Physical activity and type 2 diabetes: exercise for a better life

Including exercise in your daily routine can make a big difference if you live with type 2 diabetes. Treatment is normally focused on diet and medication, but physical activity can also be an essential ally that is often underestimated. Regular exercise not only improves insulin sensitivity and glucose control, it also contributes towards your physical and emotional wellbeing.

There are different types of exercise, and each one has a different function. Discovering them and learning how to safely integrate and balance them out can help you to maintain an active and healthy lifestyle with fewer complications.

1. Aerobic exercise: activating the heart and regulating glucose

Walking, swimming, dancing, cycling and running are aerobic activities that get the heart and lungs working. This type of exercise notably improves the body's capacity to use insulin and reduce glucose levels¹.

Regular aerobic exercise also helps with weight control, reduces blood pressure and strengthens the cardiovascular system. These are all especially important factors for people with type 2 diabetes, who are at a higher risk of heart disease².

The general recommendation is to do at least 150 minutes of moderate aerobic activity, such as brisk walking, every week, or 75 minutes if the activity is more intense³. Ideally, time should be distributed over several days to avoid long periods of inactivity.

Before exercising, check your glucose levels and follow the recommendations given by your diabetes care team regarding thresholds for hypo- or hyperglycaemia. Adjust food intake or postpone activity accordingly.

2. Strength training: building muscle, gaining control

Lifting weights, doing squats, using exercise bands or working with your own bodyweight are not just exercises for athletes—strength training is also a key factor in managing type 2 diabetes.

Building muscle encourages the storage of glucose in the muscles themselves, improves insulin sensitivity and accelerates the metabolism, which all help to maintain more stable glucose levels⁴. It also prevents the loss of muscle mass, which is common when you grow older or are inactive, and also strengthens bones and joints.

At least two sessions a week of strength training are recommended, including all the main muscle groups (arms, legs, back, abdomen). You don't have to spend hours in a gym: a well-structured session of 30 or 40 minutes is enough to start with.

Beside controlling glucose, in some people, regular strength training may reduce the need for medication or insulin.

3. Flexibility: stretching to prevent injuries

Although flexibility is often overlooked, it's an essential part of any exercise programme. Gentle exercises such as Pilates, stretching and yoga can help to keep your joints supple, reduce muscle stiffness and prevent injuries⁵.

Flexibility has no direct effect on glucose, but it does enable you to do other types of exercise more safely and comfortably. It can also alleviate pains and discomfort associated with common physical complaints that people with diabetes often suffer from, such as peripheral neuropathy and joint pain.
Brief sessions of stretching several times a week are recommended, preferably after walking or doing strength training. The important thing is not to strain yourself, but rather move gently and mindfully.

4. Balance exercises: preventing falls, gaining confidence

People living with type 2 diabetes, especially older people and those with neuropathy, may find that their sense of balance is affected. Activities such as tai chi, walking in a straight line and standing on one leg can help to improve coordination and posture, as well as reduce the risk of falls⁴.

Beside the physical benefits, balance training increases safety and autonomy in your day to day activities.

Going up the stairs, walking in the street and getting up from a chair are simpler tasks when you have good balance.

Just like stretching, balance training can be done in just a few minutes at home. With just two balance training sessions a week you'll soon start to notice a difference.

A combination that works

Combining aerobic activity with strength, flexibility and balance training offers many benefits for people with type 2 diabetes. Not only can it help to reduce glucose levels, you'll also see improvements in your quality of life, with fewer complications and a stronger body and mind.

The weekly routine below is a good example:

• Walking 30 minutes a day, five times a week.
• Two strength training sessions.
• Gentle stretching exercises after each walk.
• A tai chi or balance training session twice a week.

 
While most types of exercise help lower glucose levels, high-intensity or anaerobic activities may temporarily raise glucose due to hormonal responses. This is normal and should be taken into account when interpreting glucose readings post-exercise.

Listen to your body and be careful

It's important to monitor your glucose levels before, during and after exercise. To do this, you can use continuous or flash glucose monitors, as they can support this process and help avoid hypoglycaemia. Keep a record and have a fast-acting source of carbohydrates nearby (fruit juice or glucose tablets)⁵.

Well-planned exercise can be a powerful ally. Not only can it help to control diabetes, it improves your mood, increases energy and boosts your self-esteem. Exercise is one way of caring for your body and also a way to enjoy life with more freedom and health.