Manage your blood sugar with exercise

NEW YORK – These days, more and more people have to worry about their blood sugar.

Some 38 million Americans have diabetes, and more than two times that number have pre-diabetes. Many millions more have some form of insulin resistance, which can make you tired, irritable and even dizzy. And all of these conditions become more common as people age.

The good news is that exercise can help. It is at least as important as the diet in preventing and treating insulin resistance and diabetes. It can also help you lose weight, which is often the most important step in levelling out blood sugar.

Exercise helps the body process glucose in several unique ways, said Dr Donald Hensrud, a specialist in preventive medicine and nutrition and medical editor of The Mayo Clinic Diet. Although any exercise is good, the type of movement you choose and when you do it can play a big role in how much it helps.

Here are some things you should think about when planning workouts, say experts.

Exercise is essential for managing blood sugar

The causes of diabetes are complex. Family history, genetics, weight and diet certainly play a role. But it is clear that exercise can dramatically lower blood glucose, regardless of your diagnosis, and improve how well the body uses insulin.

In fact, research has shown that exercise is generally more effective at preventing diabetes than medication, though it is important to use all types of treatment.

During exercise, muscle cells can more easily use the glucose in blood. This lowers blood sugar directly and can also reduce the fat around the organs, an important risk factor for diabetes and insulin resistance, said Dr Gerald I. Shulman, a professor of medicine and physiology at the Yale School of Medicine.

In particular, studies show that regular high-intensity interval training or moderate continuous exercise can make a difference, reversing pre-diabetes in almost 40 per cent of participants – although it could take months or even years for many people to see long-lasting changes.

Prioritise strength training and intensity

Any movement is better than none, and simply going for a walk can have benefits. But research shows that the two most effective ways to lower blood sugar through exercise are high-intensity workouts and strength training.

A recent study found that strength training was significantly more effective for controlling blood sugar levels than aerobic exercise for people with Type 2 diabetes, and this likely holds true for other people worried about their blood sugar, Dr Shulman said.

Also, both aerobic exercise and strength training create more mitochondria, which can help fight Type 2 diabetes, but weight lifting appears to be slightly more effective than aerobic exercise, assuming you are pushing yourself, Dr Shulman added.

Strength training is especially important for older people, since insulin resistance and Type 2 diabetes accelerate the normal loss of muscle and strength that comes with age, particularly for women.

While walking is good exercise for the heart, it generally will not build much muscle, said Michael Joseph Gross, author of Stronger: The Untold Story Of Muscles In Our Lives.

The way you strength train is also important, he added. To be most effective, the weights should feel heavy. A systematic review of research found that lifting challenging weights helped to lower blood sugar more effectively than low-intensity strength training.

Consider alternating strength training with high-intensity interval training, which has been shown to be especially effective in managing blood sugar for people with pre-diabetes and Type 2 diabetes. If you have diabetes, consult a doctor before radically changing your fitness regimen.

When is the best time to work out?

If you do not have insulin resistance, the time of day you work out does not matter much.

But for people with pre-diabetes and Type 2 diabetes, studies suggest that afternoon exercise tends to help reduce blood sugar levels. That is because blood sugar rises and falls in regular patterns over the course of the day, and as the day goes on, the body becomes less insulin sensitive. Thus, afternoon exercise is typically less likely to cause dangerous glucose spikes.

Experts recommend working out at least three days a week, with no more than two days in a row without activity. For people with insulin resistance, including diabetes, the best time to exercise is about 30 minutes after starting a meal to prevent blood sugar spikes.

If morning workouts fit better with your schedule, try not to eat too many carbohydrates beforehand. Start the day with a small meal of protein and healthy carbohydrates like fruit, vegetables and whole grains.

Pre-diabetes and new-onset diabetes are much more responsive to lifestyle changes like diet and exercise than longer-term cases, Dr Hensrud said, so it is important to address insulin resistance as soon as possible.

“I tell people with new diabetes that they’re in control,” he added, “and the most important thing to do is decrease weight through dietary changes and exercise.” NYTIMES