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How to exercise with type 2 diabetes

Regular exercise plays an important role in managing type 2 diabetes thanks to its ability to help lower blood sugar levels. Physical activity doesn’t just mean a gym session (phew!)—instead it's about regular movement that exercises your whole body.
Annabel Nicholson
1/25/2022
8
min read
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Quick summary

  • Regular exercise can help you achieve your ideal weight, lower blood pressure, improve cholesterol, and help lower blood sugar levels.
  • Official recommendations are to exercise for 150 minutes a week but this doesn’t mean all in one go—break that time down into manageable chunks of time and slowly build up as you get stronger.
  • As well as running, cycling, swimming, and walking, you can also include things like gardening, dancing, washing the car, and cleaning the house in your weekly movement.
  • When possible, try to exercise your whole body to get the most benefits—as well as exercises to make your heart beat, you can try simple balancing, stretching, and strengthening exercises.

In the days and weeks following a type 2 diabetes diagnosis, you’ll come across two main themes of advice—the first is to adjust your diet and the second is to build regular exercise into your routine. This advice is spot on but you might be wondering how you should be exercising while managing a new health condition.

Well, first things first—don’t worry, you can exercise safely and regularly with type 2 diabetes. Physical activity helps boost your mood, improve your sleep, reduce stress, and keep your joints healthy. If you have type 2 diabetes, regular exercise can also help you achieve and maintain your ideal weight, lower blood pressure, improve cholesterol, and even help your body use insulin more efficiently.[1]

Even though we know all of this, exercise is one of the easiest things to ignore. During the working week it can feel like a monumental task to add a short burst of intentional movement into an already jam-packed schedule, especially if you’re also at the beginning of your type 2 diabetes journey. Some days, you really won’t feel like it—and that’s okay!

Exercise has been shown to improve insulin sensitivity for up to 48 hours after the activity

Sylow et al., Nat Rev Endocrinol

What counts as exercise?

Official guidance is to do 150 minutes of moderate intensity activity each week.[2] That sounds like a lot but remember, you don’t have to do it all in one go. We’re definitely not expecting you to don your lycra and head to the gym to pump iron for 2.5 hours. Instead, it's about breaking down the 150 minutes into manageable chunks of time and finding activities that you enjoy.

For some people, exercise is something that only happens in the gym, while for others, gyms are intimidating places to go. If you live in the UK, the weather isn’t always the best motivator for getting outside, and while we’ve all embraced home workouts during the pandemic, it’s a lot easier to forgo your workout and do something else instead. The beauty of exercise, however, is that it’s all around us! Sure, a brisk walk, jog, cycling, and swimming are perhaps the most common activities we think of, but gardening, washing the car, cleaning the house, or even walking on the spot during TV ad breaks all count. It’s not about pushing yourself to go harder or faster every time, it's about building blocks of movement into your day. 

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Break it down

If you break that 150 minutes down over the week, you could build an exercise routine that feels achievable, physically and mentally. Start small, a 10 minute walk around the block, a 5 minute jog, a dance to your favourite song while the kettle boils, and build up. Eventually, your routine could involve 30 minutes of exercise, 5 times a week, or 2 hour-long walks and a 30 minute jog, or perhaps it suits you to do a 20 minute session everyday. The most important thing is to build a routine that fits with your lifestyle and schedule. 

That being said, you also need to welcome life’s events with open arms. If your week explodes and you can’t make the yoga class you’ve booked, that’s okay. Try not to worry about missing it and see if you can add in a few extra short walks that week instead—maybe you could take a work call while walking, get off the bus a few stops earlier, or get a coffee from a cafe slightly further away than your usual haunt. 

How exercise affects blood sugar levels

So, you know that exercise helps lower blood sugar levels but how does it do this? Exercise has been shown to improve insulin sensitivity for up to 48 hours after the activity—this means your muscles find it easier to use any insulin you have available to take glucose from the blood, lowering blood sugar levels.[3] This is all made possible by a special protein called GLUT4 and research now suggests that if people with type 2 diabetes maintain their exercise routines, the amount of GLUT4 in the body increases. With more GLUT4 available, the body is better able to control blood sugar levels, which is why exercise has a lasting effect on the body.[4]

Temporary elevation of blood sugar levels can happen during exercise but this doesn’t last for long and isn’t a reason to swear off exercise for good. Before undertaking a new exercise routine, it's worth talking to your doctor, especially if you take medications to control your blood sugar levels as your dosage  may need adjusting.

Exercise your whole body

If you can, try doing a mixture of activities that use different parts of your body to reap as many of the rewards as possible. You can mix and match throughout your week, or even do a couple of different sessions back to back.  

🚴‍♀️ Aerobic exercise

Get your heart pumping and your lungs working with aerobic exercises such as brisk walking, jogging, cycling, swimming, pushing a lawnmower, cleaning the house, and marching on the spot, to build endurance. 

🏋️‍♂️ Strength training

Rebuild muscle mass to keep everyday activities like getting up from a chair or walking up the stairs easy. Squats, push-ups, and lunges are all exercises that use just your body weight, so there’s no need for fancy equipment. Carrying heavy shopping bags and heavy gardening count too!

🧘 Stretching

Increase your range of motion, reduce pain, and prevent injury with regular stretching of the main muscle groups, such as the calves, hamstrings, shoulders, neck, and hips. Be sure to warm up first and only stretch to the point of mild tension, not pain.

🤸‍♂️ Balance

Feel steadier on your feet and prevent falls by working on your balance. Run a quick internet search for suggestions, such as standing on one foot and heel-toe walking.

As you start incorporating movement into your routine, be mindful of how your blood sugar level responds to exercise and always consult your doctor if you have any concerns. 

References

[1] Diabetes and exercise. Diabetes UK. Retrieved 24 January 2022. Accessible here.

[2] Exercise. NHS. Retrieved 24 January 2022. Accessible here

[3] Sylow, L., Kleinert, M., Richter, E.A., Jensen, T.E. (2017). Exercise-stimulated glucose uptake — regulation and implications for glycaemic control. Nat Rev Endocrinol 13:133-148. Available here.

[4] Richter, E.A., Hargreaves, M. (2013). Exercise, GLUT4, and skeletal muscle glucose uptake. Physiol Rev 93(3):993-1017. Accessible here.

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