Physical Activity

For persons with diabetes or pre-diabetes, physical activity is a fantastic lifestyle modification to improve diabetes management. By participating in physical activity, individuals can experience weight maintenance, decreased heart disease risk, and increased cardiovascular fitness. Additional benefits are improved insulin sensitivity and glycemic control. By exercising, those with prediabetes can delay or even prevent the development of type 2 diabetes.

Recommendations are at least 150 minutes a week or 20-25 minutes a day of moderate-intensity exercise. Additionally, individuals should work the major muscle groups at least twice a week. Individuals who are not currently active can start with lower intensity activities, such as walking and bodyweight exercises, and gradually increase how frequently and how long activities are performed.

Types of Physical Activity:

A variety of exercises is important for all individuals. Aerobic exercise is the continuous movement of large muscle groups. Some examples of this include walking and cycling. An additional type of aerobic exercise is High Intensity Interval Training (HIIT) which is a form of interval training with short period of aerobic exercise with rest. The recommendation is 30 min/day with no more than three days in between or low volume HIIT. The recommendation is 30 min/day with no more than three days in between or low volume HIIT. Aerobic periods last from five seconds to eight minutes long, making it flexible to individuals. Following this endurance period, individuals are able to rest for equal time to recover. HITT circuit workouts are free through the American College of Sports Medicine.

Resistance exercise training is an exercise to improve flexibility and balance. It leads to an improved range of motion and minimize falls. It is also a great balance to aerobic exercise, due to a lower risk of hypoglycemia. Resistance exercise training consists of three components: intensity, frequency, sets and repetitions. These components can be changed for individuals and increased as endurance increases. Some examples include lifting weights and using resistance bands. The recommendation is 2-3 times a week every other day.

Tips & Considerations:

When participating in physical activity, there are some things to consider prior to starting exercise. Individuals with diabetes can have impaired temperature regulation and poor glucose control during exercise. Before activity, make sure to check blood sugar levels. The ideal range is 100-240 mg/dL.  If your blood sugar is below 100 mg/dL, eat 15-30 grams of carbohydrate such as a ½ cup fruit juice. If your blood sugar is above 240 mg/dL, it is possibly too elevated to exercise safely. Be sure to test your urine for ketones prior to exercise, as the presence of ketones elevates the risk for ketoacidosis.

Before exercising, make sure you wear cotton socks and well-fitting shoes. Make sure to drink plenty of fluids to prevent dehydration! Following the activity, it is important to check your feet for sores, blisters, and other injuries. If these don’t heal within two days, contact your healthcare provider.

To reduce barriers to exercising, try out a variety of new exercises to determine what you like. Talk with family or friends and schedule a time to exercise together!

References:

Colberg SR, Sigal RJ, Yardley JE, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079. doi:10.2337/dc16-1728

Get Active! Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/active.html. Published April 24, 2018. Accessed June 30, 2021.

Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320(19):2020-2028. doi:10.1001/jama.2018.14854