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Paul Rogers

The Best Exercises for Diabetes

By September 29, 2007

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Exercise is important for people with diabetes -- especially type 2 diabetes -- because it helps regulate blood sugar and provide cardiovascular fitness that protects against heart and artery disease.

But which type of exercise is best? Cardio, weights, walking -- or perhaps a combination of aerobic and resistance training?

That's apparently what a team of scientists at the University of Calgary attempted to find out by evaluating 251 adults, aged 39 to 70, all with type 2 diabetes and whom were not regular exercisers. The scientists formed four groups and gave them different programs:

  1. One group did aerobic (cardio) exercise for 45 minutes, three times each week.
  2. Another group did resistance (weights) training for 45 minutes, three times each week.
  3. A third group did both cardio and weights for 45 minutes each and three times each week.
  4. A fourth group did no exercise at all.

The study team measured a key indicator of blood glucose levels in type 2 diabetics, known as A1c, before and after the various exercise programs. A1c is an indicator of blood glucose over the previous 2 to 3 months.

Would it surprise you to hear that A1c dropped by twice as much in the group that did the combined cardio and the weights? Well, that's exactly what occurred. . .but they did twice as much exercise didn't they? The results for the cardio or weights groups alone were similar to each other and the A1c lowering effect was doubled in the combined group.

While this story created headlines all around the world, did it really answer the question "which exercise is best?" No it did not, but what it did suggest is that either aerobic or resistance training is equally good at lowering A1c.

And, that doing both provides an additive effect, which may not have been as obvious an outcome as it first seems.

Source: Sigal RJ, Kenny GP, Boule NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007 Sep 18;147(6):357-69.

Comments
October 5, 2007 at 12:18 pm
(1) John Upton says:

I have been a type 1 diabetic since 1952 and have always engaged in frequent extensive exercise. Since 1981 I have been actively engaged in both resistance and aerobic exercise programs, usually exercising 1-1.5 hours per day.
I will fully attest to the beneficial effects or frequent, prolonged cardio and resistance training. My 1AC is usually in the normal range and I feel great. Even at 62 years of age, I’m in good condition and do not suffer any complications of the disease.

I fully recommend an active and full exercise regimine for all diabetics.

October 9, 2007 at 12:22 am
(2) weighttraining says:

John, thanks for the comment. It definitely helps a great deal, particularly if one is as dedicated as you seem to be.

October 11, 2007 at 2:49 am
(3) Hank Silver says:

I’ve had type 2 diabetes since 1998. Ever since the diagnosis, I swim or walk vigorously 5 days a week for an hour each, and also lift weights each of those days for a half-hour. My A1c has consistently been below 7.0, often below 6.5 all of those years. At the age of 70, I feel great. My doctor is very pleased with my self-treatment.

August 23, 2008 at 8:59 pm
(4) sandra says:

I hate to exercise, but i know i must do something how do you get the through a day with exercise?

March 14, 2009 at 9:51 am
(5) crizzabelle says:

i m crizzabelle sense I’m 12 years old i am diabetic and I’m so tired to do house holds and i want to sleep always so what can i do to my self

March 15, 2009 at 5:47 pm
(6) weighttraining says:

crizzabelle, I hope you are able to see a doctor and afford any medication that’s necessary so that you can manage day to day living. When you’re feeling better, you could start by walking regularly as long as you have good advice about your blood glucose and insulin levels.

June 4, 2010 at 2:08 am
(7) Raj says:

Did the third group do a total of 90 minutes of exercise per session?

June 4, 2010 at 5:14 pm
(8) weighttraining says:

Raj, the researchers say that 3 exercise sessions per week were allocated. That would imply that the third group did the combined weights and cardio in one session of 90 minutes.

This is confirmed by the comments to the article in the journal.

July 2, 2010 at 12:39 pm
(9) Nigel says:

Is this serious resaerch? As a type 2 diabetic, and any one can tell you, the more exercise you do, the more your blood sugars drop. So why the surprise when people who exercise twice as long, whatever type, find their sugars have dropped By more than those exercising half as much? The usual patronizing crap. Don’t tell me – you’ve got a cure for diabetes too!!! Rubbish.

July 6, 2010 at 12:52 am
(10) weighttraining says:

Gee Nigel, why don’t you get on a high horse!

I made it quite clear that I thought the results of the additional exercise were not surprising.

And by the way, not all t2s get a blood glucose drop after exercise. Some see a temporary increase, although lower blood glucose is the most common.

