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exercise tips for people with type ii diabetes
a successful exercise routine has a lot to do with understanding how to control blood sugars while being active.
nov 20 2020
6 minute read
diabetes canada recommends 150 minutes a week of activities, but if you’re starting at zero you don’t need to get 150 right away.
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- do not start a workout if your blood sugar levels are 5.5 or lower.
- blood sugars tend to fall into a cycle; find a time when they tend to naturally be at a good level and try to consistently work out at that time
- start small; even 30 minutes a week is better than nothing.
about 11 million canadians have diabetes or pre-diabetes, according to diabetes canada . of these, 90 per cent are diagnosed with type ii, sometimes called adult-onset diabetes. this occurs when the body can no longer produce enough insulin to regulate blood sugar levels or cannot use the insulin produced. it is usually managed with diet, exercise, and sometimes medications or insulin.
healthing.ca spoke to sara hodson, a clinical exercise physiologist and the ceo of live well exercise clinics , to get tips on how people diagnosed with type ii diabetes can start exercising.
healthing: what do you tell a new patient about the first steps?
s.h.: safety is the key word; there are a lot of fears around exercising with diabetes, so people want to feel safe and secure about it.
the first thing we have to keep in mind is that even small bouts of exercise have been shown to improve blood sugars –— even 10 minutes of movement. really, movement is the way our bodies manage our blood sugars, they manage how much our muscle is soaking up the blood sugar and how much our liver has to spit out glucose into the blood. our bodies are made to absolutely balance that.
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the key is to know that you don’t need to run a marathon to manage your blood sugars. you just need to move a little bit more than you have been used to.
the second thing we look at are the medications people are taking. some diabetes medications put some people at no risk of hypoglycemia, which, you can imagine, is one of the biggest fears people have about exercise because it lowers blood sugars. if a person is on a medication that lowers their blood sugars, we tell them not to start exercise if their blood sugars are less than 5.5.
it’s about knowing where you’re starting and how to increase your blood sugars if they fall — for example, by eating a balanced snack.
what level of intensity should patients be exercising at?
data show some really interesting things about exercise, including that smaller bouts of higher intensity exercise can help to increase blood sugars.
an intense dose of exercise actually causes the liver to spit glucose into the bloodstream. therefore, if you are somebody who gets lower blood sugars, you can actually start by having an intense dose of exercise and that’ll actually increase your blood sugars.
if you’re somebody who experiences lows after exercise, at the end of your exercise session, make sure you do some intense bouts of exercise to increase your blood sugars.
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and when i say intense, i’m not talking about sprinting down the track. i’m talking about a moment, even as small as 10 seconds, of more intense movement than what you had been doing. it should be more than something you could do continuously.
what tips do you have to help someone manage blood sugar during a workout?
it’s always about monitoring, knowing where you are and trying to choose the best time of the day when your blood sugars tend to be the most stable. people with diabetes typically have times where their blood sugars will be higher or lower. for example, it might be when they wake up in the morning or after supper in the evening. so, if your blood sugars are higher after supper, that’s a great time to go for a 10 to 15 minute walk — to bring those blood sugars down.
if you use insulin and your blood sugars are lowest at a certain point in the day, you want to choose a time when blood sugars are in a healthy range; again, you don’t want to start exercise if your blood sugars are less than 5.5 if you are on insulin.
so, it’s about finding the time that works in your natural cycle?
exactly, and having a routine.
whatever time you find works — meaning your blood sugars are good before you start, they stay fairly stable and aren’t falling too low by the end of your exercise — consistently hit that same time of the day for exercise. the benefit of exercise on blood sugars lasts about 24 hours. some research has even found that is lasts up to 72 hours.
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just like a medication, you should be taking your dose of exercise at about the same time every day. that’s part of the reason we use the term ‘exercise is medicine.’ there are chemical and physiological changes happening every time you exercise — even for 10 minutes. day after day after day, you get these long-term benefits, and the way your body manages your diabetes at the cellular level changes. your body adapts and becomes better at absorbing blood glucose and releasing blood glucose as needed.
exercise is such a powerful tool. it’s not just about the exercise to get healthier. it really is the exercise working at a cellular level to affect your diabetes.
what’s the best way to to take the first step?
i always say start low and move slow. getting diabetes didn’t happen yesterday, so you don’t have to solve it tomorrow. you want to feel successful with a plan.
diabetes canada recommends 150 minutes a week of activities, but if you’re starting at zero you don’t need to get 150 this week. you could be working toward that; maybe you get 50 this week, maybe you get 15. there’s no judgment, it’s all about a personal journey. we know when you set a plan you are confident you will be successful with, you’re more likely to stick with it the next week. success breeds success, failure breeds more failure.
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what kinds of activities do you recommend?
don’t force yourself to do something you hate. if you don’t like walking, maybe try indoor cycling, or swimming, but try something you enjoy because you’re more likely to stick to it.
how can we stay active during the pandemic?
we may give up on ourselves, but we’ll never give up on a friend. find somebody who can be that friend, who can be that ‘accountabili-buddy.’ during these covid days, maybe it’s a phone call to say, ‘i’m going out on my walk, you’re going out on your walk, let’s call in 30 minutes and tell each other how we feel.’ maybe you can’t walk together, but that doesn’t mean you can’t do it together and encourage each other.
we’re not alone in this. people often think, why does it seem easy for everybody else? the reality is it’s not easy for anybody.
almost half a billion people worldwide have diabetes. you are not alone. physical activity is one of the most important things we can do. we have to create opportunities to be more active and to feel successful. we also need to understand that just 10 minutes of exercise can have a positive impact on diabetes. this isn’t about losing a whole bunch of weight or having to do push-ups. this is about moving our bodies in a way we enjoy that helps treat our diabetes.
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this story has been edited and condensed for clarity.
for more information on diabetes, support or to connect with other patients, visit diabetes canada.
emjones@postmedia.com | @jonesyjourn
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