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Exercise - Exercise's Effects on Diabetes

Description

An in-depth report on the benefits and types of exercise.

Exercise's Effects on Diabetes:

Moderate aerobic exercise can lower your risk for type 2 diabetes.

Exercise has positive benefits for those who have diabetes. It can lower blood sugar levels, improve insulin sensitivity, and strengthen the heart. Strength training, which increases muscle and reduces fat, may be particularly helpful for people with diabetes.

People with diabetes who begin a new or vigorous exercise program should have their eyes examined, and discuss footwear and heart risks with their physician.

Type 1 diabetes: Aerobic exercise has significant and particular benefits for people with type 1 diabetes. It increases sensitivity to insulin, lowers blood pressure, improves cholesterol levels, and decreases body fat.

For improving glycemic control, the American Diabetes Association recommends at least 150 minutes per week of moderate-intensity physical activity (50 - 70% of maximum heart rate) or at least 90 minutes per week of vigorous aerobic exercise (more than 70% of maximum heart rate). Exercise at least 3 days a week, and do not go more than 2 consecutive days without physical activity.

Strength Training. Strength training, which increases muscle and reduces fat, is also helpful for people with diabetes who are able to do this type of exercise. The American Diabetes Association recommends performing resistance exercise three times a week. Build up to three sets of 8 - 10 repetitions using weight that you cannot lift more than 8 - 10 times without developing fatigue. Be sure that your strength training targets all of the major muscle groups.

Some Precautions for People with Diabetes Who Exercise

The following are precautions for all people with diabetes, whether type 1 or 2:

Because people with diabetes are at higher than average risk for heart disease, they should always check with their doctors before starting a demanding exercise program. For people who have been sedentary, or have other medical problems, lower-intensity exercises are recommended, using programs the patients designed with their doctors.
Strenuous strength training or high-impact exercise is not recommended for people with uncontrolled diabetes. Such exercises can strain weakened blood vessels in the eyes of patients with retinopathy (a common diabetic complication). High-impact exercise may also injure blood vessels in the feet.

Patients who are taking medications that lower blood glucose, particularly insulin, should take special precautions before starting a workout program.

Wear good, protective footwear to help avoid injuries and wounds to the feet.
Glucose levels swing dramatically during exercise. People with diabetes should monitor their levels carefully before, during, and after workouts.
Patients should probably avoid exercise if glucose levels are above 300 mg/dL or under 100 mg/dL.
To avoid hypoglycemia (low blood sugar), people with diabetes should inject insulin in sites away from the muscles they use the most during exercise.
People with diabetes should drink plenty of fluids. Before exercising, they should avoid alcohol and certain medications, such as beta-blockers, which increase the risk of hypoglycemia.
Insulin-dependent athletes may need to decrease insulin doses, or take in more carbohydrates, prior to exercise. However, they may need to take an extra dose of insulin.

A person with diabetes must regularly check their blood sugar (glucose) level.

Resources

http://fitness.gov -- The President's Council on Physical Fitness and Sports
www.ncppa.org -- National Coalition for Promoting Physical Activity
www.acefitness.org -- American Council on Exercise
www.arthritis.org -- The Arthritis Foundation offers tips on exercising with arthritis
www.justmove.org -- Just Move (American Heart Association)
www.nhlbi.nih.gov/health/public/heart/obesity/wecan -- We Can! (National Heart, Lung, and Blood Institute)

References

Abbott RD, White LR, Ross GW, et al. Walking and Dementia in Physically Capable Elderly Men. JAMA. 2004;292:1447-1453.

American Diabetes Association (ADA). Standards of Medical Care in Diabetes -- 2008. Diabetes Care. 2008;31:S12-S54.

Brown WJ, Burton NW, Rowan PJ. Updating the evidence on physical activity and health in women. Am J Prev Med. 2007;33(5):404-411.

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Byberg L, Melhus H, Gedeborg R, et al. Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort Brit Med J. 2009;338:b688.

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Di Loreto C, Fanelli C, Lucidi P, et al. Make your diabetic patients walk: long-term impact of different amounts of physical activity on type 2 diabetes. Diabetes Care. 2005 Jun;28(6):1295-302.

Gaziano JM, Manson JE, Ridker PM. Primary and Secondary Prevention of Coronary Heart Disease. In: Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. Philadelphia, PA: Saunders; 2007:chap 45.

Johnson TRB, Gregory KD, Niebyl JR. Preconception and Prenatal Care: Part of the Continuum. In: Gabbe SG, Niebyl JR, Simpson JL, et al. (eds.) Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed. Philadelphia, PA: Churchill Livingstone; 2007.

Kruk J. Lifetime physical activity and the risk of breast cancer: a case-control study. Cancer Detect Prev. 2007;31(1):18- 28.

Larson EB, Wang L, Bowen JD, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Intern Med. 2006 Jan 17;144(2):73-81.

Meyerhardt JA, Heseltine D, Niedzwiecki D, et al. Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol. 2006 Aug 1;24(22):3535-41.

Mikkelsson LO, Nupponen H, Kaprio J, Kautiainen H, Mikkelsson M, Kujala UM. Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: A 25 year follow up study. Br J Sports Med. 2006 Feb;40(2):107-13.

Molokhia EA, Perkins A. Preventing cancer. Prim Care. 2008;35(4):609-23.

Mustelin L, Silventoinen K, PietilÃ¤inen K, Rissanen A, Kaprio J. Physical activity reduces the influence of genetic effects on BMI and waist circumference: a study in young adult twins. Int J Obes (Lond). 2009;33(1):29-36.

National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the diagnosis and management of asthma- summary report 2007. J Allergy Clin Immunol. 2007 Nov;120(5 Suppl):S94-138.

Taylor, A.H., Ussher, M., & Faulkner, G. The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: a systematic review. Addiction. 2007;102:534-543.

Tehard B, Friedenreich CM, Oppert JM, et al. Effect of physical activity on women at increased risk of breast cancer: results from the E3N cohort study. Cancer Epidemiol Biomarkers Prev. 2006 Jan;15(1):57-64.

Reviewed last on: 5/4/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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