When you have type 2 diabetes, physical activity is an important component of your treatment plan. It’s also important to have a healthy meal plan and maintain your blood glucose level through medications or insulin, if necessary.

If you stay fit and active throughout your life, you’ll be able to better control your diabetes and keep your blood glucose level in the correct range. Controlling your blood glucose level is essential to preventing long-term complications, such as nerve pain and kidney disease.

Exercise has so many benefits, but the biggest one is that it makes it easier to control your blood glucose (blood sugar) level. People with type 2 diabetes have too much glucose in their blood, either because their body doesn’t produce enough insulin to process it, or because their body doesn’t use insulin properly (insulin resistant).

In either case, exercise can reduce the glucose in your blood. Muscles can use glucose without insulin when you’re exercising. In other words, it doesn’t matter if you’re insulin resistant or if you don’t have enough insulin: when you exercise, your muscles get the glucose they need, and in turn, your blood glucose level goes down.

If you’re insulin resistant, exercise actually makes your insulin more effective. That is—your insulin resistance goes down when you exercise, and your cells can use the glucose more effectively.

Exercise can also help people with type 2 diabetes avoid long-term complications, especially heart problems. People with diabetes are susceptible to developing blocked arteries (arteriosclerosis), which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesterol—and that helps you avoid arteriosclerosis.

Additionally, there are all the traditional benefits of exercise:

Lower blood pressure

Better control of weight

Increased level of good cholesterol (HDL)

Leaner, stronger muscles

Stronger bones

More energy

Improved mood

Better sleep

Stress management

But Before You Begin Exercising…

When most people are diagnosed with type 2 diabetes, they are overweight, so the idea of exercising is particularly daunting. For your health, you have to get started on a good, reasonable exercise plan, but first, you should talk to your doctor.

Your doctor will be able to check your heart health, which is particularly important if you already have blocked arteries or high blood pressure. You also need to take into consideration any other diabetes-related complications—retinopathy or neuropathy, for example. As you begin an exercise program, your doctor can refer you to an exercise physiologist or diabetes educator to help you figure out the best exercise program that allows you to get in shape for your fitness level.

Also before you begin exercising, you need to set realistic goals. If you haven’t exercised much recently, you will want to start slow and gradually increase the amount and intensity of the activity.

Remember to stay hydrated by drinking water and always have a treatment for low blood glucose handy (a 15 g carb snack is a good idea). It is smart to check your blood sugar with your glucose meter before and after exercise to make sure you are in a safe range.

Being diagnosed with type 2 diabetes does change your life, but making small changes to your routine can help you incorporate more physical activity into your day. You need to do what works for your body and your lifestyle. See the suggestions below for what types of exercise to do.

Allow yourself some time to build up to a steady, challenging exercise routine. And be okay with going slow—it’s better for your body in the long run.

What Kinds of Exercise to Do

There are three main kinds of exercise—aerobic, strength training, and flexibility work. You should aim to have a good balance of all three.

Aerobic Exercises

Aerobic exercises include:

Walking

Jogging/Running

Tennis

Basketball

Swimming

Biking

You should aim to get at least 30 minutes of aerobic exercise most days of the week. If you think that you can’t find 30 minutes, you can break up the exercise into chunks—10 minutes here and there. Build up to 30 minutes gradually.

Also, stretch your creativity when it comes to fitting in exercise. Take a walk at lunch, or get the whole family out after dinner for a game of basketball. Remember that walking your dog is a form of exercise. Taking the stairs is exercise. Walking from your car and into the store is exercise—so park farther away.

You need to find a way to exercise that you actually enjoy—because if it’s not fun, you won’t do it. It’ll be harder to stay motivated, even if you know all the benefits of exercise. Consider taking group classes at the gym, or find a friend to walk or run with. Having someone else exercising with you does make it more fun and motivating.

Strength Training

Once you have been able to include aerobic activity into your days, then you can start including strength training.

Strength training gives you lean, efficient muscles, and it also helps you maintain strong, healthy bones. It’s really good for you when you have type 2 diabetes because muscles use the most glucose, so if you can use them more, then you’ll be better able to control your blood glucose level.

Weight training is one of the most used strength training techniques, although you can also use your own body weight to build up strength—think of pull-ups and push-ups.

When you’re starting a weight training program, make sure you know how to use all the equipment. Ask the staff at your gym how you should properly use the weights, or consider getting a personal trainer to learn the best exercises for you.

Lifting weights for 20-30 minutes two or three times a week is sufficient to get the full benefits of strength training.

Flexibility Training

With flexibility training, you’ll improve how well your muscles and joints work. Stretching before and after exercise (especially after exercise) reduces muscle soreness and actually relaxes your muscles.

And Stick with It

Make a commitment to exercise; make it a priority. Your long-term health depends on it, so as tough as it may be to find time or to motivate yourself to exercise, keep at it. It will help you lose weight (if you need to do that), and it will make your body more efficient at using its insulin and glucose.

Hi Mr Guillermo Alberto Perez Fernandez ,

it is truly remarkable that physical activity has a significant effect on the prevention of cardiovascular diseases but let me ask you another question if you allow me, it is clear that good control of blood glucose going to lead us to a good control of cardiovascular diseases, This is in regards to the patient, but if we look at the field of scientific experiments, what are the most important experiences that reached her research for the prevention of this ? 

and you have touched that a good control of blood glucose can leads also to prevent the other complications such as court-term complications and long-term complications, how can it ?

1. Eating nutritionally balanced multiple small meals 

2. Exercise

In the case of T1DM, for the majority (a small minority receives pancreas organ), insulin treatment (pump provides better control).

In the case of T2DM, if overweight, reduction to normal weight helps significantly. In cases where insulin resistance is too severe (usually with overt obesity), chemical intervention may be necessary, including use of insulin. But as the weight reduction progresses, the degree of pharmaceutical intervention also reduces.

