Instructions
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Frequency Because exercise improves insulin sensitivity for a limited time period, it should be performed frequently by people with diabetes. Daily exercise (with occasional rest days) is optimal for maintaining blood sugar control and promoting long-term weight loss. To prevent overuse injuries, it is a good idea to engage in a variety of different exercise activities, using different muscle groups. This is commonly referred to as cross-training. For example, walking or jogging on Monday/Wednesday/Friday, and swimming or using weight-lifting machines on Tuesday, Thursday and Saturday.
•Most
(if not all) days of the week
•Think
of exercise as medicine
•Insulin
sensitivity lost after 24-48 hrs
•Cross
Train to Prevent Overuse Injuries
and Burnout Progression
Most people are unable to achieve the duration or frequency of exercise that is optimal right away. It takes time and conditioning to build up to these levels. It is reasonable to start with short bouts of exercise performed at a comfortable level just a few days each week. This sets patients up for success, motivates them to continue, and minimizes the risk of soreness and injuries.
It is best to build up to the desired duration first, then build the frequency, then add to the intensity as tolerated. For example, start out with 10 minutes of light exercise three days per week. Add a minute per workout until reaching a target duration of, say, 45 minutes. Then build up from 3 days per week to 5 or 6. Once this is reached, start making the intensity/pace slightly more challenging.
Interval Training: Interval training is a safe and effective way to improve one’s stamina in a gradual, coordinated manner. Here is an example. Each 30 minutes session is broken down into three 10-minute segments. Within each segment is an “easy” portion and a challenging portion. By gradually decreasing the length of the easy portions and lengthening the challenging portions, conditioning takes place. Here is an example:
•Wk
1: 9 min easy, 1 min hard (x3)
•Wk
2: 8 min easy, 2 min hard (x3)
•Wk
3: 7 min easy, 3 min hard (x3)
•Wk
4: 6 min easy, 4 min hard (x3)
This pattern can be expanded as needed. Timing For people with diabetes who take mealtime insulin or oral hypoglycemia medications – sulfonylureas or meglitinides -- the timing of exercise is of utmost importance. As mentioned previously, pre-meal exercise usually requires extra food to prevent hypoglycemia, whereas hypoglycemia can be prevented through insulin/medication reductions when exercise takes place after meals. Exercising after meals can also minimize the blood sugar “spike” that may occur. Research has shown that exercising after meals can lower the peak after-meal blood sugar by 50 mg/dl or more.
In terms of scheduling, research has shown that those who exercise in the morning tend to adhere to their workout program longer than those who exercise later in the day. If a patient is indifferent about the time of day they exercise, it is best to encourage morning activity. However, each individual’s personal preference should be taken into account.
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