This is because your liver releases more glucose into the bloodstream so your muscles have enough energy to complete the challenging workout, which causes a spike. The 5 Best Exercises for Insulin Resistance and Metabolic Health. When people think about exercise, they often associate it with weight loss or muscle gain.

The most common types of exercise are: Aerobic exercises — i. Resistance training , or weight lifting — a type of exercise that is normally done with equipment like dumbbells or resistance bands. HIIT high-intensity interval training — which is characterized by repeated, short periods of intense or anaerobic without oxygen movements, such as squat jumps, high knees, or burpees, with brief recovery periods.

What to do: Within 2 hours of a meal, try getting at least 2 but ideally minutes of walking outside, every day. What to do: Start by doing squats until you can comfortably do 3 sets of Swimming Swimming is one of the best aerobic exercises you can do. What to do: Start by incorporating minute swimming sessions into your week and work your way up to an hour.

Burpees Burpees combine a pushup and a jump in one movement. What to do: Start by doing burpees for 30 seconds making sure to give it your all and resting for 30 seconds, and doing at least sets. Hatha yoga Yoga is a practice that is thousands of years old, but research has only recently focused on its effects on health.

Current guidelines for adults ages 18 - 64 suggest that for substantial health benefits, adults should engage in: minutes 2 hours and 30 minutes to minutes 5 hours per week of moderate-intensity exercise, OR 75 minutes 1 hour and 15 minutes to minutes 2 hours and 30 minutes per week of vigorous-intensity aerobic physical activity, OR an equivalent combination of moderate- and vigorous-intensity aerobic activity [14].

Here are examples of weekly workout routines according to intensity level:. Low-intensity workout MONDAY AEROBICS : 30 minutes of walking or light jogging TUESDAY REST WEDNESDAY STRENGTH : 30 minutes of a lower body circuit with bodyweight only 2 sets with 10 reps each of squats, forward lunges, side lunges, calf raises, step-ups THURSDAY REST FRIDAY STRENGTH : 30 minutes of an upper body circuit with bodyweight only 2 sets with 10 reps each of push-ups, crunches, shoulder taps, tricep dips, second plank SATURDAY AEROBICS : 30 minutes of walking or light jogging SUNDAY REST : 30 minutes of yoga optional or light stretching.

Medium-intensity workout MONDAY AEROBICS : minutes of brisk walking, cycling, or swimming TUESDAY ACTIVE RECOVERY : 30 minutes of active yoga Vinyasa or Hatha yoga WEDNESDAY STRENGTH : 30 minutes of a lower body circuit with dumbbells 3 sets with 10 reps each of squats, forward lunges, side lunges, calf raises, step-ups THURSDAY REST FRIDAY STRENGTH : 30 minutes upper body circuit with dumbbells 3 sets with 10 reps each of push-ups on toes or knees, bent-over rows, overhead shoulder presses, overhead tricep extensions, second plank SATURDAY AEROBICS : minutes of brisk walking, cycling, or swimming SUNDAY REST : 30 minutes yoga optional or light stretching.

Set an alarm to move during prolonged sitting periods. Going for a quick 5-minute walk around the block is a great way to get some movement in, but even standing and stretching have an impact on your glucose levels — so try to take calls while standing or invest in a laptop riser for your desk.

Ultimately, you want to enjoy your workout because the more joy you find in it, the more consistent you will be. Add an aerobic finisher i. Using health tools like a CGM can help you identify the effect of your workouts on your glucose levels throughout the day.

If you use a CGM, you may notice that exercise can cause short-term spikes in your blood glucose levels. This is normal as your muscles need this extra glucose to use as energy during and after your workout session. Although exercise is an important component of your health, other factors such as nutrition , sleep, and stress play an important role as well.

Written by: Peyton Lessard, MS. Reviewed by: Emily Johnson, MSc RD. Table of Contents 1. Similarly, individuals undertaking supervised aerobic and resistance exercise achieve greater improvements in A1C, BMI, waist circumference, blood pressure, fitness, muscular strength, and HDL cholesterol Thus, supervised training is recommended when feasible, at least for adults with type 2 diabetes.

Women with preexisting diabetes of any type should be advised to engage in regular physical activity prior to and during pregnancy.

Pregnant women with or at risk for gestational diabetes mellitus should be advised to engage in 20—30 min of moderate-intensity exercise on most or all days of the week. Physical activity and exercise during pregnancy have been shown to benefit most women by improving cardiovascular health and general fitness while reducing the risk of complications like preeclampsia and cesarean delivery Regular physical activity during pregnancy also lowers the risk of developing gestational diabetes mellitus , Once gestational diabetes mellitus is diagnosed, either aerobic or resistance training can improve insulin action and glycemic control In women with gestational diabetes mellitus, particularly those who are overweight and obese, vigorous-intensity exercise during pregnancy may reduce the odds of excess gestational weight gain Ideally, the best time to start physical activity is prior to pregnancy to reduce gestational diabetes mellitus risk , but it is safe to initiate during pregnancy with very few contraindications Any pregnant women using insulin should be aware of the insulin-sensitizing effects of exercise and increased risk of hypoglycemia, particularly during the first trimester Insulin regimen and carbohydrate intake changes should be used to prevent exercise-related hypoglycemia.

