How Much Exercise Is Advised for Patients With Type 2 Diabetes?

GUADALAJARA, MEXICO — Physical activity is important for patients with diabetes. Engaging in healthy exercise requires a personal medical assessment that identifies the type of training a patient can undertake, taking into account his or her previous health status, said Sandro Rosales Rodríguez, MD, a specialist in sports nutrition, during the Multidisciplinary Congress on Diabetes Mellitus. 

Suitable physical activity for health should not jeopardize the physical integrity of those who practice it, Rosales added. “Approximately 3.2 million people die each year due to physical inactivity, which is one of the main risk factors for developing a noncommunicable chronic disorder such as cardiovascular disease, cancer, and diabetes.”

The World Health Organization defines physical activity as any bodily movement produced by skeletal muscles that results in energy expenditure (usually measured in kilocalories). Exercise includes activities performed while working, playing, traveling, and carrying out domestic and recreational tasks. “This definition helps us provide the energy basis for the patient who is going to exercise because it is important to perform not only daily activities,” said Rosales. 

He added that one in three adults globally does not have a sufficient level of physical activity, even though this activity carries significant health benefits and helps prevent noncommunicable diseases.

When describing the benefits of exercise, Rosales pointed out that patients with low physical activity have a decrease in muscle mass, an increase in glycosylated hemoglobin, insulin resistance, and glucose intolerance. “But when that person starts exercising, we see an increase in the preservation or increase of muscle mass, better blood glucose control, a decrease in glycosylated hemoglobin, insulin sensitivity, and greater glucose tolerance.”

Rosales therefore emphasized the importance of an approach that includes exercise prescription in addition to pharmacological management, especially through the performance of low and moderate intensity exercises (from 50% to 75% of VO_2peak). “The American College of Sports Medicine and the American Diabetes Association recommend that patients with type 2 diabetes engage in at least 150 minutes of moderate exercise weekly with strength training two or three times per week,” said Rosales.

The doctor discussed resistance, strength, flexibility, and speed exercises. “The important thing is to understand that in resistance exercises, we work with a weight, and if it is of longer duration, for example, tai chi, we work on strength and endurance.” 

He also mentioned that during the exercise routine, it is important to check the pulse regularly, review glucose levels if possible, or if the patient feels unwell, not to overdo the exercises, not to perform unnecessary stretches, and above all, to maintain a rhythm in breathing. The latter point is important to avoid blood pressure effects or dizziness.

“Muscle pain during exercise is normal, but the patient should not have pulls, cramps, or joint pains. Before ending the activity, it should be reduced slowly, and upon finishing, it is necessary to check the heart rate and glucose levels again,” said Rosales.

Lastly, the clinician mentioned that when engaging in physical activity, the maximum heart rate reached should return to its normal state within 1 minute. If it takes 3 minutes, it means that the necessary physical condition is not present.

Rosales reported having no relevant financial conflicts of interest. 

This story was translated from Medscape Spanish edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.