6 consejos para hacer ejercicio con diabetes

Moving more—and in the right ways—is one of the keys to managing symptoms of diabetes.

Exercise is one of the best things anybody can do for their health, and that's especially true if you have diabetes. Physical activity naturally improves your body's ability to lower blood sugar, according to the American Diabetes Association (ADA).

Here’s how:

• Exercise increases insulin sensitivity. Insulin is the hormone that allows cells in your body to use blood sugar (glucose) for energy.
• When your muscles contract during your workout, your cells take up blood sugar and use it for energy — whether insulin is available or not.
• When you’re regularly active, exercise can also lower your

Regular exercise also reduces the risk of heart problems that can come with diabetes.

However, when you are living with diabetes, exactly how you approach your exercise time really matters. Here, experts share the smartest ways to work out to improve your health and feel great.

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Talk to Your Doctor Before Starting a New Routine

Whether you’re newly diagnosed with diabetes or have had it for years, it’s important to talk with your doctor or other member of your diabetes care team about any special considerations you need to make when exercising.

A walking routine is generally considered safe for most people with diabetes, according to the ADA. But it’s good to have help mapping out a routine that is both safe and enjoyable.

Your diabetes care team can recommend ways to start exercising if you haven't been active for some time. And if you have other health concerns or are managing health conditions besides diabetes (such as heart disease or nerve problems) your care team can let you know the best exercises to try - and which ones to avoid, if any.

"If you have heart disease or long-standing diabetes, talk to your doctor about getting a cardiac stress test," says Craig Primack, M.D., an obesity medicine specialist at Scottsdale Weight Loss Center. Your results will give them good information to recommend a safe fitness plan that's right for you.

Look For Ways To Be Active Every Day

Once you have the OK from your care team to exercise, how much daily movement should you be getting?

“Do something most days of the week,” Dr. Primack says.

Consistency is key. To help control blood sugar levels and make your body more sensitive to insulin, the ADA recommends exercising five to six days a week.

But if that's not possible, try to avoid letting more than 48 hours lapse between workouts, Dr. Primack says. This will keep your muscles in a "constant state of increased glucose uptake," notes the ADA.

These recommendations line up with the weekly exercise target from the current Physical Activity Guidelines for Americans, put out by the U.S. Department of Health. Adults should aim for150 minutes (about 2 and a half hours) of moderate-intensity aerobic exercise per week. Moderate intensity means you should be able to talk, but not sing, during your workout.

There are lots of different paths you can take to get to 150 minutes: You could do five 30-minute workouts each week, or six 25-minute sessions. And if you like a longer workout, you could hit your goal with three 50-minute workouts.

Important tip: It doesn’t have to be all at once. In fact, the ADA says it’s good to break up your day with a few different short exercise sessions, or “

You might start your day with a 15-minute SilverSneakers LIVE Express class. Later, you could take a brisk 10-minute walk after lunch and dinner. Finally, you can wind down for bed with some relaxing stretches or a gentle yoga flow.

Monitor Your Blood Sugar — and Pack a Snack

For people with diabetes, it's important to maintain stable blood sugar levels during your workouts. "Exercise naturally lowers blood sugar," says Dr. Primack, who recommends testing and tracking your blood sugar before, during, and after exercise.

As a general guideline, your blood sugar levels should be between 90 and 250 mg/dL, Dr. Primack says. If levels are lower than 90, he suggests eating 15 to 30 grams of simple carbohydrates before you lace up your sneakers. One slice of bread, a piece of fresh fruit, or six to 12 saltine crackers are all good options. Ask your care team what safe levels look like for you.

If you experience symptoms of low blood sugar during your workout, such as anxiety, weakness, and dizziness, test your blood sugar, and eat a small amount of carbohydrates if needed, says Margaret Eckert-Norton, Ph.D., R.N. She is a certified diabetes educator and an adjunct professor of nursing at St. Joseph’s College in New York City.

You should also pay close attention to any diabetic symptoms you may have while you're exercising. "Look for patterns," Dr. Primack says. "Question why your blood sugar went so low and how you can prevent the dip in the future."

As always, talk to your doctor if you notice any patterns that can’t easily be explained and follow your doctor’s recommendations.

Important tip: If you take mealtime insulin or other medications that can cause low blood sugar, the ADA recommends asking your doctor for help planning the timing of your workouts to avoid low blood sugar (hypoglycemia).

Find Low-Impact Activities You Enjoy

Eckert-Norton says low-impact exercises are best for those with diabetes. This is especially true for those who have nerve damage (known as peripheral neuropathy) in their hands and feet, she adds.

High-impact exercises, like running and jumping, can increase the risk of injury to the arms or legs. They can also limit the body's natural wound-healing processes, she explains.

To keep your exercise in the optimal range of effort, these low-impact workouts are smart . SilverSneakers instructors are specially trained to modify activities to your specific needs.

Whatever low-impact exercise you choose, it’s important to check your feet after every workout and care for any cuts or blisters right away, Dr. Primack says. Wear well-fitting shoes that are designed for the kind of activity you are doing. (This guide to finding your perfect workout shoes can help.) Call your doctor if a cut, sore, blister, or bruise on your feet doesn’t improve after two days, he adds.

Embrace Strength

Avoiding high-impact cardiovascular activity doesn't mean you can't lift weights. In fact, your body will love you for it.

According to a study in BioMed Research International, strength (or resistance) training may help improve metabolic risk factors (such as high blood sugar and excess belly fat) for cardiovascular disease in people who have type 2 diabetes. This type of exercise can also improve insulin sensitivity. Researchers also found that lifting weights can help improve overall quality of life.

Dr. Primack recommends strength training at least twice a week. SilverSneakers Classic is good for all levels and abilities, and classes are offered both in-person at participating fitness locations and online through SilverSneakers LIVE.

Remember to keep your doctor in the loop before you get going with any new strength-training routine.

Move Around After Meals

While most types of exercise are way better than no exercise, you may get bonus benefits when you are active after you eat. Turns out a short walk after you've cleared the table goes a long way, says Eckert-Norton.

A study published in the journal Diabetologia shows that in people with type 2 diabetes, walking for 10 minutes after breakfast, lunch, and dinner is better at regulating blood sugar levels than walking for 30 minutes all at once. This is likely because it helps your body more effectively use any excess blood glucose from carbohydrates, Eckert-Norton explains.

Use these tips to get the most from your post-meal walks.

If the weather isn’t cooperating, press play to try a 10-minute walking workout that you can do inside. You can also join a SilverSneakers LIVE Walk Strong Express 15-minute class.

See our sources:
Exercise and blood sugar: American Diabetes Association
Insulin basics and how exercise helps: American Diabetes Association
Role of exercise in preventing heart problems associated with diabetes: Centers for Disease Control and Prevention
Exercising with diabetes: American Diabetes Association
Current Physical Activity Guidelines for Americans
Benefits of strength training for those with type 2 diabetes:  BioMed Research International
Benefits of walking after meals for those with type 2 diabetes: Diabetologia

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