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How to manage diabetes through exercise

Christian Petersen, who lives with type 2 diabetes in Denmark, shares his tips for how to manage diabetes through exercise below. 

You’ve probably had someone tell you to make exercise part of your life. You’ve probably heard there’s a mountain of evidence that our bodies are meant to be used and move around. And you’ve probably heard your doctor recite the health benefits enjoyed by physically active people – and the risks of having a sedentary lifestyle.

I’m here to tell you that’s all true. But on top of that, if you’re living with type 2 diabetes, physical exercise has the added bonus of improving your metabolic health1.

You can put together your own programme and you’ll find there are enough options and possibilities to suit everyone. So without further ado, let’s...

… get started!

You probably have some idea of how fit you are. Suppose you added a 30-minute walk to your daily routine. Could you maintain that for a week without missing a day? If not, what amount of time could you manage? Your job is to find a daily workout routine that challenges you moderately and appropriately, without making you so exhausted that you lose motivation and stop doing it. Once you have that, stick to it for 7 days.

For some people, high-intensity activity could be a way to go. If that sounds like you, start with swimming, short runs and jumping jacks. How do you know if you’re working at a high-intensity level? Here is a tip: You should be breathless and able to say only a few words at a time while working out. Start slow, and try to aim for high-intensity activity for 20 minutes, 3 days a week2.

Three different scenarios, one where a man is biking, running and swimming.

“Your job is to find a daily workout routine that challenges you moderately and appropriately, without making you so exhausted that you lose motivation and stop doing it.“

-Christian Petersen

Once you have decided what type and amount of daily and high-intensity activity is appropriate for you, think about how much you could add to that routine one week from now. Get used to seeing your activity routine as a 7-day cycle with carefully planned weekly increases in both duration and variety.

One more thing: Try to define a goal that you can aim to achieve 1 year from now. This way, you’ll have activity destinations that take a week to reach, and a big one that will take a year to reach.

Be realistic

In all this, you need to be realistic about two things:

  • Your physical ability and endurance – which will evolve from week to week
  • Whether or not you will need friends or a professional trainer to assist you (on that, be sure to check out the bonus tip below.)

Setting achievable goals is not an easy thing to do, and there will be days when you are not very motivated. This is all normal and to be expected. Pushing yourself to constantly perform just beyond your current physical comfort zone is a challenge for everyone, so tell yourself to expect a mix of easy and not-so-easy days. And bear in mind that the reward you gain is proportional to both the amount of effort you put in and the difficulty you rise above.

A man spinning in a gym.

“Try to define a goal that you can aim to achieve 1 year from now. This way, you’ll have activity destinations that take a week to reach, and a big one that will take a year to reach.”

-Christian Petersen

To progress steadily and have a good time with physical activity, your goal is to avoid the twin dangers of:

  • Pushing yourself too hard – you may throw in the towel and lose all the health benefits
  • Pushing yourself not enough – you may experience no sense of fulfillment and only minor health benefits, leading you to lose interest and give up

When you push yourself just the right amount, you reap plenty of health benefits along with a feeling of being engaged in something rewarding and meaningful.

Make sure to keep a log or diary so you have some accountability to yourself, and so you can track your progress. This will give you the pleasure – increasingly as the weeks go by – of looking back at how far you have come. Take some pride in your results!

“Keep a log or diary so you can track your progress. This will give you the pleasure – increasingly as the weeks go by – of looking back at how far you have come. Take some pride in your results!”

-Christian Petersen

Just walk

I walk everyday, and I simply love it. Walking has been called the most underrated form of exercise, and I would agree. Below are some reasons why you should stop reading and put on your walking shoes right now.

Walking3:

  • increases heart and lung fitness
  • reduces the risk of heart disease, stroke and some cancers
  • improves management of conditions such as high cholesterol and high
    blood pressure
  • relieves joint and muscular pain or stiffness
  • increases muscle strength and endurance
  • gives you stronger bones and improved balance
  • reduces body fat

Unlike some other forms of exercise, walking is totally free, doesn’t require any special equipment or training and it allows you to talk with a friend or listen to an audiobook while at it.

Try interval training – and avoid hypos

You have to crawl before you can walk! And if you ask me, you have to walk for 7 days before you can run.

When you have found a comfortable daily distance and walked every day for a week, it might be time to see how long you can run. Running is high-intensity, so go easy on yourself. Two minutes might be enough on the first day. And in general, consult your healthcare professional about your exercise plans before starting anything ambitious.

Creating some variation might make exercise more fun and less overwhelming. Try something like:

  • 8 minutes of walking
  • 30 seconds of running
  • 8 minutes of walking
  • 30 seconds of running
  • Etc.
A cutout of two people's legs running on a street.

“Walking is exercise too! Unlike some other forms of exercise, it's totally free, doesn’t require any special equipment or training and it allows you to talk with a friend or listen to an audiobook while at it.”

-Christian Petersen

The precise details are of course up to you, and will change as you progress. But try achieving that “fast, slow, fast, slow” rhythm – also known as high-intensity interval training. If you are living with diabetes, alternating periods of short, intense exercise with less intense recovery periods can lower your glucose levels – even in a single session4.

My first piece of advice is to pay close attention to your blood sugar levels before, during and after physical activity – preferably with a blood glucose meter.

Depending on your situation, especially whether or not you need to inject insulin, it can be a good idea to check your blood sugar 15-30 minutes before you start exercising, every half hour during the workout and after the workout. Have a chat with your healthcare professional so you know for sure whether you are at risk of hypos and – if so – how you may best respond to them5.

Sneak activity into your life – plus a bonus tip

If you are living with diabetes, my advice is to seize every opportunity to sneak physical activity into your day – whether a weekday or weekend. When you get used to taking 10 minutes here and 10 minutes there to be active instead of sitting still, the impact can be considerable. Take the stairs, not the elevator. Take your bike to work. Walk instead of taking the bus. And try using headphones to listen to music or a podcast while you’re being active – it just might make the whole experience more enjoyable.

A cutout of a man's legs while he is spinning.

“A workout partner gives your activity a social dimension which can be both enjoyable and useful. It's good to have someone to discuss your goals with – and be accountable to.“

-Christian Petersen

And here’s a bonus tip: Get a workout partner. As mentioned above, an important change in lifestyle comes with a number of challenges. A workout partner gives your activity a social dimension which can be both enjoyable and useful. You will have someone to discuss your goals with and someone to be accountable to – it doesn’t have to be someone living with diabetes.

As with everything, the longer you stay with it, the better at it you will become. And when you are working on something as important as your health, progress means positive transformation across your entire life. As your diabetes symptoms become more and more manageable, you will locate newfound energy and a greater sense of wellbeing across the board.

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References
  1. American Diabetes Association Professional Practice Committee. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024 [published correction appears in Diabetes Care. 2024 Feb 05;:]. Diabetes Care. 2024;47(Suppl 1):S77-S110. 
  2. American College of Sports Medicine. Physical Activity Guidelines. Available from: https://www.acsm.org/education-resources/trending-topics-resources/physical-activity-guidelines. Last accessed: April 2024.
  3. American Heart Association. Why is Walking the Most Popular Form of Exercise? Available from: https://www.heart.org/en/healthy-living/fitness/walking/why-is-walking-the-most-popular-form-of-exercise. Last accessed: April 2024.
  4. Francois ME, Little JP. Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes. Diabetes Spectr. 2015;28(1):39-44. 
  5. American Diabetes Association. Blood Glucose and Exercise. Available at: https://diabetes.org/health-wellness/fitness/blood-glucose-and-exercise. Last accessed: April 2024.

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