July 19, 2010 at 2:45 pm
(11) Toolman says:

Good research. I think it is important to put this information out because many diabetics I’ve worked with seem a little bit afraid of exercise. They are at higher risk and they know it, but I believe when they see scientific research it helps them. I’m not diabetic, but a personal trainer/health professional, and most diabetics are way more intelligent about diabetes than I am. I try to reach out, but again, research is more effective in convincing than just listing potential benefits. Good post.

December 19, 2010 at 5:43 pm
(12) Maureen Mc says:

I am only insulin resistant, but I found the information in the article really hepful and encouraging. Also the comment that some people find that their blood sugar increases after exercise. I am one of them. Do you know why that is?

December 19, 2010 at 7:53 pm
(13) weighttraining says:

Maureen, the general opinion is that blood glucose can rise after exercise (even in non-diabetics) when the body responds to the intensity of exercise by releasing hormones such as epinephrine (adrenaline), cortisol and possibly growth hormone. All of these will dump glucose into the blood as a ‘stress’ reaction. High-intensity exercise seems to produce a worse result. Not everyone is affected in the same way apparently.
For diabetics on insulin, it may require an adjustment of insulin dose. Whether it can be dangerous or not, probably depends on what your BG is before you start. Best to see a doc or diabetes specialist if you’re unsure, even if you’re not on meds.

February 10, 2011 at 7:16 pm
(14) Saqlain Abbas says:

I am a health professional and using strength and aerobic training for my patients. Strength training is a best tool to manage the DM. It is good for both Your DM and also for your daily life like sports and fitness. if you have any doubt about the exercise or DM. straight go to see your doctor or health professional to get the certified answer.

May 17, 2011 at 10:33 am
(15) Mherrera says:

I was just diagnosed with type 2 diabetes on friday. I find walking helps. But I am still trying to get my glucose controlked. Since I found out I have been getting anxiety. What to do?

September 9, 2012 at 8:11 am
(16) Rafique says:

Please any one can help me to know that what kind of food can have for diabetic patients? and what are the food restriction?

October 22, 2012 at 4:30 am
(17) BigTexun says:

I’ve got type2, and my doctor worked very hard to find a way to control my blood sugar without insulin. It was working at first, but without modifying my lifestyle, the effect of the drugs didn’t last, my control was slipping.

He had asked me to adjust my diet, and exercise for half an hour daily.

I started dieting, and it helped some. At the time I was doing a lot of physical work, but not regular exercise. I started loosing weight, and the blood sugar levels dropped slightly, but it wasn’t enough. So I decided I needed to accept the fact I would need to go on insulin soon.

I decided to do an experiment. I started exercising on a stationary cycle, and a treadmill. A couple times a week at first, working up to daily. My weight loss slowed as I was starting to build muscle, but the important thing was the impact on the blood sugar was dramatic and persistent. My fasting blood sugar started approaching normal within three days of daily exercise. It was lower than it had been since I was diagnosed. It was not a remission, but it was real control. And the control was maintained, better than ever, and far better than the goals set by the doctor.

One week, during a stressful period, I skipped the daily exercise for three days, and the fasting blood sugar level responded as expected, it started climbing.

The point is this, small amounts of daily exercise will make the drugs more effective. I’m talking half an hour per day /every/ day. I’m sure more is better, as long as you avoid the stress response.

Compared to diet modification, half an hour of daily exercise was MUCH more effective and much easier.

January 2, 2013 at 6:56 pm
(18) Lyndal says:

Well I have found this forum very interesting, it is good to see that everyone can have an opinion. I’ve just been diagnosed with Type 2 yesterday and am trying to work out the best path to take for me. It makes sense that both cardio and weight training exercise would work best and no I don’t think it would be a cure but will give my body the best chance to beat and control this disease. Now there is no more room for excuses, now I have to lose weight and follow an exercise regime. Thanks for putting this information out there so that everyone is privy to it.

Cheers
Lyndal from Oz

December 5, 2013 at 9:51 am
(19) raj says:

i am type2 diabetic my 1AC is 6.5 my weight is 82kg and height is 6′.2″ , i work out 6days a week both cardio and weight training , would like to put on a little more muscle mass. could you please answer these 3 questions
1. what is the maximum amount of protein i can take
2. is fish a better source of protein than chicken in terms of controlling creatine levels
3 will vegetable source of protein help in increasing muscle mass

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