By the age of 28 I was diagnosed with a diabete of type 2. There is a lot of diabete into my extended family.   But I solved it completly by doing physical exercices.  I learned recently that one of the key are not the exercises themself but the rapid lost of internal fat tissues that take place in the beginning of the exercise period.  The internal fat that are located into the pancreas and other vital organ functionally prevent the good functioning of these organ and create an auto-immune response that destroyed the insuline producing cell in the pancreas.  So it is very important to have this rapid weight lost.  I have been type 2 diabate free for 35 years now. Even my vision which had deteriorated in the years of my diabete is better than it was then and I do not need to wear glasses yet.

Hello Louis,

That's really excellent!

Short of injecting yourself with leptin to reduce fat deposits (which at some point may be used), exercise is the best and readily available method to everyone.

J Biol Chem. 2006 Dec 29;281(52):40283-91. Epub 2006 Oct 12.

Combined leptin actions on adipose tissue and hypothalamus are required to deplete adipocyte fat in lean rats: implications for obesity treatment.

http://www.ncbi.nlm.nih.gov/pubmed/17038325

Trends Endocrinol Metab. 1997 Sep;8(7):276-82.

How obesity causes diabetes in Zucker diabetic fatty rats.

http://www.ncbi.nlm.nih.gov/pubmed/18406816

Proc Natl Acad Sci U S A. 2008 Apr 22;105(16):6139-44. doi: 10.1073/pnas.0801981105. Epub 2008 Apr 14.

Adipogenic capacity and the susceptibility to type 2 diabetes and metabolic syndrome.

http://www.ncbi.nlm.nih.gov/pubmed/18413598

Here is a provocative title:

Trends Endocrinol Metab. 2010 Jun;21(6):345-52. doi: 10.1016/j.tem.2010.01.009. Epub 2010 Mar 10.

Gluttony, sloth and the metabolic syndrome: a roadmap to lipotoxicity

http://www.ncbi.nlm.nih.gov/pubmed/20223680

Cell Metab. 2015 Jan 6;21(1):15-20. doi: 10.1016/j.cmet.2014.10.011. Epub 2014 Nov 20.

A new biology of diabetes revealed by leptin.

http://www.ncbi.nlm.nih.gov/pubmed/25456738

Louis, there will be a quiz tomorrow!  ;)

Dear Tausif ,

I fear I will fail!

The long term complications of Diabetes are  macrovascular ( coronary artery disease , stroke & peripheral vascular disease ) & microvascular ( retinopathy , nephropathy & neuropathy ) . In addition to diabetes , macrovascular complications are due to hypertension , lipid disorders & smoking , which are equally important . Therefore , ACEI / ARB's for treatment of hypertension & statins for lipid disorders are equally important . ACEI / ARB's also prevent progression of diabetic renal disease . It is necessary to diagnose these risk factors early by screening , so that treatment can be started early with better long term benefits .

  It is essential to keep blood sugar , lipids & hypertension under control . In addition smoking should be discontinued & obesity should be managed by healthy lifestyle as discussed by other members .

Hi Mr Tausif Alam ,

Thank you, Sir, on your answer, but I have questions, if possible.

It is very clear that the  physical  activity  of the person contributes a large margin in the control of blood glucose and thus control in the fight against complications  My question is, Is there any studies or experiments demonstrate this ? and Are there other factors  than the physical activity to combat with, who demonstrate experiments that if possible ?

Hi Mr Louis Brassard ,

Sir, I am honored your answer to my question,

You have said that one of the keys  are not the exercises themselfs but the rapid lost of internal fat tissues that take place how true is this ?

Hi Mr Singh Shivakumar,

Thank you for response to my question, 

Is there clinical studies that prove that It is essential to keep blood sugar , lipids & hypertension under control ?

There are multiple studies demonstrating the individual effects of controlling glucose, blood pressure and lipids - too many to mention. However, if you want one reference showing the effect of multiple risk factor control look at the Steno study (N Engl J Med 348:383-93, 2003)

Ali:

"My question is, Is there any studies or experiments demonstrate this ? and Are there factors other than the exercise of physical activity to combat with who demonstrate experiments that if possible ?"

"Is there clinical studies that prove that It is essential to keep blood sugar , lipids & hypertension under control ?"

Ali, being spoon-fed by others is no substitute for developing an understanding through a thorough literature survey. You are asking questions that have been studied for decades. A good deal of published information already exists. I do not wish to seem harsh but may I suggest that you begin with a few recent review articles, select the aspects that interest you and dig deeper into the original publications.

Best,

Dear Ali Merina,

We do have larger studies like Chinese Da Qing Study, Diabetes Prevention Program (DPP) and UK Prospective Diabetes Study (UKPDS) which consistently show that lifestyle modification helps in significant reduction in the diabetes complications. 

Lifestyle in the sense- Diet, physical activity and I would like to add on psychological well being overcoming stress and depression. 

"Is there clinical studies that prove that It is essential to keep blood sugar , lipids & hypertension under control ?"

I guess all the clinical studies done on diabetes are to serve the very purpose of improving glycaemic control, lipid profile & blood pressure, and 99.9% of the clinical studies would give the answer for your question. First line of treatment in preventing CKD(or any complication)  in diabetes patients is to control blood sugar and BP.

If you are wondering what the remaining 0.1% clinical studies say, I would like to emphasize that these studies which says otherwise or infact only trying to say that 'Intense control' is not necessarily essential. Glycaemic target has to be fixed considering the age and other factors, to prevent any adverse effects on the patients.

To summarise, it 'is' definitely essential to control blood sugar, BP and lipid levels in diabetes to prevent the complications, but do not overdo it with higher doses of insulin.