What Is The Best Time To Exercise With Diabetes?
by Dr. Sheri Colberg, Ph.D., FACSMThe biggest problem most insulin users face is the risk of their blood glucose going too low for up to two days after they exercise. Given that there are no clear recommendations about the best time to exercise with diabetes, a recent study published in the Journal of Diabetes Science and Technology early in 2015 tackled this issue head-on1. That study compared blood glucose levels and the number of lows during and following moderate exercise for 36 hours. A total of 35 adults with type 1 diabetes using insulin pumps undertook 60 minutes of moderate exercise on a treadmill at 7 AM (pre-breakfast) and 4 PM (pre-dinner) on different days. During exercise their insulin pumps were turned off completely and then restarted 45 minutes after they stopped working out. How frequently they developed hypoglycemia (defined as glucose values < 70 mg/dl, or3.9 mmol/l) for up to 36 hours post-workout was monitored using both continuous glucose monitor (CGM) and fingerstick tests. Overall, hypos occurred significantly less often following 7 AM exercise compared to 4 PM (5.6 vs. 10.7 hypos per person). This is not a new finding, however, as other studies done previously in both type 1 and type 2 exercisers have found that you’re more likely to get low from exercise done later in the day. Most of the lows occurred 15 to 24 hours after exercise, regardless of the exercise timing, and over half of the adults in the study had at least one low in 36 hours. On days following morning exercise, there were 20% more CGM readings between 70 and 200 mg/dL (3.9 and 11.1 mmol/l) than on the day before they exercised in the morning, meaning that doing pre-breakfast exercise kept their blood glucose levels in a more normal range and improved their overall control, all Continue reading >>
Exercise Causes Blood Sugar To Go Down—most Of The Time
You can think of exercise as a great blood-sugar-lowering drug.(HEALTH/ISTOCKPHOTO) Exercise causes blood sugar to go downexcept when it doesn't. In some cases, blood sugar can temporarily increase with exercise. Maddening? Yes. Like so many aspects of type 2 diabetes, your body's response to exercise can be highly individual. The time of day you exercise may affect blood sugar Blake Holden, of Brooklyn, N.Y., finds his blood sugar can vary depending on the time of day he is exercising. "When I exercise in the morning, go for a run, my blood sugar spikes big time. I'm not sure why that happens. But in the evening, it doesn't; it drops." That's why it's crucial to monitor your glucose levels before and after your workout (after getting clearance from your doctor). Ideally, you should check your blood sugar each time you exercise, says Ann Albright, PhD, director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention in Atlanta. But, if that proves to be a huge barrier that keeps you from exercising, then it's probably OK to do it a few times when you first start or restart your exercise routine until you get a feel for how your blood sugar reacts to exercise, Albright says. Consistency is crucial Choose a regular exercise routine and stick to it as often as possible. This can result in consistently lower blood sugar (exercise can cause a drop in blood sugar for up to 12 to 24 hours). "It is really important to have a consistent exercise plan that you can do five days a week," says Virginia Valentine, a certified diabetes educator at the Diabetes Network, Inc., in Albuquerque, N.M. "If a person is a couch potato all week and tries to jump into a significant activity for a few hours on the weekend, it could cause blood glucose that is too Continue reading >>
The Step-by-step Approach To Better Blood Sugars: Walking
If you’re like me, you might have a health-focused New Year’s resolution posted on your wall: "lose weight," "exercise more, "be less stressed." Unfortunately, making resolutions is easy, but sticking to them is hard. A 15,000-person survey found that four out of five people who make New Year’s resolutions eventually break them. And it gets worse: a sizeable percentage of people (11%) in one survey actually broke their resolution one week in! As I pondered this depressing data, I thought about scientifically testing the simplest, most fundamental exercise possible: walking. It can be done anywhere, does not cost anything, and requires no equipment. And because the barriers to doing it are so low, it also helps address that very basic New Year’s Resolution conundrum outlined above. What follows is my personal diabetes experience testing the blood sugar benefits of walking, a brief review of studies on diabetes and walking, and five tips to incorporate walking into your daily routine. If you find this article useful, check out my upcoming book, Bright Spots & Landmines! Walking with diabetes – my own experience As a fitness fiend my whole life, I tend to think of “exercise” with a very intense, all-or-nothing frame of reference: cycling, strength training, and playing basketball. So when I approached the question of how much walking could really drop my blood sugars, I was skeptical. In an effort to test it objectively, I performed a dozen periods of walking, and measured my blood glucose immediately before and immediately after finishing. I timed each walk with a stopwatch, always made sure I had less than one unit of insulin-on-board, and tried to go at a normal speed. On average, walking dropped my blood sugar by approximately one mg/dl per minute. The la Continue reading >>
