Exercise, the ‘wonder drug’1 you can prescribe yourself
Regular activity can play a key role in helping you stay well, and reduce your risk of long-term diabetes complications. Here’s what you need to know about getting into the exercise habit.
Being physically active has so many benefits for body and mind that, according to Public Health England, if exercise were a drug it would be classed as a ‘wonder drug’.1
Research shows exercising regularly reduces your risk of more than 20 medical conditions, including dementia, heart disease, stroke, depression, certain cancers and hip fracture.1 Being active can also help control your weight, boost your mood and help you get more out of life, especially if you find a type of exercise you enjoy.1
Having diabetes needn’t stop you exercising. In fact, getting active regularly can help you manage your diabetes in many ways, including:
- Helping to control glucose levels. Regular exercise has been shown to help people with diabetes lower their HbA1c even without losing weight.3
- Enabling your body to use insulin more efficiently, so you may be able to reduce insulin doses or diabetes medications, if your diabetes care team agree.2
- Improving your cardiovascular health and reducing your risk of common long-term diabetes complications such as heart disease and stroke.1
- Helping you sleep better and manage stress and anxiety, which can help you feel better about living with diabetes.2
How much exercise should I do?
The UK’s Chief Medical Officers’ guidelines recommend that every adult does 30 minutes of moderate physical activity five times every week, in sessions of at least 10 minutes.1 ‘Moderate’ means exercising hard enough to get your heart beating faster and make you warm and slightly out of breath. Bear in mind though the guidelines are for people who don’t have medical conditions that can make it harder to exercise. Talk to your healthcare professional about the level of exercising that’s safe for you.
Adults are also advised to do some kind of muscle strengthening exercise, such as weight training, carrying heavy shopping or yoga, twice a week.1
If you’re not currently active, you could work up slowly to the recommended level – for example, by going for a 10-minute brisk walk. The good news is, any amount of activity has benefits and is better than none.1
What kind of exercise is best?
Everyone’s different, and the best kind of exercise for you is the one that you enjoy, as you’re more likely to make it a regular habit.2
Research has shown that in people with Type 2 diabetes, combining aerobic exercise and resistance exercise is more effective in lowering HbA1c than doing just one type of exercise5.
Aerobic exercise is an activity that makes your heart and lungs work harder and moves large muscle groups.6 Examples include:
- Aerobic classes
- Brisk walking
Resistance exercise helps build muscle strength.6 Examples include:
- Climbing the stairs
- Carrying and lifting shopping
- Digging the garden
- Lifting weights
- Pilates, Tai Chi or yoga
Check with your diabetes care team if you have any concerns about starting a new type of activity. As well as exercising regularly, it’s important to avoid long spells of sitting. Most adults spend more than seven hours a day sitting down, either at home or at work.1 Research suggests that a sedentary lifestyle may be as dangerous to health as smoking7, so it makes sense to get up from the TV or computer screen and move around as often as you can.
Exercising with Type 1 diabetes
Being active can benefit your HbA1c3, but you may experience short-term ups and downs while you’re exercising or playing sports. Testing your glucose before, during and in the hours after exercise can help you spot trends and prevent any problems.8
Avoiding hypoglycaemia (hypo)
Exercising with too much insulin in your bloodstream can bring on hypoglycaemia (a hypo) when your muscles start to take up glucose for energy9. If your glucose is between 5-8 mmol/L ingest 10g of glucose and exercise can be started. Don’t start exercising if your glucose is lower than 5mmol/L. It’s a good idea to take hypo treatments (fast acting carbohydrate) and make sure you have a diabetes ID whenever you’re exercising.2
Avoiding a glucose spike (hyper)
Intense or competitive exercise can release stress hormones and trigger extra glucose production in the liver, risking a glucose spike or hyper2. Exercising with very high glucose levels and too little insulin can affect your performance and risk triggering dangerous levels of ketones.2 If your glucose is higher than 15.5mmol/L you should check for ketones and take corrective action as necessary. Check with your diabetes team before making any changes to your insulin doses.2
Avoiding a hypo after exercise
Your glucose can drop between eight and 12 hours after exercise, potentially causing a hypo, which could occur at night if you’ve exercised just before bed.8 To avoid this it can help to check your glucose before exercising and regularly in the hours afterwards, and record the timing of meals and exercise sessions so you can plan to keep your levels steady.8 Your diabetes care team can advise on a plan that works for you.
Exercising with diabetes? Be prepared
- Wear medical ID to show you have diabetes and whether you take Insulin in case of an accident.9
- If you’re going for a solo ramble or run, let someone know where you are.9
- Wear footwear that’s suitable for the exercise you’re doing, and make sure shoes fit well and your skin is well protected from blisters and chafing.9
1. Public Health England 2016, Guidance: Getting every adult active every day, accessed 20 March 2019, <https://www.gov.uk/government/publications/health-matters-getting-every-adult-active-every-day/health-matters-getting-every-adult-active-every-day#the-benefits-of-physical-activity>.
2. Diabetes UK 2019, Sports Nutrition and Type 1 diabetes, accessed 6 May 2019, <https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/out-and-about/sports-nutrition-and-type-1-diabetes/.>
3. Harvard Health Publishing 2019, The importance of exercise when you have diabetes, accessed 20 March 2019, <https://www.health.harvard.edu/staying-healthy/the-importance-of-exercise-when-you-have-diabetes>.
4. NHS England 2018, Get active your way, accessed 20 March 2019, <https://www.nhs.uk/live-well/exercise/get-active-your-way/>
5. Church, TS et al 2010, Effects of aerobic and resistance training on HbA1c levels in patients with Type 2 diabetes, JAMA, Vol 304, No. 20 2255, accessed 20 March 2019, from <https://jamanetwork.com/journals/jama/fullarticle/186960>.
6. British Heart Foundation 2019, Physical activity and your heart, accessed 20 March 2019,<https://www.bhf.org.uk/~/media/files/publications/heart-conditions/his1_physical-activity-and-your-heart_0113.pdf>.
7. Get Britain Standing 2018, Health risks of sitting, accessed 20 March 2019, <http://www.getbritainstanding.org/health-risks.php>.
8. JDRF 2019, Living with Type 1 diabetes – Exercise, accessed 20 March 2019, <https://jdrf.org.uk/information-support/living-with-type-1-diabetes/everyday-life/exercise/>.
9. Diabetes UK 2019, Walking with diabetes, accessed 20 March 2019, <https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/exercise/walking-with-diabetes>.