November is National Diabetes Month and we would like to help you manage or prevent this disease with some advice from our collaborators at Memorial Hermann.
The most common type of diabetes is Type 2 resulting from progressive loss of insulin secretion and usually accompanied by insulin resistance. A common feature of this disease is excess body fat in the upper body region. People who live sedentary lives put themselves at a higher risk for developing pre-diabetes and eventually Type 2 diabetes. The goal of diabetes management is trying to control the blood glucose levels using diet, exercise, and, in some cases, medications
such as insulin.
Starting an exercise program can be intimidating especially if you don’t have any experience in this area. Don’t be discouraged, you don’t have to reinvent the wheel to improve or manage your health. If you have pre- diabetes or diabetes, especially Type 2, something as simple as breaking up long periods of prolonged sitting every 30 minutes with 3 min of light walking or body weight exercises can help improve glycemic control. That is just a start though, it should complement a structured exercise program and healthy diet. There are three main types of exercise that should be included in your workout regimen: aerobic, resistance training, and flexibility.
If you are overweight or have never done any type of structured exercise before it is wise to start slow and build up. A good start is a change in your daily activities like increasing your unstructured physical activity such as taking the stairs instead of the elevator or doing household tasks, walking your dog, and parking in the back of the parking lot and walking farther to your destination. This is just a stepping stone though and should be used accordingly followed by structured aerobic and resistance training.
Aerobic exercise is what most people think when they hear the word “cardio”, these are you longer duration continuous movement of large muscle groups. Types of exercise that use primarily the aerobic energy system are walking, jogging, cycling, walking stairs, or participating in recreational sports. Some of the key benefits of this type of exercise for an individual with diabetes are increased insulin sensitivity, immune function, and cardiac output, while decreasing insulin resistance, blood pressure, and cardiovascular mortality risks.
There are different modes of aerobic exercises that range from long duration moderate intensity exercises such as cycling for an hour at a moderate pace, to high-intensity interval training (HIIT) which consist of shorter bouts of, as the name implies, high intensity exercise with small well planned breaks. Doing a mixture of both types of exercises is a good way to build a balanced aerobic conditioning level while preventing boredom from repeating the same exercises all the time.
The recommended prescription for aerobic exercises are bouts that last at least 10 minutes with the goal of 30 min/ day minimum. These exercises should be done most days of the week starting with moderate intensities and working your way up to at least 150 min/ week of moderate to high intensity. If you are doing more HIIT the time per week may be a little less than 150 minutes due to the intensity of the exercises.
Resistance training or strength training are exercises done with free weights, machines, bands, or body weight. These types of exercises are great for individuals with diabetes because our muscles use glucose for energy during strength training which can improve glycemic control. Resistance training also improves insulin sensitivity, blood pressure, physical function, and cardiovascular health.
Strength training should be done 2-3 times/week and if you’re just starting out you should use body weight or lighter weight and perform more reps. HIIT can also be performed with resistance training by doing one or multiple exercises with little or no breaks between them. HIIT has great cardiovascular benefits and should be included in at least one of your workouts throughout the week.
Anyone with special health considerations should consult their doctor before performing a structured exercise program. Individuals with diabetes should also monitor their blood glucose levels before and for several hours after workouts, especially when starting a new program. Everyone is different and not one program is right for all people, so find something you enjoy doing and keeps you motivated, be consistent, and the results will speak for themselves as you enjoy a happy and healthy lifestyle.
Authored by Blaine Schmidt
Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes
Association. Colberg et. al, Diabetes Care, 2016 Nov; 39(11) 2065-2079.
ACSM’s Guidelines for Exercise Testing and Prescription, 9 th edition.