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  • Dr. Eric Carlsen

How Exercise Helps Prevent and Manage Type 2 Diabetes: Part 2

Older man and woman at gym lifting small weights

How Exercise Helps Prevent Complications of Type 2 Diabetes

Apart from managing blood sugar and insulin levels, exercise functions to slow, stop, and in some cases, even reverse the long-term effects that occur due to the progression of type 2 diabetes. Here are some of the main ways that physical activity combats insulin resistance-related complications:

Improving Vascular Health When you exercise, your muscles release a host of compounds that benefit vascular and circulatory health, Occhipinti says. That means more oxygen and nutrients can get where they need to go, reducing the risk of diabetes-related neuropathy, vision loss, and heart issues. Improved blood flow may also aid in joint health, he explains.

Lowering Inflammation Inflammation throughout the body is believed to be a primary cause of the progression of type 2 diabetes and its related conditions such as atherosclerosis (arterial plaque buildup), cognitive decline, and joint deterioration, according to an article published in April 2019 in the European Cardiology Review. Yet routine exercise can help lower chronically high inflammation levels to mitigate its detrimental effects, Occhipinti explains.

Improving Cholesterol and Blood Pressure Apart from strengthening heart health through improvements in blood flow and reductions in inflammation, exercise also targets blood pressure and cholesterol levels, Occhipinti says. Both are leading contributors to progressive heart disease, according to the American Heart Association.

Restoring Nerve Function In one study, men and women significantly reduced diabetes-related pain and neuropathy in just 10 weeks of exercise. Researchers note that during the course of the study, nerve health and function also improved. This has broad implications for joint health, safety from injury and infection, and organ function.

Boosting Joint Health Diabetes-related joint pain and mobility limitations such as frozen shoulder are common complications of insulin resistance, says Ankush Gupta, MBBS, a diabetologist based in Pune, India. The cause isn’t always clear, but nerve damage, arterial disease, and excess body weight may play a role — and exercise combats all of them, explains Dr. Gupta. Perform both strength and mobility exercises through a full range of motion.

6 Tips to Get Started with Exercise

1. Get the go-ahead from your healthcare team. Talk to your primary care physician or endocrinologist before beginning a workout program, recommends Colin Laughlin, CSCS, founder of QualityLife Fitness virtual workout center. This will help you ensure that you’re choosing a form of exercise that is best suited for any coexisting health conditions that you may have, such as heart disease or diabetic neuropathy.

2. Make a plan to ensure your blood sugar stays in a healthy range. “Exercise must be carefully planned with the intake of food and insulin to prevent hyper- or hypoglycemia,” explains Kristen Gasnick, a board-certified doctor of physical therapy based in Livingston, New Jersey. Again, talking to your medical team can be important, as is testing your blood sugar before and after exercise. When first getting started with exercise, you may also need to test during your workout, she says. Continuous glucose monitors can be helpful for exercisers.

3. If you’re new to exercise, take baby steps. “If 150 minutes per week seems like a lot, start with a goal of 45 minutes of exercise for the week, then 60, then 75, and continue until you hit and maintain the goal of 150 minutes,” Occhipinti says. In addition to being one of the best ways to stay motivated to exercise when you have diabetes, this gradual approach to exercise will reduce the risk of exercise aches, pains, and injury.

4. Think outside of structured workouts when considering movement. Dedicated workouts are great, but including everyday activity and physical recreation is equally, if not more, important, Laughlin says. That’s because NEAT (nonexercise activity thermogenesis), which encompasses all of the energy, or calories, that you burn outside of your workouts, often accounts for more than what you might burn during structured exercise. Performing everyday physical activities like walking while doing your errands, taking out the trash, and cleaning the house also helps maintain functional strength and mobility.

5. Start with low-impact exercise, especially if you have nerve damage. Stationary cycling, weight-bearing strength training, swimming, and other low- to no-impact workouts are gentle ways to ease into exercise. They’re especially beneficial for people exercising with diabetic neuropathy. “Those with diabetic peripheral neuropathy, associated nerve damage, and loss of sensation in the feet are at an increased risk of skin breakdown and ulceration,” Dr. Gasnick says.

6. Focus on large muscle groups for maximum benefits. When it comes to resistance training, multijoint exercises such as squats, lunges, rows, and chest presses come with the greatest per-rep benefits for both blood sugar management and the progression of related complications, says Occhipinti.

For more information on starting an exercise routine, check out Diabetes Daily's article "Exercise: Getting Started with Type 2 Diabetes!"

Credit: By K. Aleisha FettersMedically Reviewed by Kacy Church, MD

Reviewed: September 15, 2020 Published in "Everyday Health"

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