Getting Started
As A Type 2 Diabetic, How Can Exercise Help Me?
Exercise can help a Type 2 diabetic in a number of ways. It can help you:
- Use insulin more efficiently (the insulin your body is already producing) – and it might eliminate your need to take insulin if you are currently on an insulin regimen.
- In fact, research shows that an effective diet and exercise program can minimize or completely eliminate the necessary medications, not just insulin, many Type 2 diabetics are dependent upon.
- Burn excess body fat – reducing body fat increases insulin sensitivity, thereby partially reversing the effects of Type 2 diabetes
- More effectively manage your blood sugar levels
- Reduce your risk for cardiovascular disease (the leading killer of diabetics)
What a wonderful reason to exercise! Let’s see here….eat recklessly, don’t exercise, and end up suffering from the myriad of complications associated with poor blood glucose control …OR…coordinate diet and exercise, be an active participant in life, and possibly not be dependent upon any diabetes-related medications. Wow, count me in!
Starting An Exercise Program
What is exercise? We’re looking at exercise as anything that gets your heart rate up and works your muscles. Even if you can’t walk or stand up, there are lots of ways to get your heart rate up even while sitting. For example, there are a myriad of chair exercises that will get your heart rate going and strengthen your muscles. Click here for one example of a chair exercise video. You can also type “chair exercises” into a Google or YouTube search to search for a low-impact exercise routine that works best for you.
Exercise is a wonderful way to increase your insulin’s effectiveness, improve your circulation, enhance your overall health, and just make you feel good! From walking to running to biking to swimming to tennis to basketball to dance, the list of potential exercises goes on – it is important to find something you enjoy and that can help you achieve your goals.
- Set GoalsSetting goals is an important first step to beginning exercise. Do you want to lose weight? Have more energy? Run a 5K? Play with your children more often? Improve your A1C's? Whatever it may be, setting a specific goal, one that you are really passionate about, is key to your success. It gives you motivation, something to strive for and work toward. Setting small goals that lead up to a major goal is a great way to track the progress you're making.
- Ease Into ItSet those goals high, but don't make them unrealistic. If you are just starting to exercise, ease into it. For example, you may start by going for a ten-minute walk after each meal, and then gradually progressing to longer walks, or one long walk per day. You might think managing your diabetes will make starting to exercise more challenging than it would be for a non-diabetic….you’ve got enough on your “plate.” Good grief. However, overcoming those challenges is the rewarding part! Be careful not to burn out too quickly, take your time and enjoy your new activity!
- Trial and Error
Another important thing to remember is that this will be a process of trial and error. Everyone is different and every diabetic's body is going to react a little differently to exercise, medications (if you are taking them), and fuel.
If you take insulin, you might need to make insulin adjustments, because your body will use insulin differently when you exercise, and similarly, if you are taking medications (especially a sulfonylurea), your dosage may need to be adjusted (after speaking with your doctor) and you may need to be alert for hypoclycemia (low blood sugar). Type 2 diabetics who manage their diabetes with diet and exercise alone very rarely have to worry about hypoglycemia.
Don't be discouraged if things are out of wack at first. Even if you experience multiple episodes of low blood sugar during or after exercise at first, don't give up. It will be a process of trial and error before you get the hang of how your body reacts to the positive changes you're making. Make sure you review this process with your doctor.
- Keep a Log
Keep an exercise log that includes your goals. Goals can be wide in variety. Here are some examples:
I want to exercise 4 hours per week. This could be chair exercises, walking, jogging, anything that gets your heart rate up.
I want to run a 5K.
I want to lift more weight than I did last week.
I want to raise my heart rate 4 hours per week.Exercise will help support these types of goals as well:
I want to lose 2 pounds per week.
I want my A1Cs to be 6.0.
I’m going to test 8 times per day and I never want my blood sugar to be above 200.Keeping Track Tracking this information will help you see what works, what doesn't work and how your body reacts during exercise. You can use the one below as a guide and tweak it to your liking.
Before
Exercise - Activity and Intensity:
Time of day:
Blood sugar:
Heart rate:
Food or drink consumed (calories and carbs):
Medication/Insulin (type and dosage):
During
Blood sugar:
Heart rate:
Food or drink consumed (calories and carbs):
How do you feel:
After
Blood sugar:
Heart rate:
Food or drink consumed (calories and carbs):
Medication/Insulin (type and dosage):
How do you feel now:
Notes regarding your workout:
Precautions and Important Considerations
Hypoglycemia (Low Blood Sugar):
It is important to remember that exercise increases your body’s sensitivity to insulin. This means exercise will lower your blood sugar levels, which is a good thing! However, you must also be aware that there is the potential for your blood sugar levels to fall lower than you might expect. This is predominantly a risk for Type 2 diabetics who take insulin and/or certain types of medications (i.e. sulfonylureas). There is almost no risk of hypoglycemia for Type 2 diabetics who manage their diabetes with diet and exercise alone.1 However, there is always still some potential risk, so be alert for signs of hypoglycemia.
Whether you take medication or not, make sure you have access to some form of carbohydrate when exercising. It will help if your blood sugar happens to fall and it’s also a good source of energy in general. I always carry Gu. It fits in your pocket easily, is easily digestible (has a relatively high glycemic index) and packs about 25 grams of carbs per packet. In my case, 10 grams of carbs will bump my BG up about 40 points. Know your formula (see Management Tools). But any form of carb will work; M&M’s, cookies, fruit, but make sure it’s a low glycemic index form of carbohydrate.
Secondly, always check your blood sugar before exercising. Most sources suggest that if it is below 100 mg/dl, you should hold off, eat a small snack (containing about 15g of carbohydrates) and test again 15-30 minutes later. If you are a Type 2 diabetic using insulin, try to avoid exercising when your insulin peaks. This doesn’t eliminate the risk for low blood sugar during exercise, but it does reduce it. If you use insulin, see the Type 1 Exercise section for more detailed information about how to balance insulin and exercise.
It is also important to pay attention to your blood sugar after you exercise and make adjustments as necessary. Again, as a Type 2 diabetic, your risk for low blood sugar after exercise is not as high as that of a Type 1 diabetic’s, but it is still something to be aware of. Of special importance, the more you exercise, the less dependency you should have on medications associated with Type 2 diabetes. Please keep your doctor aware of your exercise program.
Diabetes Complications:
If you have had diabetes for a long time, or if you currently suffer from any diabetes complications (i.e. neuropathy or retinopathy), or other health challenges, consult your doctor about safe exercise options. It is also important to note that diabetics need to pay special attention to their feet; if you notice any abnormalities, such as corns, calluses, irritated areas, or blisters, contact your doctor right away.
If you are suffering from diabetes complications right now, don’t let that discourage you from exercising! Your doctor can help you find exercises that are safe for you and they will make a difference.
Hydration:
Make sure you drink plenty of water before, during, and after exercise, as dehydration can affect blood sugar levels.
Conclusion:
Being aware of the potential risk of hypoglycemia (especially if you take insulin) and listening to your body will allow you to exercise safely and successfully. If you feel, or if you tested and your blood sugar is low (or excessively high), follow these steps:
- Stop exercising.
- If you can test your blood sugar, do so, but if you can’t and you feel low do not wait to act. Trust your instincts—if your body tells you your blood sugar is low, take immediate action to correct it. If you think your blood sugar is high, however, wait until you can test your blood sugar before taking any insulin (if you take insulin).
- References1. American Diabetes Association. Complete Guide to Diabetes. Alexandria, VA: American Diabetes Association, Inc., 2011.
