Diabetes is a group of metabolic diseases where there is abnormal metabolism of glucose, categorised into; Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus. Diabetes is characterised by high blood glucose levels, resulting from impairments in either production of, or the response to hormone, insulin. This means the amount of circulating glucose, or ‘sugar’, in your bloodstream is not being balanced effectively around meals, sleep and physical activity. This can result in you feeling tired, hungry and thirsty, gaining weight and it puts you at greater risk of secondary co-morbidities like cardiovascular disease. Poorly managed diabetes can progress to involve significant impairments in vision, limb sensation and wound-healing.
What Can You do to Manage it?
Diabetes treatment varies depending on the type and severity of your condition, often involving a combination of pharmacological intervention and lifestyle change that considers your nutrition, sleep, sitting patterns and physical activity. The good news – you have control of the lifestyle factors that help manage diabetes!
Exercise increases the body’s demand to use fuel (read: glucose!), which increases insulin sensitivity. During exercise, alternate pathways are also used to move glucose out of the blood without insulin. Regular exercise at a sufficient intensity can help improve blood glucose level control. Beyond this, exercise has terrific impact on improving body composition and cardiovascular function to reduce the impact of diabetes and reduce your risk of further co-morbidities and complications.
What Type of Exercise?
Frequency
Three or more times per week, with no more than 2 consecutive days without exercise, as insulin sensitivity is increased for 48 hours after exercise.
Intensity
Moderate – RPE 12-13/20 HRmax 55-69% OR Vigorous – 14-16/20 RPE 701-89% HRmax. Your Exercise Physiologist can help you understand and quantify your Rate of Perceived Exertion (RPE) and individual Heart Rate Maximum (HRmax), along with other intensity guides that work for you.
Time
Accumulate 210 minutes per week of moderate intensity, or 125 minutes per week at vigorous intensity.
Type
A combination of aerobic and resistance training, with resistance training taking up two or more sessions per week. Insulin sensitivity increases in the muscles that are used, therefore it is recommended to do compound movements utilising multiple large muscles.
What are the Safety Considerations?
Check your Blood Glucose Level before exercise, to be within a safe range of 5mmol/L to 14mmol/L. Check your Blood Glucose Level after exercise too, considering the timing of meals and insulin (if you take it) can help find an ideal time to exercise. Bring some fast-acting carbohydrate with you in case there’s a hypoglycaemic event. Ensure the exercise is right for you as an individual and your severity of diabetes, for example it may be important to have a foot check for wounds before commencing something like hydrotherapy or exercises in standing. It is best not to exercise when you have an illness or fever as blood glucose control and response is less predictable. Consider the safety of any other co-morbidities you may have along with diabetes.
Who Can Help Me?
Having a care team may involve your Endocrinologist, a Diabetes Educator, a Dietician and an Exercise Physiologist to care for multiple facets of diabetes.
An Exercise Physiologist, like Uplift, can help you feel confident and safe to participate in exercise and provide individualised exercise prescription to help you manage your diabetes and reduce the risk common co-morbidities and secondary complications from prolonged high blood glucose.
This may look like helping you explore your current strength and fitness, your current diabetes severity and any other barriers you have personally, to meet you where you’re at and prescribe the optimal exercise option and intensity for you, to achieve better blood glucose control. …And achieve all the other benefits that come with exercise and goals you may have!
Individualised exercise prescription and support can also help those at risk of developing T2DM or GDM, preventative care is the best care.
Reach out to our team by clicking here to start your journey towards improved health and well-being!
Written by Uplift Exercise Physiologist, Rebecca Starr
References:
Brill P. ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities, edited by J. Larry Durstine, Geoffrey E. Moore, Patricia L. Painter, and Scott O. Roberts. Activities, Adaptation & Aging. 2012;36(2):182-3.
Hordern MD, Dunstan DW, Prins JB, Baker MK, Singh MAF, Coombes JS. Exercise prescription for patients with type 2 diabetes and pre-diabetes: A position statement from Exercise and Sport Science Australia. Journal of science and medicine in sport. 2011;15(1):25-31.
Wu N, Bredin SSD, Guan Y, Dickinson K, Kim DD, Chua Z, et al. Cardiovascular Health Benefits of Exercise Training in Persons Living with Type 1 Diabetes: A Systematic Review and Meta-Analysis. Journal of clinical medicine. 2019;8(2):253.