How Exercise Lowers Blood Sugar In Type 2 Diabetes
If you stick with it, exercise can reduce your need for blood-sugar-lowering drugs.(ISTOCKPHOTO) You may consider exercise a nuisance, a chore, or simply a bore. But if you've been diagnosed with type 2 diabetes, you need to look at physical activity in a whole new light. Now it's a tool. Just like taking a drug or altering your diet, exercise can lower blood sugar on its own, even if you don't lose weight. "Exercising is the most underused treatment and it's so, so powerful," said Sharon Movsas, RD, a diabetes nutrition specialist at the Clinical Diabetes Center at Montefiore Medical Center in New York City. For most people with diabetes, exercise is a safe and highly recommended way to reduce the risk of complications. However, check with your doctor to make sure you don't have heart problems, nerve damage, or other issues that need special consideration when you are working out. How exercise affects blood sugar In general, blood sugar drops after exercise and is lower for the next 24 to 48 hours, says Movsas. "If I take a blood sugar reading after aqua-aerobics, I usually notice it's down," says David Mair, 79, of Marquette, Mich. When you exercise, your muscles become more sensitive to insulin and absorb more glucose from the blood. However, like many aspects of type 2 diabetes, the response can be highly personal. Exercise can sometimes boost blood sugar. At first, you'll need to test your blood sugar before, after, and sometimes during exercise, to see how your body responds). Exercise also helps lower blood pressurean important benefit since high blood pressure can contribute to heart attacks, strokes, eye problems, kidney failure, and other type 2 diabetes complications. Next Page: Start slow [ pagebreak ]Start slow and work up Even if you know exercise is good Continue reading >>
The Best Kind Of Exercise To Control Your Blood Sugar
You don’t need to be working out for longer, but you should probably be working harder—in spurts, at least. Studies have shown that interval training can help people burn more fat, and increase fitness levels even after just 15 or 20 minutes of exercise. And a new study found that people with type 2 diabetes benefited more from interval walking—their blood sugar was more controlled—compared to people who walked continuously. “The return on investment of interval training is fabulous, and it keeps exercise interesting,” says Richard Cotton, the National Director of Certification at the American College of Sports Medicine, who was not involved in the new research. “Walkers can incorporate interval training by warming up and walking for three minutes and jogging for one minute and repeating that pattern for let’s say, 30 minutes.” Interval training means alternating between different intensities of exercise and allowing time to rest in between bursts of action. This can mean simply speeding up your walk to a jog for a few minutes or, in the more extreme, it can mean high-intensity interval training (HIIT) and Tabata. But they’re all based in the same idea: short explosions of exercise that get your heart rate up followed by periods of rest or lower intensity provide a greater benefit. Martin Gibala, the chairman of the department of kinesiology at McMaster University in Hamilton, Ontario has been studying interval training for years, though his focus has been primarily on very intensive exercise like HIIT. Some of his recent research has looked at whether quick HIIT sessions can stimulate similar fitness levels as moderate-intensity continuous training. “There’s a very large growing body showing interval training can be safely applied to many differ Continue reading >>
The Best Time To Exercise With Diabetes
