How people with type 2 diabetes can get the benefits of exercise while reducing the risks
Adults with type 2 diabetes may have more to gain by participating in physical activity and exercise than healthy adults, but they may also have more to lose, according to University of Alberta exercise and diabetes physiology researchers.
"Exercise can improve one's glucose levels, which can help slow the progression of diabetes and reduce the need for additional medications," said U of A diabetes researcher Normand Boulé. "On the other hand, (people with type 2 diabetes) have more risk factors for cardiovascular events with exercise and, depending on the medications they take, may be at greater risk for low blood sugar, which can result in a variety of harmful symptoms such as shakiness, or even loss of consciousness."
According to the 2018 Clinical Practice Guidelines for Physical Activity and Diabetes— co-authored by Boulé, who is also the director of the Physical Activity and Diabetes Lab—at least 150 minutes per week of aerobic exercise and at least two sessions per week of resistance exercises are recommended for adults with type 2 diabetes.
The guidelines also suggest reducing sedentary activities and recommend trying to interrupt sitting time by getting up every 20 to 30 minutes. Boulé noted that incorporating a healthy, appropriate diet with exercise can help further reduce glucose levels for people with type 2 diabetes.
Striking a healthy balance
Jordan Rees, a Ph.D. student in Boulé's lab, said finding an achievable balance between exercise and diet requires planning.
"The overall health benefits of regular exercise and physical activity can help adults living with diabetes reach a variety of goals, such as increased fitness and energy levels, help with glycemic control, decreased insulin resistance, and reduction and maintenance of weight loss," she said.
Boulé and Rees are recruiting subjects for a study to compare exercise in the morning, after an overnight fast, with the same activity performed after breakfast. In recent years, the importance of the timing of exercise has been a topic of debate and led to conflicting recommendations. The researchers hope the results can offer people with type 2 diabetes simple strategies for more effective exercise.
Until then, Boulé and Rees encourage people to start a regular exercise program by following a few simple steps:
- Step 1: Have a conversation with your doctor about the risks and benefits of exercise, and discuss what may be best for you as part of your current treatment plan.
- Step 2: Consider your past history with sport, exercise and physical activity to help determine which activities you most enjoy and feel comfortable participating in.
- Step 3: Set achievable goals. Rees suggests a walking program is a great place to begin, and simple strategies like walking with friends or family, or joining a walking club, can increase your likelihood of sticking with it over time.
While incorporating a physical activity program is important for all adults, Boulé said everyone has preferences and barriers for physical activity and exercise, and setting achievable, realistic goals is an important part to help favour participation.
"For some people, exercise may not improve glucose levels as effectively as it does for others, or the rate of weight loss may not come as fast for some as it does for others," he said. "What's important to remember, however, is that for people with diabetes, exercise is not just about glucose or body weight; there are many other benefits such as improving your fitness, which substantially lowers mortality in people with diabetes and helps increase your quality of life."