Physical Activity and Type 2 Diabetes

Why is activity so important for people with diabetes?

Almost everyone, whether or not they have diabetes, benefits from regular exercise. Well-known health benefits include weight loss, stronger bones, improved blood pressure control, lower rates of heart disease and cancer as well as increased energy levels.

Regular exercise also has special advantages if you have type 2 diabetes. Regular physical activity improves your body’s sensitivity to insulin and helps manage your blood glucose levels.

If you have been inactive for some time, talk to your doctor before starting any exercise program that is more strenuous than brisk walking. Speak to your doctor if you become short of breath or have chest pain.

Monitor your blood glucose before, during and after your activity to see how it affects your blood glucose levels. Carry some form of fast-acting carbohydrate with you in case you need to treat low blood glucose (hypoglycemia), for example, glucose tablets (preferred) or Life Savers.

Both aerobic and resistance exercise are important for people living with diabetes. Aerobic exercises (such as brisk walking, running, swimming, dancing, hockey and skiing) work your heart and lungs and carry oxygen to your muscles. Resistance exercises (such as weight training) increase muscle strength and complement the benefits of aerobic exercise. Make sure you have the right shoes this is so important for people with diabetes. Buy the right shoes for your activity (e.g. tennis shoes for tennis, walking shoes for walking, pool shoes for swimming).

If you decide to begin resistance exercise, you should first get some instruction from a qualified exercise specialist and start slowly. Your goal should be to complete at least 150 minutes of moderate- to vigorous-intensity aerobic exercise each week (e.g. 30 minutes, 5 days a week).

You may have to start slowly, with as little as 5 to 10 minutes of exercise per day, gradually building up to your goal. If you are able and when you are ready, try adding resistance exercises like lifting weights 3 times a week.

Habits can be hard to change, so be prepared with a plan in case your motivation starts to fade:

  • Do something you like! It is hard to stick to an activity that is not fun. It may take you a few tries before you find the activity that is right for you.
  • Have a support network. Ask your family, friends and co-workers to help you stay motivated by joining you for a walk or a workout at the gym.
  • Set small, attainable goals and celebrate when you reach them. Reward yourself in healthy ways.
  • Maintain a healthy weight.
  • Seek professional help from a personal trainer, or someone knowledgeable who can help you find a fitness regimen that will work for you.

Physical activity and diabetes can be a complex issue but regardless of your age, making the decision to become more physically active will benefit your body and your mind. It will help you sleep better, have more energy for daily routines and a good way to get the whole family involved.

Physical Activity and Type 1 Diabetes

As people with type 1 diabetes know, many factors influence blood glucose levels. While exercise has been shown to improve blood glucose management in people with type 2 diabetes, the story is more complicated with type 1 diabetes.

In people with type 1 diabetes, blood glucose levels vary considerably depending on the type of activity, duration, intensity of activity, as well as the amount and timing of insulin administration and carbohydrate intake.

Low- to moderate-intensity exercise lowers blood glucose levels both during and after the activity, increasing the risk of hypoglycemia. In contrast, high-intensity exercise raises blood glucose levels during and immediately after the activity. The stress of competition and even heat can also affect the delicate balance between glucose and insulin. These effects on blood glucose levels can be addressed by carefully matching carbohydrate intake to insulin and planning the type and timing of exercise.

Self-monitoring of blood glucose before, during and, especially, for many hours after exercise (including overnight if necessary) is critical for establishing how your body responds to exercise. This information will help you make the right adjustments to exercise, medication or carbohydrate intake to avoid high or low blood glucose. Remember to record your results so you can accurately track your response and report it to your doctor.

Blood glucose (sugar) is the amount of glucose in your blood at a given time. Checking your blood glucose levels will:

  • Provide a quick measurement of your blood glucose level at a given time.
  • Determine if you have a high or low blood glucose level at a given time.
  • Show you how your lifestyle and medication affect your blood glucose levels.
  • Help you and your diabetes healthcare team to make changes to your lifestyle and medication that will improve your blood glucose levels.

A blood glucose meter is used to test your blood glucose at home but talk with your diabetes educator or pharmacist about which model is right for you.

Other questions you should ask your diabetes educator should be:

  • the size of the drop of blood needed
  • the type of blood glucose strips to use
  • how to clean the meter
  • how to check if the meter is accurate
  • how to code your meter

Note: Your province or territory may subsidize the cost of blood glucose monitoring supplies. Contact your local Canadian Diabetes Association branch to find out if this applies to you

You should try to keep your blood glucose as close to target range as possible. This will help to delay or prevent complications of diabetes. Maintaining healthy eating habits and an active lifestyle, and taking medication, if necessary, will help you keep your blood glucose levels within their target range.

With careful planning and common sense, the benefits of exercise almost always outweigh the risks. However, if you have been inactive for some time and want to start an exercise program that is more strenuous than brisk walking, you should first see your doctor. He or she will want to ensure that you don’t have any conditions or complications that might be aggravated by exercise. If you are at high risk of heart disease, you may undergo an exercise stress test. This test monitors your heart rate while you walk on a treadmill.

If you have neuropathy (nerve damage), retinopathy (persistent inflammation or acute damage to the retina of the eye), very high blood pressure, or very high blood glucose your doctor may want you to avoid some kinds of exercise or take special precautions.

Decide on the timing, type, duration and intensity of exercise. Every person with type 1 diabetes will have a different response to exercise so the only accurate way to determine your response is frequent self-monitoring of blood glucose. People who exercise vigorously or who train for competition should work closely with their healthcare team.

If your pre-meal blood glucose level is >14.0 mmol/L and urine ketone level is >8.0 mmol/L or blood ketone level is >3.0 mmol/L, exercise should not be performed as it could cause high blood glucose and more ketone production. Wait until your blood glucose is back in the normal range before exercising.

A general rule of thumb for most moderate-intensity exercise is 15 to 30 g of carbohydrate every 30 to 60 minutes of exercise. Estimate how much carbohydrate and insulin you need to keep your blood glucose levels stable. If you use an insulin pump, see your healthcare team for more information on how to calculate carbohydrate intake and to adjust the basal and bolus components of your insulin dosage. Keep some form of fast-acting carbohydrate with you at all times in case you need to treat low blood glucose.