Fighting diabetes? Here are some exercises for you.

Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. Of the more than 30 million Americans with diabetes, 90 to 95% percent have type 2, according to the U.S. Centers for Disease Control and Prevention. In this post, we’ll focus on guidelines for type 2 diabetes.

Type 2 diabetes develops over many years and is usually diagnosed in adults, which is why it has been traditionally called “adult-onset diabetes.” But more and more, it is also being found in children, teens, and young adults. Diabetes is the 7th leading cause of death in the United States.

More than 84 million U.S. adults – over a third – have prediabetes, and 90% of them don’t know they have it (CDC). You may not notice any symptoms, so it’s important to get your blood sugar tested if you’re at risk.

“Diabetes management isn’t all about healthy eating,” says Larry Wu, M.D., a regional medical director for Blue Cross and Blue Shield of North Carolina. “It is also important to get your daily dose of exercise. Staying active has many benefits, such as…helping control your blood glucose level.” Be sure to check with your health care professional before beginning a new program to ensure that it’s appropriate for you.

A growing body of evidence points to resistance (strength) training as a way to manage or prevent type 2 diabetes. Here’s why.

In people with type 2 diabetes, muscle tissue can become unresponsive to insulin, preventing insulin from its important duty of clearing the blood of excess glucose. Normally, 70 to 75% of insulin-stimulated glucose clearance happens at the skeletal muscle level.

The stored form of glucose in muscle fibers is glycogen. The more glycogen in the muscles, the more your muscles resist the action of insulin. The first step to improving insulin sensitivity is reducing glycogen levels in muscle fibers. And muscle contraction – strength exercise – is how to make this happen.

Research has found that the skeletal muscles of people with type 2 diabetes have metabolic dysfunctions like insulin resistance, lipid accumulation, impaired glucose synthesis, and weakened mitochondrial function. The good news is that exercise – especially resistance training – can reverse these dysfunctions.

The American Diabetes Association (ADA) recommends getting 30 minutes of moderate-to-vigorous intensity aerobic exercise at least 5 days a week or a total of 150 minutes per week and doing some type of strength training at least 2 times per week in addition to aerobic activity.

Moderate intensity is working hard enough that you can talk, but not sing, during the activity. Vigorous intensity means you cannot say more than a few words without pausing for a breath during the activity.

Spread your activity out over at least 3 days during the week and try not to go more than 2 days in a row without exercising.

But if you are not yet able to meet these guidelines, know that any amount of exercise you do is better than nothing. Start small with 10 or 15 minutes a day of light to moderate intensity, and work your way up to more.

Examples of aerobic activities include:

• Bicycling or stationary cycling
  
• Dancing
• Fast walking – outdoors, or on a treadmill
• Low-impact aerobics
• Swimming or water aerobics
• Athletic activities such as running, tennis, skating, rowing or skiing
• Stair climbing
• Hiking

Strength training activities include:

• Using free weights (dumbbells, barbell, kettlebells)
  
• Weight machines at the gym
• Strength training classes
• Exercises that use your body weight to work your muscles (such as push-ups, sit-ups, squats, lunges, wall-sits, and planks)
• Using resistance bands
• Activities that build and maintain muscle like yard work
• Lifting light weights or objects like canned goods or water bottles at home

Moving more can help keep your blood glucose levels under control and also burn calories. All movement counts, so try to be more active throughout your day. You could take the stairs instead of the elevator; get up from your desk regularly to stretch and walk around; walk your dog, or do housework. The ADA recommends that prolonged sitting should be interrupted with light activity every 30 minutes for blood glucose benefits.

Guidelines from the American Council on Exercise for people with type 2 diabetes include:

Time your food intake and medication dosage to maintain the proper glucose balance.

Check your blood glucose level before and after exercise. Carry a portable glucometer with you if exercising away from home.

Avoid exercise in the late evening. A person can have an insulin reaction during sleep if he or she exercises too close to bedtime and is low in carbohydrates. Since the person is unaware of the insulin reaction, they could go into a coma and die.

Take very good care of your feet. Check regularly for any cuts, blisters or signs of infection. Good quality exercise shoes are very important.

Stay well hydrated and drink water frequently throughout exercising. Be especially cautious in hot environments, as blood glucose can be impacted by dehydration and the sweating response of diabetics may be impaired.

Keep a rapidly-absorbed carbohydrate available (such as orange juice) in case of a hypoglycemic (low blood glucose) emergency.

Know the signs of an insulin reaction. Early symptoms of hypoglycemia include anxiety or uneasiness, irritability, extreme hunger, confusion, headaches, or insomnia. Late symptoms can include double vision; sweating/palpitations; nausea; loss of motor coordination; pale, moist skin; strong, rapid pulse; convulsions; loss of consciousness; coma.

If you are having an insulin reaction, stop all exercise immediately. Sit down and check your blood glucose level. Do not resume activity until your glucose levels are within a normal range. If you do not improve, seek medical attention right away.

Remember that although exercise is beneficial, as a diabetic you will not be able to get your blood sugar under control without a proper diet.

Exercise and healthy eating work hand-in-hand to improve your diabetes, your weight, and your overall health.