Exercise in Type 2 Diabetes: Your Natural “Medicinal” Tool

Regular physical activity is one of the three cornerstones (along with nutrition and medication therapy) of successful management of type 2 diabetes. Its effect is so powerful that doctors often call it a “multi-action medicine.” Exercise is not just a morning ritual, but a conscious, consistent investment in your health.

Why does it work? Key benefits

1. Improved insulin sensitivity.
   This is the crucial point. During active work, muscles begin to absorb glucose from the bloodstream without the participation of insulin and become more responsive to it. This effect can last from several hours up to two days after a workout.

2. Lower blood glucose levels.
   Physical activity helps “burn” excess glucose, reducing its level both during and after exercise.

3. Fighting insulin resistance.
   Systematic training makes the body’s cells more responsive to its own insulin.

4. Weight control and reduction of abdominal fat.
   Physical activity helps create a calorie deficit and is especially effective against visceral fat (around the abdomen) — the main contributor to insulin resistance.

5. Improved cardiovascular function.
   Diabetes sharply increases the risk of heart disease. Exercise strengthens the heart, lowers blood pressure and “bad” cholesterol (LDL), and raises “good” cholesterol (HDL).

6. Prevention of complications.
   Better circulation is the best protection for the blood vessels of the legs, eyes, kidneys, and nerve endings.

7. Stress reduction and mood improvement.
   Physical activity stimulates the production of endorphins and helps combat anxiety and depression — particularly important in chronic disease.

What should an ideal exercise program for type 2 diabetes include?

The program should be comprehensive and consist of three main components.

1. Aerobic (cardio) activity — to “burn” glucose and train the heart

What is it?
Rhythmic, continuous exercises engaging large muscle groups: walking (including Nordic walking), jogging, swimming, cycling, dancing, elliptical training.

Recommendation:
At least 150 minutes per week of moderate intensity (for example, brisk walking where you can talk but not sing) or 75 minutes per week of vigorous intensity. It is best divided into at least 3 days per week, with no breaks longer than 2 days.

2. Strength (resistance) training — to build muscle mass

What is it?
Muscles are the main consumers of glucose. The more muscle you have, the lower the insulin resistance. These include exercises with weights: dumbbells, resistance bands, gym machines, and body-weight exercises (squats, push-ups, planks, lunges).

Recommendation:
2–3 times per week on non-consecutive days. Perform 8–10 exercises for major muscle groups, 2–3 sets of 10–15 repetitions.

3. Flexibility and balance exercises — to prevent injuries and improve quality of life

What is it?
Stretching the major muscle groups (after the main workout) and balance exercises (standing on one leg, tai chi, yoga). Especially important for older adults and for prevention of diabetic foot syndrome.

Recommendation:
2–3 times per week for 5–10 minutes.

Critically important safety rules

1. Consult a doctor.
   Before starting any program — especially if complications are present (retinopathy, neuropathy, heart or kidney problems) — a medical evaluation is necessary.

2. Monitor glucose levels.

   • Before exercise: If glucose is above 13–14 mmol/L and ketones are present (check with a test strip), postpone the workout. If it is below 5.5 mmol/L, eat a small carbohydrate snack (an apple or a crispbread).

   • During exercise: For prolonged activity (>30–60 minutes), an additional snack may be needed.

   • After exercise: Always measure glucose to understand your body’s response and adjust food intake or medication dose.

3. Foot care.
   Always train in comfortable, properly fitting shoes and socks without rough seams. After exercise, inspect your feet for injuries, abrasions, or blisters.

4. Hydration.
   Drink water before, during, and after training.

5. Gradual progression.
   Start small (for example, a 10-minute walk) and slowly increase duration and intensity.

6. Consistency.
   Twenty minutes daily is better than two hours once a week.

Example weekly plan for beginners

• Mon: 30 minutes of brisk walking

• Tue: 15–20 minutes of strength training with dumbbells or resistance bands

• Wed: 30 minutes of swimming or cycling

• Thu: Rest or light stretching

• Fri: 30 minutes walking + 10 minutes strength exercises (squats, wall push-ups)

• Sat: Active leisure (dancing, park walk)

• Sun: Rest

Key takeaway

Movement is life — and in type 2 diabetes this is especially true. Find an activity you enjoy, start small, follow safety rules, and turn exercise into a healthy habit. It will become a reliable ally in controlling blood sugar and improving well-being for many years.