Exercise For Diabetes

The best time for people who have Type 2 diabetes to get physical activity is right after eating. But current physical activity guidelines don’t yet reflect this new knowledge.

When people with Type 2 diabetes walk after eating, blood glucose levels averaged a drop of 12 percent more than at any other time of the day. This is the conclusion of a randomized crossover study that the journal Diabetologia first published online in October 2016. The study’s lead author, Andrew Reynolds, Ph.D., of the Department of Human Nutrition, University of Otago, New Zealand, sent me the full text.

The researchers prescribed walking to 41 people with Type 2 diabetes in two-week blocks, separated by a month. The people in the study were instructed to walk either for 30 minutes a day or to walk for 10 minutes after each main meal, starting within five minutes after they finished eating. When they took their 10-minute walks, their post-meal blood glucose levels averaged 12 percent lower than when they took a 30-minute walk at sometime during the day.

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If you have prediabetes, the standard advice to avoid getting diabetes is to do three things at once: cut calories, eat a low-fat diet, and get exercise. But a recent study shows that it makes more sense to focus on just the last one of these.

Ever since 2002, when researchers published the results of the Diabetes Prevention Program, we have known that intensive lifestyle changes are the best way to avoid diabetes. That program aimed at reducing your weight by 7 percent, eating a low-fat diet, and increasing your physical activity to at least 150 minutes per week of moderate exercise, such as walking or biking.

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Hard exercise, like high-intensity interval training, undoubtedly can provide metabolic, heart disease, and fitness benefits. But a leading expert on diabetes fitness says that it’s too hard for almost all people with diabetes.

The best exercise is the hardest exercise than you will do. High-intensity interval training may be the current fitness craze, says Sheri Colberg-Ochs. “Its health efficacy is not in question,” she says. But “despite its current popularity, there is no evidence supporting HIIT as a viable public health strategy.”

Sheri Colberg-Ochs, Left, Receives Outstanding Educator Award

Credit: American Diabetes Association

Dr. Colberg-Ochs addressed the recent annual convention of the American Diabetes Association in New Orleans on “The Feasibility of Doing High-intensity Interval Training (HIIT) in Persons with Diabetes” in a presentation that I had the opportunity to hear. Dr. Colberg-Ochs was diagnosed with Type 1 Diabetes almost 50 years ago, when she was 4. Recently retired from Old Dominion University in Norfolk, Virginia, where she was a professor of exercise science, Dr. Colberg-Ochs is best known for her book Diabetic Athlete’s Handbook. During the convention, Margaret Powers, the American Diabetes Association’s president health care, presented her with the 2016 Outstanding Educator in Diabetes award.

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Credit: Harbor Athletic Club

When you do the ancient Chinese exercise of tai chi, you can minimize your risk of heart problems, the most common and serious complication of diabetes, according to a meta-analysis of 35 randomized clinical trials. Just published in the March 9, 2016, issue of the Journal of the American Heart Association, the study shows that tai chi and other traditional Chinese exercises like qigong can lower the blood pressure, improve the cholesterol and triglyceride levels, boost the quality of life, and reduce the depression of people living with heart disease and stroke.

The improvements in blood pressure and lipid levels were statistically significant. People in the studies reported more satisfaction with their quality of life and lower levels of depression.

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Credit: pedometersaustralia-blog.com

It’s a myth that we should walk 10,000 steps every day. Yet walking is the easiest and best physical activity for almost all of us who have diabetes. More is almost certainly better.

Do you know why and when the 10,000 figure originated? Way back in the 1960s a Japanese company was trying to sell pedometers. Some really smart people came up with that number for its extremely successful marketing campaign.

This advertisement didn’t have its roots in research, and my search of the U.S. National Library of Medicine didn’t turn up any scientific basis for it. While some studies have used the 10,000 step figure as a benchmark in the past few years, they are taking it for granted rather than as a fact.

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