Hello friends! Something that has weighed on my mind is the lack of accurate resources about exercise with conditions. With my rebrand last year, I have wanted to try and fill this void a bit. Science backed information is the lynchpin for making exercise work for you, so let’s go!
I have lamented the lack of oversight that personal trainers have in the US. There is no central education or certification process. In fact, all you need is decent knowledge of a weight room and an enviable body (whatever that currently means) to call yourself a trainer. While there are smart, honest, and very dedicated trainers, there are still way too many working with clients when they do not have the knowledge or skills necessary to deal with more complicated physiological issues.
I believe that both trainers and exercises alike deserve the resources they need. This means clear and concise information that is backed by science and practice. You might be asking who do I think I am to provide this? My education and credentials are available on my About Me page. And I’ve put that education to the test working with clients and students for two decades. I know what the science says and I know what works in practice.
Diabetes is a condition that can have two physiological pathways. In Type 1, the pancreas doesn’t make the insulin the body needs to move simple sugar (glucose) from the blood into the tissues. In Type 2, the pancreas makes insulin, but the receptors on the tissues can’t sense it well enough to allow the glucose in.
In either pathway, the result is the same: our organs and tissues do not have the glucose they need to perform their functions. In terms of exercise, the breakdown of glucose in muscle cells is what allows the muscle to contract. And muscle contractions are what move our body.
The good news? Exercise works like an insulin supplement. In Type 1, the receptors on the cell work fine, so increased muscle contractions create a need for glucose to pass into the cell (and out of the blood). In Type 2, the muscle contractions allow the glucose to bypass the receptors to get into the cells. Long story short…exercise allows better control of blood sugar regardless of which type of diabetes.
Better blood sugar control has a ton of benefits. Short term, keeping the blood sugar more steady means fewer cravings, more stable energy, better focus, and improved sleep. From a long term perspective, there is a reduced risk of stroke and heart attack and less risk of diabetes related complications like neuropathy, retinopathy, and kidney failure.
There is a fine line, though. Too much of a good thing if you will. Long bouts of exercise can deplete enough glucose from the body that there are other consequences. Shakiness and irritability are the most common symptoms of hypoglycemia. Usually a bit of fast acting sugar (like 4 ounces of juice) will do the trick here. Of course, stop any activity, and once stable, have a snack with a some complex carbohydrates and protein to further stabilize blood sugar. If hypoglycemia has advanced to fainting or worse, that’s an emergency situation for 911.
Additionally, diabetics need proper recovery time. Shorter bouts of exercise done more frequently are usually the most beneficial. Think 30 minute sessions five times per week without going more than 48 hours between any one session. Total recovery after short sessions is usually more manageable. And moving more frequently amps up the glucose control aspect that exercise offers.
As with any exerciser, a mix of cardiovascular and strength work is ideal. The cardiovascular exercise is going to have the bigger impact on blood sugar in any given bout of exercise. Strength training is going to have a longer term impact on blood sugar control and it serves as major protection against neuropathies.
The last piece of the puzzle is what I’ll call emergency management. If you are new to exercise, check with your doctor first. If you are the trainer, make sure you have that clearance. Monitor your blood sugar, especially if you take supplemental insulin. If your blood sugar is below 70 mg/dL or your low threshold an hour prior, consume some quick acting carbohydrate.
If you are new to exercise, monitor frequently during your sessions to learn your individual glucose response patterns. If you can’t do 30 minutes at once, it is more than fine to split your sessions into smaller chunks as you build capacity. Lastly, make sure you have fast acting glucose handy during exercise. Four ounce juice boxes (100% juice), a small piece of candy, or honey packets are portable, convenient, and palatable. Trainers, you should have a few of these in a first aid kit as well.
Here is a great overview to sum and print if you need to keep handy . I’m going to throw these breakdowns into the Wellness Toolkit so that they are easily searchable as well. And if you have any questions about exercise with diabetes, throw them in the comments. Until next time, move well friends!
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