Exercise to regulate blood sugar and improve fitness
Managing blood glucose levels is the number one goal for people with diabetes. Exercise interventions lasting eight weeks or longer have been shown to reduce levels of hemoglobin A1c (HbA1c), a marker of long-term blood glucose control, in people with type 2 diabetes. In addition, exercise improves cardiovascular fitness and can help to preserve mobility in people who are overweight and have diabetes.
Aerobic exercise has long-established benefits in helping to reduce diabetes risk and diabetes complications, but the new standards point out that adding weight training to your exercise program could increase these gains. Weight training as a stand-alone intervention has been found to reduce HbA1c levels in older adults with type 2 diabetes, and exercise programs that combine aerobic and weight training exercise have been found to have more HbA1c-lowering effects in adults with diabetes than either type of exercise alone.
How much exercise is enough?
“Exercise has been shown to improve blood glucose control, reduce cardiovascular risk factors, contribute to weight loss, and improve well-being,” the authors of the standards said. “On the basis of physical activity studies that include people with diabetes, it is reasonable to recommend that people with diabetes will specifically benefit from following the US Department of Health and Human Services’ physical activity guidelines.”
Here are the exercise guidelines described in the standards:
- Aerobic exercise: Adults with diabetes should engage in moderately-intense aerobic exercise for at least 150 minutes per week, or vigorous aerobic exercise for at least 75 minutes per week, spread over at least three days with no more than two days in a row without exercise.
- Weight training: People with diabetes should engage in muscle strengthening activities that involve all major muscle groups in the body on at least two days per week.
- Sedentary time: All individuals, including those with diabetes, should limit the amount of time they spend in sedentary activities and interrupt extended periods of sitting (longer than 90 minutes) by briefly standing or walking.
- Getting started: Starting with short periods of low-intensity exercise and gradually increasing both the intensity and duration is the best approach for people with a high risk of cardiovascular disease. Each person’s age, fitness level, and health, should be considered when developing an exercise program.
Another reminder to exercise, eat well, and manage weight
Obesity, especially abdominal obesity, and insulin resistance (when insulin no longer works efficiently to control blood sugar levels) are the most important components of metabolic syndrome—a cluster of conditions, such as high blood pressure and large waistline, that are linked to an increased risk of diabetes and heart disease. Scientists are still working out the causes, but ways to reduce your risk and help address metabolic syndrome are well established:
- Lose weight. If you are overweight, set an initial goal of losing 7 to 10% of your current body weight.
- Examine eating patterns. Eat a diet that is low in sugars and refined grains, and high in vegetables, fruits, whole grains, and nuts and seeds.
- Exercise. The evidence strongly supports the positive role of exercise in improving blood sugar control and reducing heart disease and diabetes risk. Following the guidelines set out in the 2016 Standards of Medical Care in Diabetes will help ensure long-term health.
(Diabetes Care 2016;39:S23–S35. doi:10.2337/dc16-S006)