Living with diabetes can be challenging, but exercise is proven to help you better manage those challenges. Whether you are a Type 1 or Type 2 diabetic, working out regularly can help improve blood pressure, lower rates of heart disease, help manage weight, increase energy levels, and bring down average blood glucose levels. Staying physically active is a vital part of improved health. However, there are important things to consider before jumping on the treadmill. Here’s what you need to know about exercise for diabetics.
How does diabetes affect physical activity?
According to Dr. Michael Riddell, a professor at the School of Kinesiology and Health Science at York University who researches the benefits of regular exercise for diabetics, exercise can affect their blood sugar—both positively and negatively.
“If anybody living with diabetes is on insulin, whether they have Type 1 or Type 2, aerobic exercise—even if it’s grocery shopping, [running] errands, [or] going for a jog or a bike ride—causes hypoglycemia [a low blood sugar] at a very high frequency,” he says. “On the other hand, there are other forms of activity—like hockey, mixed martial arts, or competitive events, like a sprint or boxing match—[and the] stress associated with those forms of exercise [that] can cause high blood sugar—the exact opposite.”
Aerobic exercise tends to cause low blood sugars and anaerobic exercise can cause highs. Due to this, Dr. Riddell says doing an activity that’s a mix of both—like interval training—has a moderating effect. “If you combine aerobic and anaerobic exercise, you get better [blood sugar] control,” he explains.
One thing to be aware of, however, is that both types of exercise for diabetics can produce hypoglycemia in late recovery—often while people are sleeping. This means that it’s vital to ensure that blood sugars are properly managed post-workout, too.
What should diabetics consider before working out?
Before working out, Dr. Riddell says that it’s important for diabetics to understand how different forms of exercise affect their body. Additionally, they should learn to properly manage blood glucose levels. The American Diabetes Association echoes this. It encourages diabetics to check blood sugars before, during, and after a workout.
When it comes to nutrition, Dr. Riddell says that it’s good to let insulin (associated with a previous meal) work its way out of the bloodstream before starting a workout. “A lot of people don’t realize when they take insulin that it has a lasting effect of up to five hours,” he says. “People take their needle with lunch. Then an hour later, if they’re going for a walk, they don’t realize that the insulin is in action. This is why it’s best to have a meal well in advance. Get the food and insulin in the body, and then have it disappear so [that] you have less variables for exercise.”
On top of letting insulin and food work its way out of the body before exercise, it’s also important to account for the exercise itself. For people who are on an insulin pump, Dr. Riddell says that you can reduce the basal rate ahead of exercise. If you’re not on a pump, you have to rely on “free carbs,” or exercise carbs, to account for the amount that you’ll need for your workout. This can be calculated with the help of a website like ExCarbs.com, which lets you know how many carbs and how much insulin you’ll need for an activity. Note: The American Diabetes Association also suggests keeping snacks on hand during a workout, should you get low blood sugar.
How does working out help manage diabetes?
Exercise for diabetics, whether you do aerobic or anaerobic exercise, improves health risks associated with diabetes. “We know from large epidemiological studies that if people living with Type 1 or Type 2 diabetes do regular physical activity, they live longer—ten years longer on average, which is incredible,” Dr. Riddell says.
Dr. Riddell also points to research that says regular exercise for diabetics is associated with a slightly better than average glucose. This in turn lowers lipid levels, reducing the risk of complications to the eyes, kidneys, and heart. “It’s pretty much the magic bullet for diabetes.”
Apart from these long-term benefits, exercise can help moderate blood sugars on a day-to-day basis. “If you check your sugar and you see that you’re kind of high, then you would intuitively understand that you should probably do aerobic exercise to bring it back down to target,” Dr. Riddell says. “If, on the other hand, you’re at target or trending a bit low, then you could switch gears and do mixed or anaerobics. It’s about understanding the principles of the physiology, and then choosing the activities that are best for you.”
What is the best type of exercise for diabetics?
The American Diabetes Association says that both aerobic and resistance exercises are important for people living with diabetes, as both have significant health benefits. Dr. Riddell encourages his patients to do whatever exercise they like, whether it be biking, hockey, or resistance training, and tries not to put restrictions on them. The one caveat, however, is if people have complications associated with their diabetes.
In these cases, Dr. Riddell advises that it’s best to not raise blood pressure too high. This can be caused by heavy weight lifting or even stair climbing. “[These things] tend to bring the blood pressure up a bit towards what can be dangerous as far as complications to the eyes or to the heart,” he says. “But other than that, I think all forms of exercise have shown [positive] outcomes in Type 1 and Type 2 diabetes.”
How often should you exercise if you’re diabetic?
Dr. Riddell says that regular exercise is super beneficial to managing both types of diabetes. He encourages people to live active lives. He suggests getting in at least 10,000 steps every day, and ensuring that you do another form of exercise—like resistance training—three days a week. “That would be the ideal so [that] there’s not a day off of active living,” he explains. “Honestly, the more exercise the better.”