But the truth is, everyone needs to get physical activity — and it’s even more important when you have diabetes, which can also affect your heart. “What’s crucial is to understand that diabetes is not just about blood sugar,” says Nathan Wong, PhD, FACC, a professor of medicine and the director of the Heart Disease Prevention Program at the University of California at Irvine and a fellow of the American College of Cardiology. “Cardiovascular disease is really the major risk for people with diabetes,” Dr. Wong explains. This is because high blood sugar levels can damage nerves and blood vessels throughout the body. Diabetes is often accompanied by high cholesterol or other lipid problems, such as high triglycerides, as well as high blood pressure, which together can greatly increase the risk of heart disease and stroke. “One can live many healthy years with diabetes, but to ensure that, you have to get your risk factors under control,” says Wong. He adds that good control of your blood sugar, cholesterol, and blood pressure can reduce your risk of cardiovascular disease by 50 percent or more. In addition to taking any prescribed medications for diabetes, cholesterol, blood pressure, or other conditions; following a healthy diet; and not smoking, getting physical activity is crucial to lowering your risk of diabetes complications. And different forms of exercise can help you in different ways.
Aerobic Exercise for Heart Health
Cardiovascular exercise, also known as aerobic exercise, is what helps the heart most. “Cardiovascular exercise works your heart muscle and gets blood and oxygen flowing to your tissues,” says Megan Porter, RD, CDE a dietitian and certified diabetes educator in Portland, Oregon. “It also helps to decrease bad cholesterol and increase good cholesterol, as well as decrease blood pressure.” Aerobic exercise is any exercise that uses large groups of muscles, such as those in your legs, for a sustained period of time. Examples include:
WalkingSwimmingCyclingJoggingDancingUsing an elliptical machine
The American Diabetes Association (ADA) recommends that you get 30 minutes of moderate-to-vigorous-intensity aerobic exercise at least five days a week, or a total of 150 minutes each week. To lower blood pressure and cholesterol, the American Heart Association recommends 40 minutes of moderate-to-vigorous activity three or four times a week. “Moderate to vigorous” will depend on your overall fitness level, but in general, brisk walking is a moderate activity and jogging is considered vigorous.
Strength Training for Diabetes Management
While aerobic activity is essential for maintaining heart health in people with diabetes, “weight training is integral to directly impacting diabetes itself,” says Stanley Bassin, EdD, a clinical professor of medicine and an exercise physiologist in the Heart Disease Prevention Program at the University of California at Irvine. This is because strengthening muscles can help lower blood sugar and make your body more sensitive to insulin. Doing strength-training exercises does not mean you need to become a bodybuilder. Anything that creates muscle resistance will work. This can include:
Using resistance bandsLifting handheld weights or using weight machinesCalisthenics, such as plank poses, sit-ups, squats, and lungesStrength-training group classesHeavy gardening or other household chores that involve lifting objects
Bassin emphasizes the importance of learning how to do resistance exercises properly before getting started. To prevent injury, find a certified, trained person to teach you a weight-training program that is suitable for your age and physical condition,” he says. This can be a personal trainer, an exercise physiologist, or another exercise professional. The ADA recommends that you do some type of strength training at least twice a week, in addition to aerobic exercise.
Flexibility Exercises for Overall Health
One last form of exercise to incorporate in your regular routine are flexibility exercises. That’s because our bodies can become less flexible, especially as we get older. “Stretching is really important, particularly for those over age 40, to promote flexibility,” Bassin says. Stretching exercises can help keep your joints limber, allow your muscles to use the full range of motion, and reduce your chance of getting injured doing other activities. Examples of flexibility exercises are:
YogaTai chiPilatesBasic stretches (taught by a certified exercise professional)
While the ADA does not have a set recommendation for how often to stretch, stretching can easily be added to the beginning or end of your aerobic exercise routine, such as 5 minutes of stretching before you start walking. And some forms of flexibility exercises, like yoga, can double as both strength training and stretching. No matter how you incorporate these exercises, Bassin suggests that you have a trained professional, such as a certified personal trainer, show you the proper way to stretch to help prevent injury.
Before You Get Started
“Anyone with diabetes should discuss with their doctor any precautions that they may need to follow prior to starting an exercise program,” says Porter. Bassin agrees, saying, “First, get an evaluation by your physician for cardiovascular and weight training activity.” This can reduce your risk of injury, particularly if you’ve already experienced heart problems. Once you’re cleared, the best way to start an activity program is by walking — it’s a simple activity that you’re probably doing every day already. Bassin recommends using a pedometer to track how much you walk each day, and then to gradually add to the amount you walk. From there, in addition to walking, Bassin recommends incorporating activities you liked when you were younger. “Any type of activity that you enjoy — and you will continue to do — that makes you breathe harder is the best type of activity,” says Porter. Just be sure to protect and monitor your feet for any injuries, cuts, or other abnormalities, and to report these to your doctor.
Putting it All Together
When you first get started on your exercise routine, your main focus should be on moving more each day, says Bassin. In fact, if you’re sitting for extended periods, the ADA recommends getting up and moving every 30 minutes. And don’t worry if you can’t do 30 to 40 minutes of exercise all at once. Instead, aim for three to four 10-minute periods of activity throughout your day. Start by:
Walking instead of driving to run an errandDoing some stretches by your deskGoing to a parkCarrying your groceries by hand to the car instead of using the grocery cartTaking the stairs whenever you can
“You can always find ways to be physically active,” Bassin says. “It all starts with the first step.”
