Lack of exercise is a major factor contributing to type 2 diabetes. Compared to physically active individuals, those who are inactive have a 50% to 80% higher risk of developing type 2 diabetes. Lu Hua, Associate Chief Physician of Cardiothoracic Surgery at the First Affiliated Hospital of Jinan University, states that for patients with prediabetes or metabolic syndrome, aerobic and resistance training can prevent progression to overt diabetes.Additionally, aerobic and resistance training effectively manage blood sugar levels, lower blood pressure, facilitate weight loss, enhance maximal exercise capacity, and improve dyslipidemia in diabetic patients.
Diabetes can be improved through exercise training.
Lu Hua explained that aerobic exercise not only helps diabetic patients improve blood glucose control and insulin resistance but also enhances blood pressure and lipid profiles while gently reducing weight. Research indicates that exercise intensity is more important than exercise volume; individuals engaging in moderate-to-high intensity exercise face significantly lower risks of metabolic impairment compared to those expending the same energy through low-intensity activities.
Sedentary individuals can enhance muscle insulin sensitivity with relatively low exercise volume (400 kcal/week), with further improvements occurring as volume increases. While the optimal combination of duration and intensity remains undetermined, high-intensity interval training (HIIT) yields superior metabolic benefits and fitness gains compared to moderate-intensity aerobic exercise.
Post-exercise muscle glucose uptake increases, with skeletal muscle glucose uptake persisting for up to 48 hours. This response is dose-dependent on exercise intensity and volume. Therefore, diabetic patients engaging in high-intensity or competitive exercise should account for this to prevent hypoglycemia. Type 1 diabetics can reduce exercise-induced hypoglycemia by consistently performing resistance training or interval training.
Exercise Recommendations in Three Parts
Assess Before High-Intensity Exercise
Clinically, the most ideal exercise recommendations for individuals with diabetes are:
1. At least 30 minutes of moderate-intensity exercise daily (e.g., brisk walking, swimming), plus 15 minutes of resistance training 3–5 times weekly;
2.Incorporate 30 minutes of low-intensity physical activity (e.g., standing, walking) every 30 minutes;
3. Increase flexibility and balance training, especially for the elderly or those with microvascular damage due to diabetes.
Lu Hua reminds that all diabetic patients should undergo cardiovascular and blood glucose assessments before high-intensity exercise, including evaluation of hypoglycemia risk factors, history of hypoglycemic episodes, and presence of neurological complications.Asymptomatic diabetics with normal cardiovascular assessments and maximal exercise test results may participate in all forms of exercise.
Importantly, all diabetics should remain vigilant for chest discomfort or abnormal breathing difficulties during exercise, as these may indicate coronary heart disease. Immediately cease activity and seek medical evaluation if such symptoms occur.
Persistent long-term exercise significantly reduces mortality in both Type 1 and Type 2 diabetes patients. However, exercise cannot fully offset diabetes-related risks. Patients must maintain glycemic control through medication and must never discontinue prescribed drugs, as this can cause serious harm.