The thing about diabetes and exercise is that they're actually a really great combo. From the benefits of moving more regularly to helping to keep blood glucose levels more constant, exercising with diabetes doesn't have to be a worrisome affair. In fact, thanks to a veritable bevy of experts, we have everything you need to know about how to safely exercise with diabetes.
Before we continue, though, there are some marked differences between type 1 and type 2 diabetes. People with type 1 diabetes are unable to produce insulin due to a pancreatic issue and, because of this, insulin will need to be injected. However, for those with type 2 diabetes, it's slightly more nuanced. Whilst they do produce insulin, the cells in the body where it's needed are unresponsive and, as such, the insulin is not effective.
The current advice about exercising with type 1 or type 2 diabetes is largely the same, with only a handful of differences. As always, contact your GP if you need any further clarification or help.
1. There are multiple benefits to exercising with diabetes
'Exercising when you have type 1 or type 2 diabetes can help you manage your blood sugar levels and weight, help to reduce your risk of a heart attack and a stroke, reduce cardiovascular risk factors, and promote overall health,' says Dr Emeka Okorocha, GP and brand ambassador of AI-based fitness and lifestyle coaching app Freeletics.
However, and this is something Dr Okorocha stresses: exercise alone is not the only factor to consider when trying to improve your overall health. Ensuring you eat a balanced, nutrient-dense diet, look after your sleep and try and manage stress will also majorly contribute to living a healthy lifestyle.
2. It's better to start slowly
The tortoise... the hare... you know where we're going with this. Success comes from steady, sustainable habits. If you're just starting out with exercise, the experts suggest taking it slowly and scaling up.
'Exercise affects everyone differently. If you are only just starting to exercise, you should take it slowly and see how mild and moderate activities – such as walking or cycling – affect you. If you find that your glucose levels drop while exercising, try a different activity or talk to your doctor about what may help,' says Hussain Abdeh, Clinical Director and Superintendent Pharmacist at Medicine Direct.
3. Cardio and resistance training may affect your blood sugar differently
Some days you like to sweat it out, other days it's straight to the strength training area. Fortunately, both have their benefits.
'Research suggests that both aerobic exercise (cardio) and resistance training enhances insulin sensitivity and improves glycemic control (balancing blood sugar levels). The effects of exercise can still be seen 24 hours after physical activity by impacting the body’s sensitivity to insulin and in turn, causing your blood sugars to stay more constant,' says Registered Dietitian Roxane Bakker, Head of Nutrition at Vitl.
Saying this, depending on which type of diabetes you have, exercise could affect your blood sugar in different ways.
'If you have type 1 diabetes, exercising can have an effect on your glucose levels and your levels can rise or fall depending on the type of exercise you do. For example, running and playing football may cause your glucose levels to rise,' explains Abdeh. 'However, moderate exercise for people with type 2 diabetes can help your muscles to take up more glucose, which works to lower your blood sugar levels.'
A good rule of thumb is to remember that everyone is different. Keep an eye on your own numbers and track how each type of exercise makes you feel.
4. There is a "right" time to exercise
'For people with type 1 diabetes, it's best to avoid exercise in the late evening – this is to prevent nocturnal hypoglycaemia (low blood sugar). For those with type 2 diabetes, they should try to plan their exercise to be at the same time of day each time,' says Steve Beere, Regional Health Lead for Better Leisure.
Beere says tracking your blood glucose levels during physical activity is the key to knowing how it'll affect you. He suggests that those with type 1 diabetes do the following for three sessions to get a good gauge:
Take your blood sugar before the warm-up
Take it again 30 mins into the main session
And again after the cooldown
And, finally, around an hour after the session.
'This should also be done, where possible, for those who are type 2 and using insulin,' says Beere.
5. How you fuel yourself is majorly important
'It's important that you know your blood sugar levels before exercising. If you are diabetic and your levels are lower than 100mg/dL, it may be too low for you to exercise safely,' says Abdeh. 'If this is the case, eat a snack that contains between 15 and 30 grams of carbohydrates before exercising. These include fruit, crackers or fruit juice. Most people will be fine to exercise if their blood sugar levels are between 100 and 250 mg/dL.'
Type 1: Exercising before breakfast may be best for those with type 1 diabetes – if their schedule allows for it.
Type 2: People with type 2 diabetes should eat breakfast no matter what their blood sugar is, suggests Abdeh.
'You should take snacks with you if you plan to be out exercising for a long time, such as going on a day-long hike and count the carbohydrates in the snacks you take. If you are going on an intensive form of exercise, it is a good idea to take liquid/gel carbs, such as energy drinks; this is because your body absorbs carbs faster if they are in liquids and gels.'
'When you have completed your physical activity, check your levels again. If your levels are below 100mg/dL, you should eat a snack. If your levels have not improved at bedtime, double up on the snack.'
Remember: hydration is also majorly important. Carry a water bottle with and, if you feel comfortable, something that identifies you as having diabetes if you're heading away from home for your sweaty endeavours.
6. Keep it varied!
'You should try to do a good mix of cardio exercise, strength training, and flexibility training as they can work out different areas of your body. Aim for 30 minutes of cardio per day, and 20-30 minutes of strength and flexibility training two or three times a week. Take your time to work your way up to that if you’re not used to exercising regularly,' says Dr Grant.
Not sure where to start? Let us help.
This is a brilliant strength training for beginners guide to get you going
Want to brush up on your resistance training nous? We've got you covered
Learn about the best exercises for beginners if you're at the start of your journey
Add in some flexibility sessions with different types of yoga
7. Some days it's just not going to work
Not every workout is going to happen. It's frustrating, but, if your blood sugar isn't within the threshold to make exercise a reality, it's far safer to skip it, or wait until it's risen again.
'Do not exercise if your blood sugar levels are lower than 70mg/dL. If you feel weak, confused or shaky, it is also not a good idea to exercise. Eat or drink something that will raise the blood sugar levels, like a few sweets (check the packaging to see how many carbs they contain) or fruit juice. Wait for 15 minutes and check your levels again; if they are still too low, have a further 15g serving of a carbohydrate-containing food or drink,' says Abdeh.
Hypoglycemia (low blood sugar) is the biggest concern during exercise but there are ways to mitigate the effects:
'If you’re on insulin or taking medication for diabetes then you need to check your blood sugar levels before and after exercising. You may need to eat a carbohydrate-rich snack to ensure you don’t experience hypoglycemia,' says Dr Don Grant (MB, ChB, DRCOG, MRCGP, Dip.orth.med) of The Independent Online Pharmacy.
8. There are important warning signs to be aware of to stop exercising
Knowing when to stop is crucial to keeping you safe during exercise – being aware of the signs could be the difference between a smaller blip and finding yourself in danger.
Rob Barraclough, Train Fitness level four obesity and diabetes personal trainer and tutor says to be aware of and on the lookout for the symptoms of low blood sugar.
Early signs of a low blood sugar level:
Feeling shaky or trembling
A fast or pounding heartbeat (palpitations)
Becoming easily irritated, tearful, anxious, or moody.
If a low blood sugar level is not treated, you may get other symptoms, such as:
Confusion or difficulty concentrating
Unusual behaviour, slurred speech, or clumsiness (like being drunk)
Seizures or fits
Collapsing or passing out
Never feel like you can't walk out of a class or stop a workout, your health is the #1 priority and we need you to keep it that way. If you feel nervous in a group setting, have a word with the instructor beforehand or take a friend with you. Having someone there who knows and is also aware, is an added layer of security.
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