There is no doubt that exercise is good for you, and for people with diabetes, the benefits go beyond just trimming your waistline. If you have diabetes, regular physical activity can help you manage your blood sugar levels better by relieving stress, aiding sleep, increasing energy, and more, According to the American Diabetes Association. Exercise can also help reduce the risk of diabetes complications.
“Exercise is the cheapest prescription,” he says. Osama Hamdi, MD, PhD, medical director of the Clinical Obesity Program and director of the inpatient diabetes program at the Joslin Diabetes Center at Harvard Medical School in Boston. “No co-payments required. No insurance required. Sometimes I write ‘workout’ on my prescription and give that to my patients.”
That’s why it’s important to note the newly released second edition of the US Department of Health and Human Services (HHS) Physical Activity Guidelines for Americans, which experts say contains useful information for people managing diabetes. Namely, while most of the advice remains unchanged, the new guidance, released in mid-November 2018, offers more options on how to reach the minimum activity goals.
Related: New physical activity guidelines say we should move more throughout the day
How much exercise do diabetics need?
According to HHS, 4 out of 5 people do not exercise enough, and more than a quarter of American adults do not do any physical activity.
For significant health benefits, regardless of whether you have diabetes, the new guidelines encourage adults to exercise in one of the following ways:
- At least 2 hours 30 minutes (150 minutes) to 5 hours (300 minutes) of moderate-intensity exercise per week, such as brisk walking at 4 miles per hour (mph); Heavy cleaning with light cycling or lawn mowing, According to Harvard T.H. Chan School of Public Health
- 1 hour and 15 minutes (75 minutes) to 2 hours and 30 minutes (150 minutes) of vigorous aerobic physical activity per week (for example, playing soccer or basketball, shoveling, hiking, or jogging at 6 miles per hour , according to Harvard University.)
- An equivalent combination of moderate and vigorous activity
“The only thing that’s really new is that before the instructions we only talked about doing at least 10 minutes at a time of a planned workout at a specific intensity,” he says. Sherry R. Kohlberg, Ph.D.author The Diabetes Athlete’s Guide: Expert Tips for 165 Sports and Activities and Professor Emeritus of Exercise Science from Old Dominion University in Norfolk, Virginia. “Now there is no minimum requirement to do this activity simultaneously. What matters is the cumulative amount over the course of the week.”
The guidelines recommend that people with chronic diseases, including diabetes, who cannot meet the recommended minimum activity level, exercise according to their abilities and avoid inactivity.
Related: 10 amazing benefits of exercise
Tips for reaching your exercise goal when living with diabetes
If you’re not already exercising, the idea of fitness can seem daunting. This can be especially true when managing your blood sugar day in and day out. But you don’t need to complicate it by signing up for an expensive gym membership or signing up for boutique fitness classes. “What matters is how much activity you accumulate to get to 150 minutes per week,” says Petul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic in Ohio. “Can you take a break and walk three or four minutes around the block, at home, or in the office? You don’t have to do as many exercises to accumulate 25 minutes of exercise a day.”
Dr. Kohlberg says another change to the guidelines may be welcome news for weekend warriors, as HHS says people can get similar positive results if they bundle all of their activities into a weekend rather than spreading out their workouts throughout the week.
Related: All you need to know about fitness
But you’ll want to check with your doctor about this suggestion because your blood sugar level may be stable if you spread out your physical activity. “I think it’s best for people with diabetes to spread their physical activity as much as possible throughout the week, because the effect of exercise on improving blood sugar by improving insulin resistance lasts about 24 hours,” says Dr. Hatipoglu. “So if you exercise fairly every day, you get the beneficial effect every day.” Insulin resistance is a hallmark of type 2 diabetes and a large body of research, as detailed in A Review published in July 2015 in Journal of obesity and weight loss treatmentsuggests that exercise can help improve insulin sensitivity, making blood sugar control easier.
One of the major new guidelines for adults is to move around more and sit less. Hatipoglu says incorporating more movement into your daily activities can help. She recommends using the stairs when possible, standing further from your destination to walk more, standing while taking notes, and figuring out other ways to just move around in your daily life.
Related: 6 great exercises for diabetics
Importance of muscle training for diabetics
The new guidelines suggest that adults do muscle-strengthening activities of moderate or greater intensity involving all muscle groups on two or more days per week.
“Maintaining muscle activity is a very important treatment for diabetic patients because it lowers the blood sugar level and improves physical fitness,” says Dr. Hamdi. “When the muscles are active, the muscles take in glucose without the need for insulin.”
He adds that strength training is especially important for people with diabetes, as these individuals tend to lose muscle mass every year.
Related: How to organize your workouts to better control your blood sugar
Experts also recommend stretching and balancing activities for people with diabetes. Hatipoglu says falls are common among people with type 2 diabetes who have neuropathy, which is damage to the peripheral nerves, often in the feet. She recommends yoga as part of balance training. Although she says it may sound funny, one of her colleagues says that you can improve your balance every morning if you brush your teeth while standing on one foot.
Hamdi wishes the guidelines would emphasize stretching more. “People with diabetes underestimate the importance of stretching,” he says. “It increases flexibility in your joints, improves blood flow, increases range of motion, and prevents injury.”
Related: 4 great exercises for people managing diabetic neuropathy
The guidelines state that the more you exercise, the better – is this true for diabetics?
Another notable change in the guidelines, Kohlberg says, is that the more you exercise, the more health benefits you’ll reap — even if you exceed the recommendations above.
But in the case of intense exercise, it can be risky for diabetics, says Hamdi. “People with diabetes should not do vigorous, continuous exercise,” he says. “The best way to do vigorous exercise is interval training. So maybe do a vigorous five-minute fast and then rest for another five minutes.” He cautions that intense exercise that exceeds a certain limit may cause the liver to push sugar into the circulation to compensate. “If you push too much sugar out of the liver, the blood sugar goes up.”
Overall, Hamdi, Hattopoglu, and Kohlberg all advise that exercise is one of the best health motivators.
“I tell my patients that if you leave the car in the garage, it will rust,” Hamdi says. “To live long, I give them three tips: exercise, exercise, and exercise.”
Related: 7 ways to stay motivated to exercise if you have diabetes
