New research on exercise and diabetes

It is becoming more likely you will have a person with diabetes in your studio, fitness class, or as a personal training client. In fact, Diabetes Canada recently reported that 640 Canadians are diagnosed with Diabetes each day – one person every six minutes.

It is National Diabetes Awareness month and as fitness professionals we need to be educated and informed about the complications around exercising with diabetes, and how to best support individuals living with diabetes. We recommend fitness professionals become trained in medical fitness if this is a population you want to work with. That said, there is exciting research and studies to share. .

Know your scope. If you aren’t qualified to work with someone with diabetes, refer them to a fitness specialist who is, or become certified in medical fitness. There is a huge opportunity for Canadian fitness professionals to serve this population, but you must be educated and certified in order to work with this complex population.

Exercise can restore brain insulin sensitivity in people living with obesity.
A new study from a small cohort in Germany, found promising results that one hour of exercise, performed three times a week, can restore brain insulin sensitivity. The link between brain insulin insensitivity and diabetes is well-established, but that connection is still being studied. What is known is that when the brain loses sensitivity to insulin, it can increase hunger, disrupt metabolism, and lead to weight gain. But the study authors found that healthy levels of brain insulin sensitivity were restored after only eight weeks of exercise.

A little goes a long way. One of the key things I tell LIVE WELL members who have diabetes is this: You don’t have to run a marathon or spend hours in the gym to manage blood sugars! In fact, a little goes a long way. Here is what happens to a person with diabetes who starts exercising: after about 10 minutes of any movement, the muscle starts soaking up the blood sugar. In fact, it starts to create a partnership between the muscle cells and the insulin pathway that helps mobilize glucose in the short term and the long term. How fascinating is that? You move your body and the activation of the muscles helps your blood sugars stabilize.

New research shows afternoon workouts might be best for people with diabetes.
We want our clients to exercise whenever they can fit it in, but we have seen that with people with diabetes sometimes “dosing” exercise has the biggest impact on their blood sugar control. This means encouraging clients to get a dose in the morning, and one again in the afternoon, even if it is a morning walk at a moderate intensity. But most importantly, dosing their exercise to align with the time that their blood sugars are the highest.

Interestingly, a recent study from the Netherlands that looked at 6,671 people living with obesity between 2008 and 2012 found an association between insulin resistance and the time of day for exercise. Findings suggest that moderate to vigorous physical activity in the afternoon led to an 18% reduction in insulin resistance, and the same type of activity in the evening was linked to a 25% reduction – this compared to physical activity spread throughout the day.

Intensity matters. Low to moderate exercise intensity is shown widely to decrease blood sugars. But what about that client whose blood sugars go low during or after exercise? Data shows fascinating results for bouts of higher intensity exercise to help increase blood sugars. An intense dose of exercise (relative to that individual’s exercise capacity) can cause the liver to release glucose into the bloodstream. Studies have shown that someone who gets low blood sugar levels can actually start by having an intense dose of exercise, which will increase their blood sugar levels.

Exercise is such a powerful tool – not simply to help people with diabetes get healthier, but to truly change their lives. Encourage clients with diabetes to seek out educated professionals, to start low, and move slow. The best thing you can do is to help them find accountability partners, and to take steps towards the 150 minutes per week that we know helps reduce rates of diabetes.

Most importantly, remember to hold your judgment. We are all on our own health journey.

(originally published In Can-Fit Pro November 2022)