When it comes to exercise and managing diabetes, good timing can make a big difference. Regular workouts are a key tool to help you control your blood sugar level. And choosing the right time to exercise can help even more. Timing exercise for better blood sugar is a topic you'll want to discuss with your doctor or certified diabetes educator (CDE). It's especially important if you take insulin to manage your diabetes. The National Institutes of Health (NIH) offers these recommendations for timing workouts for better blood sugar levels: Check your blood sugar level. The NIH recommends that people with diabetes check their blood sugar before working out, immediately after, and again sometime later (exercise can impact your blood glucose level for up to 12 hours). Working out longer than 45 minutes? Check your blood sugar during exercise, as well. If you're on medication to control your blood sugar, and workouts routinely cause low blood sugar (hypoglycemia), your doctor may need to adjust your dosage. Take extra care if you use insulin. Ask your doctor or CDE for advice on what you should eat before, during, and after workouts, as well as if you need to adjust your insulin dose to compensate for physical activity. Keep a carb-rich snack on hand. In the event you do experience hypoglycemia, a small snack, such as a half-dozen hard candies, fruit juice, or regular soda, can help raise your blood sugar level in a hurry. Ask your doctor or CDE which snacks are best. Maintain a consistent workout schedule. Exercising at the same time each day, and at the same intensity, makes it easier to keep your blood sugar level on an even keel. If you have type 1 diabetes, your doctor may tell you to avoid strenuous workouts when you have ketones (chemicals your body produces when blood Continue reading >>
Diabetes And Exercise: When To Monitor Your Blood Sugar
Exercise is an important part of any diabetes treatment plan. To avoid potential problems, check your blood sugar before, during and after exercise. Diabetes and exercise go hand in hand, at least when it comes to managing your diabetes. Exercise can help you improve your blood sugar control, boost your overall fitness, and reduce your risk of heart disease and stroke. But diabetes and exercise pose unique challenges, too. To exercise safely, it's crucial to track your blood sugar before, during and after physical activity. You'll learn how your body responds to exercise, which can help you prevent potentially dangerous blood sugar fluctuations. Before exercise: Check your blood sugar before your workout Before jumping into a fitness program, get your doctor's OK to exercise — especially if you've been inactive. Talk to your doctor about any activities you're contemplating, the best time to exercise and the potential impact of medications on your blood sugar as you become more active. For the best health benefits, experts recommend at least 150 minutes a week of moderately intense physical activities such as: Fast walking Lap swimming Bicycling If you're taking insulin or medications that can cause low blood sugar (hypoglycemia), test your blood sugar 30 minutes before exercising. Consider these general guidelines relative to your blood sugar level — measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Lower than 100 mg/dL (5.6 mmol/L). Your blood sugar may be too low to exercise safely. Eat a small snack containing 15 to 30 grams of carbohydrates, such as fruit juice, fruit, crackers or even glucose tablets before you begin your workout. 100 to 250 mg/dL (5.6 to 13.9 mmol/L). You're good to go. For most people, this is a safe pre-exercise Continue reading >>
Exercising With Diabetes: Is It Better To Eat Before Or After Your Workout?
Whether it’s best to eat before or after a workout has been debated for decades, and the decision becomes even more complicated if you have diabetes. “For someone with diabetes, they not only have to think about fuel for exercise, but they also have to think about glycemic control,” says Monet S. Bland, a clinical exercise physiologist and diabetes educator with Joslin Diabetes Center in Boston. Exercise impacts your blood sugar, so you need to make sure your levels aren’t too high when you start exercising, but also not so low that they’ll plummet during your workout. So while a study published in November 2010 in the Journal of Physiology found that not eating before exercise helped people burn fat, people with diabetes need to maintain blood sugar levels, and should plan to eat before, after, and sometimes even during exercise, Bland says. That’s the general recommendation, but it’s not a one-size-fits-all approach. You need to keep an eye on how your body responds, since “some people are more sensitive to the effects of exercise versus others,” Bland says. Not sure where to start? Bland recommends working with an endocrinologist or an exercise physiologist to establish blood glucose targets and an exercise plan that’s safe for you. No matter what, you’ll want to check your blood sugar before working out so you know how to fuel up. Your goal is a level greater than 100 milligrams per deciliter (mg/dL) — but always skip the workout if your blood sugar is at or higher than 250 mg/dL and ketosis is present, or greater than 300 mg/dL without ketosis. Be sure to talk to your doctor about your blood glucose targets before and after exercise. The Best Pre-Workout Snacks Your best bet is eating a balanced meal an hour to an hour and a half before your Continue reading >>
When Is The Best Time To Exercise And Why?
