Keep in mind that going to the gym is not necessary to get an aerobic workout — any form of physical exercise that increases the heart rate will do. These can include taking a brisk walk outside or on a treadmill, gardening, cleaning house, swimming, ice skating, playing tennis and riding a bicycle or a stationary bike indoors.

Patients with diabetes and prediabetes should exercise for at least 30 minutes, five days a week at moderate intensity. Adults with prediabetes who exercised for 150 minutes per week as part of a diabetes prevention program, lost approximately 10 to 20 pounds without making any dietary changes.5 The regimen also helped delay or prevent diabetes, data indicated.


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Aerobic exercise improves whole-body insulin sensitivity levels in just one week6 and can moderately decrease bad cholesterol levels, lower blood pressure and reduce the risk of cardiovascular disease and early mortality.1

Brisk walking and other moderate exercises can improve blood glucose levels and reduce the risk of cardiovascular disease, but are not enough for major weight loss. Those who intend to lose a large amount of weight and maintain their new weight may need to put in up to seven hours a week of moderate to vigorous exercise.

Together clinicians and patients can develop a good strategy for reaching the goal of exercising at least three days a week. Patients should slowly build up to the goal of exercising 150 minutes per week by gradually increasing the intensity and length of the workout.

To date no studies have been done to determine the best way to gradually increase exercise, but taking small steps toward an aerobic exercise goal may help people avoid injury and may make it easier to stick to a new exercise resolution.

Stay strong

Building strong bones and strong muscles is especially important for patients with diabetes. Strength training, also known as weight training or resistance training, increases the amount of calories that a person burns even when resting.

People with diabetes should undertake strength training at least twice a week, using resistance machines or free weights that work the major muscle groups — upper body, lower body and core — according to the ADA.1 People can use light weights to work out at home, but should first receive instruction or supervision from a qualified exercise trainer to develop a safe and effective strategy.

Like aerobic exercise, strength training can have long-term beneficial effects on insulin action. Strengthened muscles may continue to take up blood glucose, and heavy weight training may also reverse or prevent the loss of skeletal muscle, and lower BP.

Keep active throughout the day

A sedentary person usually takes between 1,000 to 3,000 steps per day, or about a half a mile to 1.5 miles. Studies have shown that increasing the number of steps taken throughout the day to 10,000 may reduce the risk for diabetes and obesity.7

Going out and walking five miles each morning is not necessary to reach a goal of 10,000 steps a day. In fact, most of the steps a person takes come from short walks at low speeds. Daily activities like doing laundry or grocery shopping add to cumulative steps per day.

People who use a pedometer, a device that counts steps, generally increase the number of steps taken by about 25%.1

Other ideas to increase daily physical activity include taking the stairs instead of the elevator, parking at the far end of the parking lot, and walking instead of driving places. These small steps can add up to big health improvements.

Other considerations

Before a patient with diabetes begins developing or changing an exercise routine, encourage them to consider the following factors:

  • Completing both aerobic exercise and strength training on the same days, as this approach produces the best results for diabetes management.1 No studies have yet looked at the effects of alternating strength training on one day and aerobic exercise the next.
  • Having a qualified exercise trainer to supervise workout sessions also improves outcomes.

Haley Bridger is a freelance medical writer living in the greater Boston area.

References

1. American College of Sports Medicine; American Diabetes Association. Med Sci Sports Exerc. 2010 Dec;42(12):2282-303.

2. CDC. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.

3. Williamson DA, Rejeski J, Lang W et al. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Arch Intern Med. 2009;169(2):163-71.

4. Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care. 2007;30(2):203-9.

5. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346:393-403.

6. Winnick JJ, Sherman WM, Habash DL, et al. Short-term aerobic exercise training in obese humans with type 2 diabetes mellitus improves whole-body insulin sensitivity through gains in peripheral, not hepatic insulin sensitivity. J Clin Endocrinol Metab. 2008;93(3):771-8.

7. Dwyer T, Ponsonby A-L, Ukoumunne OC, et al. Association of change in daily step count over five years with insulin sensitivity and adiposity: population based cohort study. BMJ. 2011; 342: c7249.

8. Gleeson-Kreig J. Social support and physical activity in type 2 diabetes: a social-ecologic approach. Diabetes Educ. 2008;34(6):1037-44.