Diabetes and exercise: What endocrinologists want you to know about fitness and diabetes care
March 27, 2024

Diabetes and exercise: What endocrinologists want you to know about fitness and diabetes care

Rachel Wadsley, PhD

Is regular exercise part of your diabetes care routine? "Physical activity is an important component of diabetes self-care that is often overlooked," explained Dr. Akuffo Quarde, a board-certified physician in internal medicine, endocrinology, diabetes, and metabolism. 

"Regular exercise allows the human body to use insulin (the hormone that reduces blood sugar) better," says Dr. Quarde. In general, exercise helps people with type 1 and 2 diabetes reach their ideal weight, reduces cholesterol levels, reduces the risk of cardiovascular disease, improves heart health, improves high blood pressure, increases physical strength and bone density, and reduces anxiety, depression, and stress levels. A consistent strength training routine, whether you're weight training, using resistance bands or body weight, or leaning into cardio focused workouts, will lead to many positive health benefits.

How exercise affects blood sugar levels

Harvard Health found that regular exercise can reduce A1C by 0.7% even when you maintain your current weight. While aerobic activity, resistance training, and strength training workouts have beneficial effects, you'll see the best results when you incorporate a variety of activities into your workout routine.

Dr. Arti Thangudu, an internal medicine doctor board-certified in endocrinology, diabetes, and metabolism, says, "exercise, even in small amounts, can make a huge difference for diabetes. One bout of exercise can actually lower excess blood sugar for 24 hours." 

The Diabetes Care journal found that getting up from sitting every 30 minutes has unique benefits and boosts overall health. This is a simple lifestyle change, in general, that will help add a little bit of improved movement patterns to your day. If you have limited mobility, taking brief breaks from sitting might be easier than scheduling longer exercise sessions or focusing on specific strength training exercises. 

How much exercise do people with diabetes need

For younger individuals and more physically fit adults, the American Diabetes Association suggests at least 150 minutes per week of moderate exercise. Aim to exercise at least four days a week (on a regular basis),  whether you are participating in regular cardio exercise, following a strength training program, or simply enjoying a walk outside.

While 150 minutes can sound intimidating, this breaks down to about 20 minutes per day. The best part is you can spread this time out over the entire day! 

For example, you can go for a 5-minute walk around the office in the morning before getting your coffee, do 10 minutes of yoga after work, and do another 5 minutes of walking before curling up to watch Netflix. Bam. You've gotten in 20 minutes of movement, and you didn't even have to lift heavy weights or go for a run.

Dr. Quarde says, "for people with limited mobility, minor activities such as gardening, dancing, yoga, walking (even less than a mile) and housework have a healthy impact on blood sugar control." So get those walking shoes on and rethink what exercise looks like. 

How to get started

Talk to your doctor

According to Dr. Quarde, start by talking "to your primary care doctor or endocrinologist before engaging in any new exercise routine." Your health care team will help you determine which exercises are the safest and best choices for your health. You can also discuss how to safely manage your blood glucose levels during and after exercising.

Always check your blood sugar

Keeping an eye on your blood sugar levels is incredibly important to prevent hypoglycemia (low blood sugar). Ideally, plan your exercise for times your blood sugar is naturally higher. For most people, this is one to three hours after eating.

Dr. Quadre suggests having " a light snack to help prevent low blood sugar if your blood glucose is less than 100mg/dl before you engage in moderate to vigorous intensity physical activity." Another good practice is testing 30 minutes after your snack, even if you're still exercising, to ensure your blood sugar is stable.

Harvard Health also cautions against exercising when your blood sugar is over 250 as some forms of exercise increase blood sugar levels instead of lowering them. For example, aerobic exercise like cardio workouts tend to cause blood glucose levels to fall, while anaerobic exercise like weight lifting / weight training increases blood sugar. 

Take care of your feet

"Peripheral neuropathy (nerve damage) involving your feet can increase your risk for blisters and ulcers. It is important to check your feet daily," cautions Dr. Quarde. Invest in supportive shoes and good cotton or wool socks to keep your feet dry. 

Start small

Remember, exercise doesn't have to mean long sessions at the gym or running for miles. Like Dr. Quarde and Dr. Thangudu advised, even small amounts of movement are crucial for your diabetes care plan. Low-impact exercises and shorter durations of exercise are just as good as vigorous activities if it means you'll actually get up and move. Check out this post about little ways to fit exercise into your day

Find something you like

Exercise shouldn't feel like a punishment or something you dread. Because you make time for the activities you enjoy, choose activities that excite you or, at the very least, sound appealing. Any form of movement, from walking to dancing to gardening, counts!

Make a date with yourself

It's easy to get caught up with the demands of life and put self-care on the back burner. Schedule exercise time like you would a work meeting or doctor's appointment. Alternatively, leave for an errand 15-30 minutes early. Take that extra time to walk or stretch.  

Get an exercise buddy

Let’s face it, exercising can be lonely and boring. Plus, it's tempting to start late, stop early, or give it a half-hearted effort when no one's around. Enlist family or friends to be active with you or be your accountability partner. 

If you want additional support or aren't ready to share your journey with others, consider getting a fitness trainer. They can guide you every step of the way in a nonjudgemental space. A couple of added benefits of having a personal trainer are knowing where to start and getting a personalized routine you’ll actually want to follow. 

Get your trainwell (formerly CoPilot) fitness trainer today and start improving your A1C levels!

Connect with the blog contributors:

Dr. Akuffo Quarde is board certified physician in internal medicine, endocrinology, diabetes, and metabolism. You can view his blog here https://www.myendoconsult.com

Dr. Arti Thangudu is a triple board-certified specialist in hormonal care. You can visit her website https://sacomplete.com or follow her on Instagram @drartithangudu

Written by Rachel Wadsley, PhD

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