When is the best time to exercise and why? When is the best time to exercise and why? We were having this discussion in chat yesterday and I'm curious. Especially for Type 1's (not to leave out Type 2's, but it's to help me figure out my issues! ) Do you find it better to work out first thing in the morning or later in the day? I have found working out in the morning, my sugar raises for a bit, and then 6 to 8 hours later I start going low low low. Please tell me the time of day you exercise and why you do or do not like it! Also, for pumpers, do you set temp basals? If so, when and for how long? Thanks everyone for your input. I always exercised in the morning I cannot help with the pump issue's yet I havn't attempted it. But since my bg's are the most stubborn in the morning I used to workout an hour after breakfast, and have a big lunch eating and giving myself less insulin for the lunch so i wouldn't plummit after cause that sounds like me I got low low low later on so let me think I used to eat and back in those day I ate about 60 carbs and I used to give myself 5 units for that, and I would give myself four instead......that is what I did, somedays I would go up a little bit after exercise other times, I dropped when I worked out, it depended on the day.... Now I have heard from advice from some pumpers about exercise they do a temp basal rate an hour before they workout an leave it that way for three hours after the fact......they say it works for them.... D.D. Family T1 since Nov '91, Pumping with Apidra since Aug 08 I exercise when I can fit it in! One day a week I swim in the morning because if I swim any other time of day it gives me indigestion. I tend to be more insulin resistant in the morning so this means I can reduce my breakfast fast acting insulin bu Continue reading >>
Timing Exercise For Maximum Blood Glucose Control
A study recently published in the Journal of the American Medical Directors Association indicates that engaging in moderate physical activity after an evening meal is more effective at controlling postprandial (after-meal) blood glucose levels in people with Type 2 diabetes than engaging in the same activity before the meal. The researchers, out of Old Dominion University, looked at six men and six women with Type 2 diabetes and an average age of roughly 60. Each was being treated with either diet alone or with a combination of diet and oral medicines. The study involved serving the participants a standardized dinner on each of three days. On separate days over the course of the trial period, the after-meal blood glucose effects of no exercise, 20 minutes of self-paced walking on a treadmill immediately before the meal, and 20 minutes of the same activity 15–20 minutes after the meal were evaluated in each person. Blood glucose patterns were determined by blood samples drawn at 30-minute intervals for a 4-hour period before and after the dinner and physical activity. The data showed that walking after the meals stabilized blood glucose levels and resulted in less of a postmeal blood glucose rise than walking prior to dinner. The investigators note that engaging in physical activity at any time of day is likely to improve overall blood glucose control. As this research demonstrates, however, the short-term effect of exercise on blood glucose levels may depend on the timing of the exercise. Based on the findings, the study’s authors advise older people with diabetes “to undertake aerobic exercise after meals, including the evening one, to… reduce the likelihood of negative health consequences associated with postprandial glucose excursions.” For more information Continue reading >>
- Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study
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Type 2 Diabetes And Exercise
When you have type 2 diabetes, physical activity is an important component of your treatment plan. It’s also important to have a healthy meal plan and maintain your blood glucose level through medications or insulin, if necessary. If you stay fit and active throughout your life, you’ll be able to better control your diabetes and keep your blood glucose level in the correct range. Controlling your blood glucose level is essential to preventing long-term complications, such as nerve pain and kidney disease. Exercise has so many benefits, but the biggest one is that it makes it easier to control your blood glucose (blood sugar) level. People with type 2 diabetes have too much glucose in their blood, either because their body doesn’t produce enough insulin to process it, or because their body doesn’t use insulin properly (insulin resistant). In either case, exercise can reduce the glucose in your blood. Muscles can use glucose without insulin when you’re exercising. In other words, it doesn’t matter if you’re insulin resistant or if you don’t have enough insulin: when you exercise, your muscles get the glucose they need, and in turn, your blood glucose level goes down. If you’re insulin resistant, exercise actually makes your insulin more effective. That is—your insulin resistance goes down when you exercise, and your cells can use the glucose more effectively. Exercise can also help people with type 2 diabetes avoid long-term complications, especially heart problems. People with diabetes are susceptible to developing blocked arteries (arteriosclerosis), which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesterol—and that helps you avoid arteriosclerosis. Additionally, there ar Continue reading >>
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6 Great Exercises For People With Diabetes
