How active are you? Unless you’re exercising more than several hours a day already, you probably have room to add more in for additional health benefits. Exercise is about the best medicine that there is for so many health conditions, including diabetes. Being active helps manage emotional stress and stave off depression. It naturally bestows your body with antioxidant-effect, making you less likely to develop most types of cancer—or even the common cold.
When it comes to managing diabetes, the benefits are even greater. Many times, exercise can virtually erase your blood glucose mistakes. It acts like an extra dose of insulin by getting the glucose out of your blood and into your muscles without insulin (through an insulin-independent mechanism related to muscle contractions themselves). When you’re not active, your body needs insulin to stimulate that uptake. Being regularly active makes your muscles more sensitive to any insulin in your body as well, so it takes less to get the job done. What better way to help erase a little overeating of carbs (or a slight lack of insulin or insulin resistance) than a moderate dose of exercise?
One thing to know, though, is that exercise doesn’t always make your blood glucose come down, at least not right away. Intense exercise causes a burst of glucose-raising hormones (like adrenaline and glucagon) that raise your blood glucose instead, albeit usually only temporarily. But even if a workout raises it in the short run, over a longer period of time (2-3 hours), the residual effects of the exercise will bring your blood glucose back down while you’re replacing the carbs in your muscles. If you take insulin, take less than normal to correct a post-workout high or your blood glucose can come crashing down later. A cool-down of easy exercise (like less-than-brisk walking) can also help bring it back to normal.
How much muscle you have also matters to blood glucose management. Exercise helps you build and retain your muscle mass, which is the main place you store carbs after you eat them. Almost any type of exercise uses up some of your muscle glycogen, but if you don’t exercise regularly, your muscles remain packed with it. There is a maximal amount that fits in muscles, which is why building up your muscle mass helps with being able to handle the carbs you eat more effectively. Your liver stores some glucose as glycogen, but not much relative to your muscle storage capacity. Being sedentary ensures that no amount of insulin is going to be able stimulate more blood glucose uptake into your muscles. Without regular exercise to use up glycogen, you really have nowhere to store carbs, so your blood glucose goes up and some of the excess gets turned into body fat instead. Doing resistance or heavier aerobic training is critical to maintaining the muscle mass you have and offsetting the effects of aging on muscles.
People with naturally lower levels of insulin generally live longer (think of centenarians and elite athletes, both of whom have low insulin levels). Exercise helps you keep your insulin needs low, which makes it easier to either make enough of your own or get by with much smaller doses (resulting in less of a margin for big errors in dosing). Plus, it’s a lot harder to lose body fat if your insulin levels are high or you take large doses because insulin promotes fat storage from excess blood glucose. Both the last time you exercised and how regularly you’re active have an impact on the insulin sensitivity of your muscles, so aim to exercise as least every other day (although daily is likely better) and keep all those muscle fibers you have by using them regularly.
If nothing else, start getting more active by standing up more, taking extra steps during the day, fidgeting, and just generally being on the move whenever and wherever possible. Knowing that hopefully takes away your excuses for not being more active. If you can’t get in a planned workout on any given day, you can certainly add in more steps or other activity all day long instead (or do it in addition to your usual exercise). Every bit of movement you do during the day counts, so fidget away as part of your daily dose of exercise!
Are you physically active and do you have diabetes (of any type)? Now is your chance to share how you manage your diabetes and fitness regimen.
A new edition of Dr. Sheri Colberg’s book, Diabetic Athlete’s Handbook, is coming out in Spring 2019. Please complete this athlete survey no later than May 15 for possible inclusion.
Please pass the survey on to everyone else you know who is active with diabetes. Thanks for your time and input!