Wear good, protective footwear to help avoid injuries and wounds to the feet.
• Glucose levels swing dramatically during exercise. People with diabetes should monitor their levels carefully before, during, and after workouts.
• Patients should probably avoid exercise if glucose levels are above 300 mg/dL or under 100 mg/dL.
• To avoid hypoglycemia (low blood sugar), people with diabetes should inject insulin in sites away from the muscles they use the most during exercise.
• People with diabetes should drink plenty of fluids. Before exercising, they should avoid alcohol and certain medications, such as beta-blockers, which increase the risk of hypoglycemia.
• Insulin-dependent athletes may need to decrease insulin doses, or take in more carbohydrates, prior to exercise. However, they may need to take an extra dose of insulin.

A person with diabetes must regularly check their blood sugar (glucose) level.

Resources

• http://fitness.gov -- The President's Council on Physical Fitness and Sports
• www.ncppa.org -- National Coalition for Promoting Physical Activity
• www.acefitness.org -- American Council on Exercise
• www.arthritis.org -- The Arthritis Foundation offers tips on exercising with arthritis
• www.justmove.org -- Just Move (American Heart Association)
• www.nhlbi.nih.gov/health/public/heart/obesity/wecan -- We Can! (National Heart, Lung, and Blood Institute)

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• Reviewed last on: 5/4/2009
• Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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