Diabetes and Exercise
- The risk of developing both metabolic syndrome (MS) and diabetes is inversely associated with regular exercise training. Excess weight is also strongly associated with increased risk of both these conditions.1
- 150 min/wk of physical activity, such as walking, along with a weight loss of 5-7%, reduces the risk of progressing from impaired glucose tolerance (prediabetes) to diabetes by 58%.2
- The 2008 Federal Physical Activity Guidelines recommend obtaining at least 150 min/wk of moderate-intensity physical activity, 75 min/wk of vigorous-intensity physical activity, or a combination of the two.1 More than four hours a week of moderate to vigorous exercise will also lower cardiovascular risk. 2
- For people with established diabetes, regular physical activity for 2 months will reduce HbA1C even when exercise is not accompanied by weight loss. Intensifying the level of exercise will further improve the level of control of diabetes.2
- Exercise pattern should be at least three times a week. The impact of aerobic exercise on insulin sensitivity may last from one to three days.2
- For the purpose of general health, exercise programs should have both aerobic and resistance training components. Resistance training may further improve insulin sensitivity.
- Although only structured training programs have been studied, it would seem likely that increasing muscle mass through daily activities, such as farming, would also be beneficial.2
- There is no evidence that intensive testing, such as an exercise tolerance test, is necessary for patients with diabetes to begin a moderate exercise program like walking.2
- Before beginning an exercise program, special precautions or limitations are needed for patients with diabetes who have severe peripheral neuropathy, autonomic neuropathy, or retinopathy. These people may need to reduce the intensity of exercise, change the type of exercise, and check their feet carefully after exercise.2
- Hypoglycemia (low blood sugar) is a possible complication of exercise for all patients with diabetes. Those who develop hypoglycemia will need a carbohydrate snack before exercising. Blood glucose levels may need to be checked before and several hours after exercising.2
- Synchronized, low, moderate and intense lifestyle intervention to promote weight loss (5%) among adults (who have yet to develop prediabetes or diabetes) might reduce the number of people with prediabetes globally by about 10 million by 2020.2
Sources
1. Church T. Exercise in obesity, metabolic syndrome, and diabetes. Prog Cardiovasc Dis. May-Jun 2011;53(6):412-418.
2. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD. Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. Jun 2006;29(6):1433-1438.