TO PREVENT & MANAGE DIABETES EXERCISE OFTEN

Want to control or prevent diabetes?  Regular physical activity is key and the evidence supporting this fact has never been stronger.  Two recent reports illustrate how regular physical activity is an instrumental part of better blood sugar control.  And, compelling findings on the importance of breaking up sedentary time and doing short stints of activity throughout the day has prompted to the American Diabetes Association (ADA) to release new activity recommendations for diabetics.  The ADA advises diabetics break up sedentary time by doing 3-minute or longer bouts of activity every half hour rather than every 90 minutes as had been previously recommended. 

While regular physical activity is a cornerstone in prevention and management of type 2 diabetes,  the relationship between time spent doing activity and diabetes risk reduction has not been clearly quantified.  A recent meta-analysis examined the existing studies on the relationship between physical activity and the incidence of diabetes.  These studies included over 1.2 million subjects.  The analysis found a clear dose response relationship between activity and diabetes risk prevention and the relationship held over a broad range of activity levels.  Even doing as little as 5 minutes of activity many times a week offers some benefit.  The recommended 150 minutes per week of moderate cardio (such as 30 minutes of brisk walking five times per week) reduces the risk of diabetes by 26%.  And, exceeding recommendations has additional risk reduction benefit.  Doing more than 300 minutes per week resulted in a more than 50% reduction in diabetes risk.

Another recent trial investigated the blood sugar control benefits of exercising for short bouts after meals versus exercising for a longer period once per day.  In the study, for 14 days each, 41 adults (aged 18-75) with type 2 diabetes either walked 30 minutes daily or walked for 10 minutes after breakfast, lunch, and dinner.  Fasting blood samples, weight, height and waist size were taken on days 1 and 14.  Participants wore accelerometers to track activity, completed food journals to track intake, and wore continuous glucose-monitoring systems to gather blood sugar information. Overall it was found that after meal blood sugar was an average of 12% lower during the "post-meal walking intervention" part of the study than when following the "30 minutes of daily activity" intervention.  Interestingly, researchers found a marked 22% reduction in blood sugar following the walk after the evening meal.  Adding in walking in the evening produced more significant changes because participants tended to be mostly sedentary in the evening and the dinner meal tended to contain the largest portions of carbs and starches.
  

Also, this week the ADA announced recommendations that persons with diabetes, in addition to doing regular structured activity,  should do three or more minutes of light activity every 30 minutes when engaged in prolonged periods of sitting, such as working on a computer or watching television.  Previously, they had recommended doing a few minutes of light activity at least every 90 minutes during sedentary time but when the ADA reviewed over 180 studies on the topic, researchers found significant blood sugar control and circulatory benefits to breaking up sedentary time even more.  Examples of suggested light activities include overhead arm stretches, walking in place, leg lifts or extensions, desk chair swivels, torso twists, and side lunges.

What to do:  Whether you have diabetes or not, do regular cardiovascular activity.  To prevent and control diabetes, aim for at least 30 minutes of activity on most days and if you can do more, the additional activity yields meaningful benefit in diabetes prevention and control.  Doing activity after meals, especially the dinner meal, and adding in brief periods of activity every 30 minutes when sedentary will further benefit your blood sugar control and circulatory health.

Information adapted from articles available at:

https://www.sciencedaily.com/releases/2016/10/161018094926.htm

https://www.sciencedaily.com/releases/2016/10/161021123123.htm?trendmd-shared=0

https://consumer.healthday.com/diabetes-information-10/diabetes-management-news-180/new-guidelines-urge-diabetics-to-move-more-716205.html

http://care.diabetesjournals.org/content/39/11/2065

Sources: 

Smith AD et al. Physical activity and incident type 2 diabetes mellitus: a systematic review and dose–response meta-analysis of prospective cohort studies.  Diabetologia; 2016.   DOI: 10.1007/s00125-016-4079-0

Reynolds AN et al. 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. Diabetologia; 2016. DOI:  10.1007/s00125-016-4085-2 

American Diabetes Association Press Release, October 25, 2016.  http://www.diabetes.org/newsroom/press-releases/2016/ada-issues-new-recommendations-on-physical-activity-and-exercise.html?referrer=https://www.google.com/