How Exercise Can Help You Manage Diabetes
Exercise is a crucial component of diabetes management. Diabetes is a condition in which the body either does not produce enough insulin or does not respond normally to insulin, causing glucose levels in the blood to become too high. Exercise lowers blood sugar by increasing the insulin sensitivity of the body’s cells; as muscles contract, they are better able to use any available insulin to take up glucose for energy. Experts recommend engaging in both aerobic and resistance training exercises to manage blood glucose.
Mechanism of Diabetes in the Body
Diabetes is a condition in which the body either does not produce enough insulin or does not respond normally to insulin, causing glucose levels in the blood to become too high. It affects 34.2 million people in the United States.
Normally, the pancreas makes insulin, a hormone that allows cells to obtain sugar from the blood and use it for energy. With type 2 diabetes, the most common type of diabetes, cells do not respond properly to insulin(insulin resistance). The pancreas makes more insulin to compensate, which leads to a rise in blood sugar.
Type 1 diabetes, which accounts for 5-10% of cases, is caused by a deficiency of insulin secretion due to autoimmune destruction of the insulin-producing cells in the pancreas. It is common in kids and young adults.
Type 2 diabetes, which accounts for 90-95% of cases, results from a combination of the inability of muscle cells to respond to insulin properly (insulin resistance) and inadequate compensatory insulin secretion. Type 2 diabetes can occur at any age and is related to lifestyle factors.
A less common form of diabetes that affects pregnant women is gestational diabetes. During pregnancy, the cells of the body develop insulin resistance, but this resistance goes away after birth. However, gestational diabetes is associated with a 40 to 60% chance of developing type 2 diabetes in the next decade.
Symptoms of diabetes can vary but may include high blood pressure; frequent infections of the skin, gums, vagina, and bladder; slow-healing sores; unexpected weight loss; increased thirst and frequent urination; constant hunger; fatigue and weakness; tingling or numbness in the feet and hands; blurred vision; chronic pain; pain in the joints and muscles; and cramping or pain in the legs or limping when walking.
How Exercise Can Help Manage Diabetes
Exercise is a crucial component of diabetes management. Exercise has numerous benefits including helping to control weight, lower blood pressure, LDL cholesterol, and triglycerides, raise HDL cholesterol, and strengthen muscles and bones. For diabetic patients, exercise can help lower blood glucose levels and boost the body’s sensitivity to insulin, helping to counter insulin resistance. Exercise also improves vascular health; when exercising, muscles release a host of compounds that benefit vascular and circulatory health, allowing more oxygen and nutrients to get to all parts of the body and therefore reducing the risk of diabetes-related neuropathy, vision loss, heart issues, and joint pain.
Research has shown that exercise lowers HbA1c values (a measure of your blood glucose level over the last 2-3 months) by 0.7 percentage points in those with diabetes. One study showed that when women with diabetes exercised four hours per week (walking), they had a 40% lower risk of developing heart disease than those who didn’t exercise.
Exercise lowers blood sugar by increasing insulin sensitivity. As muscles cells contract, they are better able to use any available insulin to take up glucose for energy during and after exercise. Research has shown that a combination of aerobic and resistance training exercises is most effective in managing blood glucose than either type of exercise alone. Both aerobic and resistance training promote adaptations in skeletal muscle, adipose (fat) tissue, and the liver that are associated with enhanced insulin action and blood sugar management.
Exercise Recommendations for Diabetic Patients
As a diabetic, it is important to test your blood sugar before, during, and after physical activity. Follow the 15-15 rule when exercising. The 15-15 rule involves checking your blood sugar. If it reads at 100 mg/dL or lower, eat 15 grams of carbohydrate to raise blood sugar. Then check your blood sugar after 15 minutes. If blood sugar is still below 100 mg/dL, have another 15-gram serving of carbohydrates and repeat blood sugar testing until blood sugar is 100 mg/dL. If your pre-exercise blood sugar levels are between 100 to 250 mg/dL, you are in a safe range to exercise. However, if your blood sugar is 250 mg/dL or higher, your blood sugar may be too high to exercise safely.
Experts recommend engaging in both aerobic and resistance exercise for optimal effects on blood sugar management. Aerobic exercise recommendations include walking, swimming, or cycling, while resistance training involves the use of free weights, weight machines, and resistance bands to build muscle.
Physical therapists can help diabetic patients improve their physical fitness and engage in exercise safely. Physical therapists design a customized exercise program tailored to the patient’s abilities, allowing diabetic patients to learn how their body responds to exercise under the supervision of the therapist while building endurance, strength, and mobility. A physical therapy program for a diabetic patient can include a graded, progressive exercise program involving aerobic and resistance training, stretching and balance and coordination training, chronic pain treatment, and foot pain assessment and strengthening.
Are you managing diabetes and would like to increase your strength and mobility safely? Work with a physical therapist to safely exercise and gain the many benefits of exercise for diabetes management!
