Best Exercises for Diabetes
If you have diabetes, one of the best things you can do for your blood sugar and your cardiovascular health is to get moving. "Diabetes is a metabolic condition where blood sugar has a difficult time getting into muscle where it belongs," explains registered dietitian Rebecca Toutant, a certified diabetes care and education specialist and personal trainer in Boston. Physical activity makes it easier for blood sugar to get into muscles to be used for energy. This ultimately makes your muscles more sensitive to insulin and reduces insulin resistance, says Toutant.
What's more, regular physical activity can help lower your risk for heart disease. "Exercise helps increase 'good' HDL cholesterol, improve blood pressure and improve blood vessel function to protect your heart," says Toutant. Since having type 2 diabetes doubles your risk for heart disease or a stroke, according to the Centers for Disease Control and Prevention, getting regular exercise is especially important. (These Are the 5 Best Exercises for Your Health, According to a Harvard Doctor.)
Getting regular exercise can also improve your mood, help you manage stress and improve your sleep quality—all of which can help you manage your blood sugar. Stress increases the release of the hormone cortisol, which can worsen insulin resistance and raise blood sugar, says Toutant. Stress management may also help you improve your relationship with food, while better sleep can help balance hunger hormones. As a result, it may be easier to make food choices that are best for your blood sugar when you are well rested and aren't feeling stressed.
How much exercise should you get if you have diabetes?
The current guidelines from the American Diabetes Association recommend 150 minutes per week of structured physical activity. Ideally, for best insulin function, you should not allow more than two days to go by without exercising. And aim for two or three sessions of resistance exercise per week.
Hitting the 150-minute-per-week mark comes out to about 20 minutes per day. You can break this up in any way that best fits your schedule, says Toutant. Maybe that is getting the full 20 minutes in the morning or afternoon, or maybe it's taking your dog out for a 10-minute walk in the morning and then doing a 10-minute YouTube video later in the day. Even getting four 5-minute spurts can be good for you.
"Take an inventory of what you're currently doing. I recommend starting where you are—not where you think you need to be," Toutant says. Meaning: There's no need to jump right to an hourlong workout every day. In fact, planning for too much—or more than your schedule or ability allows—can lead to burnout and injury. If you're not currently active, start with 10 minutes per day and build up to 20 minutes from there.
What's the best exercise to do if you have diabetes?
You'll be happy to hear that "every single type of exercise is beneficial," says Toutant. If you're new to exercise or aren't sure what you really like, sample all kinds of activities. This will help you pinpoint those that feel like joyful movement to you, and that's the x-factor in maintaining a routine. If you love it, you'll do it.
No idea where to start? Think about what you loved as a kid, recommends Toutant. If you were a young explorer, then find walking or hiking trails near you. If you liked team sports, then joining a beginner's running club or group fitness classes can provide the camaraderie that lights your fire. If you're more of a go-it-solo person, there's nothing wrong with turning on a video or following an app for a workout in your living room.
Keep in mind that some medications can leave you at risk for low blood sugar when paired with a change in exercise. If you are currently taking a blood sugar- or blood pressure-lowering medication, you can still exercise safely, but talk to your doctor first. Your doctor can make any adjustments to your medications if needed and can talk with you about how to monitor your blood sugar in response to exercise.
Taking a short stroll after a meal is one of the best things you can do for your blood sugar, suggests a 2016 study in Diabetologia. Adults with type 2 diabetes who walked for 10 minutes after each meal had lower post-meal blood glucose levels compared to those who walked for 30 minutes once per day. The effects were especially potent after dinner, which is the meal that is usually the most carb-heavy and one where many people eat and then sit down on the couch, the authors say.
Finding it tough to get yourself out there? Pair the activity with something that motivates you. (Toutant labels this as "looking for carrots.") Maybe it's cold out, but you're going to bundle up and listen to a podcast on your walk, or walk to a local coffee shop so you can get a tea to go.
Cardio workouts, like jogging, increase your body's ability to gobble up glucose in the moment, and so they're a great way to drive down your blood sugar. While a casual walk does it, picking up the pace or intensity and moving to a jog will raise your heart rate. "You'll increase the amount of glucose needed now and for hours after the activity. This gives you what's called a residual burn," says Toutant.
The good news is that even a little bit of jogging or running is useful. One study in the Journal of the American College of Cardiology concluded that just 5 to 10 minutes per day of slow running significantly reduces the risk of death from heart disease by 45%. So don't worry about being able to do a 5K right off the bat. Start with one minute of light jogging and build up from there. If you enjoy the activity and want to work up to longer distances, look for a training program to help you build up miles safely.
Research shows that strength training has many benefits for people with diabetes. Ultimately, strength training builds muscle. "This creates more insulin receptors, providing more opportunity for blood sugar to go somewhere and not get stuck in the bloodstream," says Toutant. Not only does that make muscles more sensitive to insulin, but, she says, it creates "more doors" for the glucose to go through, improving blood sugar control.
Another surprising benefit? Resistance exercise may help you lose more visceral fat compared to cardio, research suggests. Aim for two to three strength-training sessions per week. This includes lifting weights or performing body resistance exercises, like squats, lunges or modified push-ups.
Swimming or Cycling
Both swimming and cycling are low-impact activities that can benefit people with diabetes. Just two months of in-the-water exercise can help lower your A1C levels (a measure of average blood sugar over three months) just as well as on-the-ground activity, found a 2017 study. You don't have to swim laps—aquatic exercises or classes can be both enjoyable and easy on the joints.
If getting in the pool isn't for you, biking is another great option. And you don't need an in-home exercise bike to benefit: going out for a leisurely bike ride helps your blood sugar too. Danish research shows that both biking as a mode of transportation and for fun improves cardiorespiratory fitness and insulin sensitivity, as well as decreases visceral fat—and the faster you pedal, the bigger the benefits.
Some types of yoga can get your heart pumping (like power/vinyasa-style yoga), but there's value in gentle yoga or stretching, too. "These activities can reduce cortisol to help improve blood sugar management," says Toutant. What's more, activities like yoga can improve balance, thereby reducing the risk of injuries.
People who practice yoga are more likely to eat fruits and vegetables and eat more mindfully, and practicing yoga as a person with diabetes is linked to weight loss and glucose management, according to a study out of India. Even sessions as short as 10 minutes are important.