iStock.com; Raymond Forbes/Stocksy; iStock.com Making Exercise a Routine Do you get enough exercise? If you're like many Americans, the answer is no — and that's especially true for those of us with diabetes. Studies show as few as 39 percent of people with type 2 diabetes participate in regular physical activity, compared with 58 percent of other Americans. And that's a shame, because working out can help increase insulin action and keep blood sugars in check, says Sheri Colberg-Ochs, PhD, founder of the Diabetes Motion Academy in Santa Barbara, Califorinia, and professor emerita of exercise science at Old Dominion University in Norfolk, Virginia. Exercise also helps you lose weight and improve balance, which is important because many people with type 2 diabetes are at risk for obesity and for falls. “I fully recommend that anyone over 40 with diabetes include balance training as part of their weekly routine, at least two to three days per week,” says Dr. Colberg-Ochs. “It can be as simple as practicing balancing on one leg at a time, or more complex — like tai chi exercises. Lower body and core resistance exercises also double as balance training.” Here are six great workouts you can easily work into your daily routine. Be sure to check with your doctor before beginning any exercise regimen, and go slowly at first. Over time, you can increase the length and intensity of your routine. Continue reading >>
7 Things You Need To Know About Exercising With Diabetes
If there’s one thing people with diabetes know, it’s that regular exercise requires more than just discipline and hard work. Mismanaging your blood sugar, diet and exercise intensity levels can have adverse and unpredictable effects on your body. This month, we spoke with Dr. Jonathon R. Fowles, an exercise physiologist at the Centre of Lifestyle Studies at Acadia University, to help answer some common questions about exercising with diabetes: 1) How often should I exercise? “Regardless of whether you have type 1 or type 2 diabetes, the CDA recommends 150 minutes a week of moderate to vigorous exercise,” Fowles says. “You should be combining both aerobic (running, swimming etc.) and anaerobic (resistance training, weight lifting) activity.” 2) What are the benefits? “People with type 2 diabetes can expect to lower their AIC levels after a couple months of meeting the guidelines, and drastically reduce the progression of their diabetes, as well as their cardiovascular risk,” Fowles says. For people with type 1 diabetes, Fowles says the benefits are a little different. “The combination of exercise with insulin can be quite dramatic. People with type 1 diabetes should communicate openly with their diabetes educator or physician, to learn the interaction between exercise, food and insulin," he says. “The evidence isn’t quite as strong for glucose regulation for people with type 1 diabetes, but it’s definitely beneficial for their cardiovascular risk reduction, overall health and quality of life.” 3) Why is anaerobic exercise important? While the treadmill or tennis court may be tempting if you’re looking to lose weight, Fowles says building muscle is essential for all people with diabetes, especially as they age. “Most of your blood glucose is Continue reading >>
5 Tips For Exercise With Type 1
A diabetes life coach shares her secrets for good blood glucose control while working out. Throughout July, we’re featuring excerpts from Ginger Vieira’s new book, Dealing with Diabetes Burnout. In this final edited excerpt from the book, the longtime life coach and diabetes advocate shares the lessons she’s learned from years of exercise with Type 1 diabetes. There is no doubt that exercising with diabetes is about one million times more challenging than exercising without diabetes, particularly if you take insulin. Low blood sugars and high blood sugars are major party-poopers in the middle of a walk, yoga, spinning class, tai chi, or strength-training. I’m here to tell you that it can be done and you can enjoy exercise, but it takes a little work, a little more effort, and a bunch of self-study. sponsor When I personally started to become really active and committed to exercising regularly, I was working really hard to balance my blood sugar during things like Ashtanga yoga, strength-training, and various forms of cardio like power-walking and the stairmaster. And it wasn’t easy, but at the very same time I was learning with the help of my trainer, Andrew, about what was literally going on in my body during different types of exercise. Learning about this basic science, taking a deep breath, and viewing my body as a science experiment is the only reason I am able to exercise happily and confidently today. Read “25 Facts to Know About Exercise and Type 1 Diabetes.” Here are five lessons I’ve learned on balancing blood sugars during exercise: 1. Understand What Type of Exercise You’re Doing Jogging and strength-training will both have very different impacts on your blood sugar, even though your heart rate may rise during both. Cardiovascular or aerobi Continue reading >>
The Best Time To Walk
The surprising news is that taking a walk before eating is a great way to keep our blood glucose levels low. But whether we take a walk before or after eating — or both — we will bring down our blood glucose level at the point where it goes highest. Taking a little walk after dinner used to be a tradition in this country. Few people do that any more, and now is the time for those of us who have diabetes to bring it back. While we are at it, we can start a new tradition of even shorter walks before dinner. Walk After Eating A study in The American Journal of Clinical Nutrition shows that a little physical activity can be a big help in bringing down our blood glucose level after a meal. Entitled “Breaking prolonged sitting reduces postprandial glycemia in healthy, normal-weight adults: a randomized crossover trial,” the study was written by six researchers at the University of Otago in Dunedin, New Zealand. This study focused on helping people with pre-diabetes so they won’t get diabetes. Of course, what works for them will work just as well for those of us who have diabetes. But even before this study appeared we had anecdotal evidence for it. I knew from my own experience and that of my late wife that a brisk walk of half an hour can bring down our glucose level. I well remember when Catherine asked what she could do when her blood glucose meter showed that her level was above 200 about an hour after dinner. I suggested that we take a brisk walk around the block, and when we got back home and she tested again, her level was almost down to normal. Walk Before Eating Another study, this one published last year in Diabetologia, which is the professional journal of the European Association for the Study of Diabetes, looked at what happens when people get their phy Continue reading >>
