/ Categories: Better Health (BH)

Diabetes – Time to Get Moving

Author   by  Karl Knopf, EdD


Adapted with permission from FEOAA News, Volume 14, Issue 3.

Studies suggest that exercise can positively influence the course of pre-diabetes and diabetes. The Centers for Disease Control & Prevention (CDC) estimates that 88 million US adults (1 out of 3 adults)  have prediabetes.  Without taking action, many of these individuals can develop type 2 diabetes within five years.

There are two distinct forms of diabetes: type 1 or insulin-dependent diabetes mellitus and type 2 non-insulin-dependent diabetes mellitus. For those of us who work with the older adult population, it is important to be informed about type 2 diabetes since about 90 percent of the diabetic population has this form of the disease. Whereas type 1 is characterized by an absolute insulin deficiency caused by an auto immune destruction of the insulin-producing beta cells of the pancreas, type 2 is characterized by a relative insulin deficiency.

Diabetic populations develop cardiovascular disease at an earlier age and with greater severity than do people who do not have diabetes.  It has long been recognized that diabetes accelerates the arteriosclerotic process and is considered an independent risk factor for heart disease—right along with obesity and high blood pressure. Diabetes not only can contribute to heart disease but can also contribute to blindness and the loss of limbs due to poor circulation. The bottom line is that diabetes is not a simple and common condition to be dismissed as just a blood sugar imbalance.

Many experts in this field believe that proper lifestyle changes can and will positively influence the course of this disease. Many doctors suggest that the first course of treatment for a person with adult onset diabetes is to get more active and lose weight.


The interplay between exercise and diabetes is a critical one.  This is because of the way in which exercise influences metabolism. Exercise contributes to glucose control, weight control, and stress management. In short, exercise helps! It has been shown to:

1.     Improve glucose uptake and help control glucose levels.

2.     Promote weight control. Reduction of excess body fat has been shown to decrease insulin resistance. The National Institute of Diabetes and Digestion and Kidney Diseases (NIDDK) explains that insulin resistance is “when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily take up glucose from your blood. As a result, your pancreas makes more insulin to help glucose enter your cells. As long as your pancreas can make enough insulin to overcome your cells’ weak response to insulin, your blood glucose levels will stay in the healthy range.”

3.     Help regulate stress level. Exercise de-stresses the body. DIS-stress (bad stress) can disrupt the individual’s ability to maintain the delicate balance of hormones, ketones, free fatty acids, and urine output.

Although physical activity is in an important part of a healthy lifestyle, the NIDDK suggests that you talk with your health care team before beginning a new exercise program, especially if you have other health problems. They can help you determine a safe range for your blood glucose level and the best time of day to exercise based on many factors, including your diabetes medication.  If taking insulin, it is imperative to balance activity with insulin doses and meals to avoid low blood glucose, or hypoglycemia.  Your health care team may suggest that you check your blood glucose level before, during, and immediately after exercise.


1.     Avoid stressful activities to the feet. Wear appropriate shoes, even during vertical water exercise.

2.     Avoid exercise when blood sugar levels are greater than 250 mg/dl. (Consult health care team for your specific guidelines.)

3.     Avoid exercise if blood pressure is elevated above 160 systolic/100 diastolic. (Consult health care team for your specific recommendations.)

4.     If you have retinopathy, a disorder of the retina that may be a complication of diabetes or high blood pressure, your health care team will give you specific exercise precautions, which may include contact sports and heavy weightlifting.

5.     Avoid exercising in extreme weather conditions.


In addition to a healthy diet and proper medication, regular physical activity is crucial for managing diabetes or reversing pre-diabetes.  For more information on managing your diabetes and how exercise fits into your wellness equation, visit the American Diabetes Association (ADA) website, diabetes.org.  Regular exercise can help you be in control of your life!



Dr. Karl Knopf has been involved in health and fitness for over 45 years, working in almost every aspect of the industry – from personal trainer and therapist to consultant. While at Foothill College, he was the Director of the Fitness Therapy Program, a teacher of adaptive PE, and recognized with several awards for teaching excellence. For 15 years, Dr. Knopf served as the President and Founder of Fitness Educators Of Older Adults. He has authored many articles, has written over 20 books, and has been a frequent guest on the Sit and Be Fit television show.

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