By: Jessica Lime and the Ageility Team
Type 1 diabetes
This type of diabetes can develop in any age group. However, it is most common to appear in our adolescent years. Type 1 diabetes is when your body produces little to no insulin, caused from a cellular-mediated autoimmune dysfunction of the B-cells within the pancreas1. The CDC indicated that roughly 1.6 million Americans have Type 1 diabetes 2. The typical treatment is daily insulin injections to regulate glucose levels throughout the day.
Type 2 diabetes
This type of diabetes is more common for adults. Type 2 diabetes results when your body does not utilize the insulin it produces properly. The main way to treat this condition is to follow healthy lifestyle changes, by increasing daily activity and maintaining a well-balanced diet. However, this does not resolve all cases and some individuals may still require insulin injections or oral medications to regulate glucose.
Benefits of exercising with diabetes
Staying fit and active throughout your life has many benefits. The biggest benefit of exercise for individuals with diabetes is helping to regulate insulin and preventing long-term complications. Exercise helps increase insulin sensitivity, which means your body does not need as much insulin to process carbohydrates. All forms of exercise such as aerobic (cardio) training, strength/resistance training, high intensity interval training (HIIT), etc. are equally beneficial when it comes to lowering HbA1c levels1.
Types of exercise
In individuals with Type 1 diabetes, aerobic training increases cardiorespiratory fitness, improves lipid levels, improves endothelial levels, and decreases insulin resistance1. In individuals with Type 2 diabetes, regular aerobic training reduces A1c, blood pressure, insulin resistance and triglycerides1. Also, high intensity interval training (HIIT) can be performed by individuals with Type 1 diabetes without diminishing glycemic control; and it can also increase glycemic control and insulin sensitivity in Type 2 diabetes1. Balance exercises are especially beneficial for individuals that have limited range of motion in the joints which forms due to glycation end products that occur with aging and further increase due to hyperglycemia1. Group exercise classes such as strength training, balance training, resistance training, and yoga/tai chi training are beneficial for fall prevention, but also increase posture, stability, neuropathic system, glycemic control, mood and overall health for Type 2 diabetes.
Physical activity and Type 1 diabetes
Recommendation from the American Diabetes Association
- Monitor glucose regularly during physical activity to avoid hypoglycemic reaction.
- Carbohydrate or insulin reduction is typically required to maintain glycemic balance throughout or after exercise. Again, be sure to monitor regularly to find a pattern of when to adjust carbohydrates or insulin.
- Blood glucose responses to physical activity in all people with Type 1 diabetes are highly variable based on activity type/timing and require different adjustments.
Physical activity and type 2 diabetes
Recommendation from the American Diabetes Association
- Exercise daily to increase insulin production and balance.
- Perform both aerobic and resistance training to regulate glycemic index and overall health
- Individuals with diabetes or prediabetes are encouraged to increase their total daily incidental (non-exercise) physical activity to gain additional health benefits.
Physical recommendations for both Type 1 and Type 2 diabetes
Recommendation from the American Diabetes Association
- Most adults with diabetes should engage in 150 min or more of moderate-to-vigorous intensity activity weekly, spread over at least 3 days/week, with no more than 2 consecutive days without activity. Shorter durations (minimum 75 min/week) of vigorous-intensity or interval training may be sufficient for more physically fit individuals
- Adults with diabetes should engage in 2–3 sessions/week of resistance exercise on non-consecutive days.
- Flexibility training and balance training are recommended 2–3 times/week for older adults with diabetes. Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance.
Exercise is extremely beneficial for someone who is diagnosed with diabetes, and often it is a management strategy for Type 2 diabetes. Exercising for those with Type 1 diabetes helps them reach their lipid target and glycemic goals. However, Type 1 individuals need to be more diligent about checking their glucose levels regularly during exercise and adjust accordingly. Always consult with your physician before participating in any new activity and make sure your monitor is appropriate for the chosen exercise or activity.
References:
1) Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes care, 39(11), 2065–2079. https://doi.org/10.2337/dc16-1728
2) Kirwan, J. P., Sacks, J., & Nieuwoudt, S. (2017). The essential role of exercise in the management of type 2 diabetes. Cleveland Clinic journal of medicine, 84(7 Suppl 1), S15–S21. https://doi.org/10.3949/ccjm.84.s1.03
