For Type 2 Diabetics Who Exercise, Some Approaches Are Better Than Others
Rutgers researchers conclude that timing and type of training are critical for optimal effects
Highlights • Regular aerobic exercise helps control blood glucose. • Resistance exercise benefits insulin sensitivity in people with type 2 diabetes. • Movement throughout the day by dividing sitting time benefits blood glucose and insulin. • Physical activity after meals reduces blood glucose. • Exercising later in the day can benefit glycemic control and insulin sensitivity. |
Summary
Exercise is a recommended first-line therapy for patients with type 2 diabetes (T2D). Although moderate to vigorous exercise (e.g., 150 min/week) is often recommended in conjunction with diet and/or behavior modification, exercise is a stand-alone treatment that can prevent, delay, or reverse T2D. Regular exercise, whether aerobic, resistance or a combination, promotes better glycemic control in the short and long term. Recent work also shows that high-intensity interval training is successful in lowering blood glucose, as is breaking up sedentary behavior with short bouts of light to vigorous movement (e.g., up to 3 minutes). Interestingly, exercising in the afternoon compared to the morning, as well as after meals versus before meals, may produce a slightly better glycemic benefit. Despite these benefits of exercise for T2D care, optimal exercise recommendations remain unclear when considering diet, medication, and/or other behaviors.
Comments
An analysis of the positive effects of exercise on blood sugar levels in people with type 2 diabetes shows that, while all exercise helps, certain activities, and their timing, are extremely good for people’s health.
The study, published in The American Journal of Medicine , provides a comprehensive but straightforward summary of the benefits of exercise in controlling blood glucose levels in people with type 2 diabetes.
"The challenge with this is that most people, if not all, know that exercise is good for them, but they don’t know what the best approach is," said Steven Malin, associate professor in the Department of Kinesiology and Health at the Rutgers School of Arts and Sciences and author of the study. “We address this issue by focusing on a few key parameters: the usefulness of aerobics versus weight lifting, the time of day that is optimal to exercise, whether to exercise before or after meals, and whether we need to lose weight to gain benefits. or not."
As part of the analysis, the researchers reviewed dozens of studies and drew common conclusions. Some of the key findings include:
- Regular aerobic exercise : Physical activity, such as cycling, swimming, and walking, which increases heart rate and the body’s use of oxygen helps control blood glucose.
- Resistance exercise : Working muscles using an opposing force, such as dumbbells, resistance bands, or a person’s own body weight, benefits insulin sensitivity in people with type 2 diabetes.
- Movement throughout the day by breaking up sitting time benefits blood glucose control and insulin levels.
- Exercising later in the day can result in better control of blood sugar levels and improved insulin sensitivity.
“In short, any movement is good and more is generally better,” Malin said. “The combination of aerobic exercise and weight lifting is probably better than either alone. Evening exercise may work better than morning exercise for glucose control, and exercise after a meal may help a little more than before a meal. And you don’t have to lose weight to see the benefits of exercise. This is because exercise can reduce body fat and increase muscle mass.”
More than 37 million Americans have diabetes, and 90 to 95 percent have type 2 diabetes, according to the U.S. Centers for Disease Control and Prevention. People with type 2 diabetes are insulin resistant , which means that your cells do not respond normally to insulin, a hormone that controls the level of sugar or glucose in the blood. High blood sugar is harmful to the body and can cause serious health problems.
While insulin resistance is harmful, scientists believe that increased insulin sensitivity is beneficial. High insulin sensitivity allows the body’s cells to use blood glucose more effectively, lowering blood sugar.
Malin researches insulin sensitivity and teaches kinesiology, the study of human movement. He and several other Rutgers faculty members support the concept of "exercise as medicine." The idea, which is supported by the American College of Sports Medicine and increasingly confirmed by research, is that exercise can be considered a first-line therapy.
“I’m one of those people who subscribes to that notion, and in that way, I think of exercise as a drug,” Malin said.
Malin and his colleagues wrote the study to offer the medical community up-to-date practical advice for their patients.
“Together, this insight into the timing and type of exercise is important because it helps medical professionals more accurately recommend exercise prescriptions to combat high blood glucose,” Malin said.
Other Rutgers researchers in the study included: Afsheen Syeda, a graduate student in the Department of Nutritional Sciences in the Rutgers School of Environmental and Biological Sciences; Daniel Battillo, graduate student in the Department of Kinesiology and Health; and Aayush Visaria, internal medicine resident at Rutgers Robert Wood Johnson Medical School. He conducted the research as a postdoctoral fellow at the Rutgers Institute for Health, Healthcare Policy and Aging Research.
