It is commonly known that diabetes is a huge problem in the UK and worldwide. There are two types of diabetes: Type 1, which is caused by a failure of the pancreas to produce insulin (no one quite knows why); and Type 2, which is common in older people. Lifestyle changes are especially important in people with Type 2 diabetes. One such lifestyle intervention involves becoming more physically active – but for someone with diabetes and previously unused to exercising this can be quite daunting.

Of course, being physically active results in many benefits such as lowered blood pressure, lowered stress, an improved immune system, increased muscle strength and reduced cardio-vascular risk. However, for people with diabetes and poor insulin control, exercise (combined with medication and diet) is key to keeping blood glucose levels down.

There are many ways that exercise helps to lower blood glucose but most important is something known as “insulin sensitivity”. With exercise the cells in the body become more sensitive to insulin, making them more effective at burning glucose as energy rather than storing it as fat. This leads to an improvement in blood glucose levels that can last 12 to 72 hours after exercise and which has long-term benefits in people who are regularly active.

There are, however, concerns, particularly with Type I diabetes or younger people, that exercise can lead to a dangerous drop in blood glucose levels. Although this is generally not the case for most people there are a few tips that are worth considering if new to an exercise programme.

1. Always check glucose levels before beginning a reasonable bout of exercise (walking for more than 40 minutes, for example). Generally if blood glucose is less than 100 mg/dL / 4 mmol/l before exercise, you should eat at least one carbohydrate before the workout: e.g. banana.

2. Always keep some quick sources of sugar handy in case you need it while exercising. This can be glucose tablets, glucose gel, hard candy (not sugar-free), fruit juice, raisins or a regular soft drink.

Guidelines tell us that you don’t need to do excessive amounts of exercise to get long-term blood glucose control. A moderately paced walk of 30 to 45 minutes five times a week should be sufficient, or a shorter bout of exercise if of higher intensity. Ideally, aerobic exercises should be performed regularly as stronger muscles can contribute to improvements in blood glucose control.

If you have diabetes and feel uncomfortable about beginning an exercise programme, why not get started with the help of a physiotherapist?


Rachel Garrod PhD MSc is a physiotherapy lecturer and stop smoking counsellor

Tel. (+34) 652 281 122

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