Other strategies involve including short sprints, performing resistance exercise before aerobic exercise in the same session, and activity timing. Exercise-induced hyperglycemia is more common in type 1 diabetes but may be modulated with insulin administration or a lower-intensity aerobic cooldown.

Exercising with hyperglycemia and elevated blood ketones is not recommended. Some medications besides insulin may increase the risks of exercise-related hypoglycemia and doses may need to be adjusted based on exercise training. Exercise-induced hypoglycemia is common in people with type 1 diabetes and, to a lesser extent, people with type 2 diabetes using insulin or insulin secretagogues.

In addition to insulin regimen and carbohydrate intake changes, a brief 10 s maximal intensity sprint performed before or after a moderate-intensity exercise session may protect against hypoglycemia Performing high-intensity bouts intermittently during moderate aerobic exercise also slows blood glucose declines 81 , , , as can resistance exercise done immediately prior to aerobic Exercise-induced nocturnal hypoglycemia is a major concern Exercise-induced hyperglycemia is more common in type 1 diabetes.

Purposeful insulin omission before exercise can promote a rise in glycemia, as can malfunctioning infusion sets Individuals with type 2 diabetes may also experience increases in blood glucose after aerobic or resistance exercise, particularly if they are insulin users and administer too little insulin for meals before activity Overconsumption of carbohydrates before or during exercise, along with aggressive insulin reduction, can promote hyperglycemia during any exercise Very intense exercise such as sprinting , brief but intense aerobic exercise , and heavy powerlifting , may promote hyperglycemia, especially if starting blood glucose levels are elevated Hyperglycemia risk is mitigated if intense activities are interspersed between moderate-intensity aerobic ones 82 , Similarly, combining resistance training done first with aerobic training second optimizes glucose stability in type 1 diabetes Millán, personal communication.

Excessive insulin corrections after exercise increase nocturnal hypoglycemia risk, which can result in mortality Adults with diabetes are frequently treated with multiple medications for diabetes and other comorbid conditions.

Some medications other than insulin may increase exercise risk and doses may need to be adjusted , Although appropriate changes should be individualized, Table 4 lists general considerations and guidelines for medications.

Exercise considerations for diabetes, hypertension, and cholesterol medications and recommended safety and dose adjustments. If exercise-induced hypoglycemia has occurred, decrease dose on exercise days to reduce hypoglycemia risk.

May increase risk of hypoglycemia when used with insulin or sulfonylureas but not when used alone. Generally safe; no dose adjustment for exercise but may need to lower insulin or sulfonylurea dose. Doses may need to be adjusted to accommodate the improvements from training and avoid dehydration.

Physical activity increases bodily heat production and core temperature, leading to greater skin blood flow and sweating. In relatively young adults with type 1 diabetes, temperature regulation is only impaired during high-intensity exercise , With increasing age, poor blood glucose control, and neuropathy, skin blood flow and sweating may be impaired in adults with type 1 , and type 2 diabetes, increasing the risk of heat-related illness.

Chronic hyperglycemia also increases risk through dehydration caused by osmotic diuresis, and some medications that lower blood pressure may also impact hydration and electrolyte balance. Active individuals with type 1 diabetes are not at increased risk of tendon injury , but this may not apply to sedentary or older individuals with diabetes.

Given that diabetes may lead to exercise-related overuse injuries due to changes in joint structures related to glycemic excursions , exercise training for anyone with diabetes should progress appropriately to avoid excessive aggravation to joint surfaces and structures, particularly when taking statin medications for lipid control Physical activity with vascular diseases can be undertaken safely but with appropriate precautions.

Physical activity done with peripheral neuropathy necessitates proper foot care to prevent, detect, and prevent problems early to avoid ulceration and amputation. The presence of autonomic neuropathy may complicate being active; certain precautions are warranted to prevent problems during activity.

Vigorous aerobic or resistance exercise; jumping, jarring, head-down activities; and breath holding should be avoided in anyone with severe nonproliferative and unstable proliferative diabetic retinopathy. Exercise does not accelerate progression of kidney disease and can be undertaken safely, even during dialysis sessions.

Regular stretching and appropriate progression of activities should be done to manage joint changes and diabetes-related orthopedic limitations. Macrovascular and microvascular diabetes-related complications can develop and worsen with inadequate blood glucose control , Vascular and neural complications of diabetes often cause physical limitation and varying levels of disability requiring precautions during exercise, as recommended in Table 5.

Physical activity consideration, precautions, and recommended activities for exercising with health-related complications. Coronary perfusion may actually be enhanced during higher-intensity aerobic or resistance exercise. Onset of chest pain on exertion, but exercise-induced ischemia may be silent in some with diabetes.

Stop exercise immediately should symptoms of myocardial infarction such as chest pain, radiating pain, shortness of breath, and others occur during physical activity and seek medical attention. Stop exercise immediately if symptoms of a stroke occurring suddenly and often affecting only one side of the body happen during exercise.

Lower-extremity resistance training improves functional performance Low- or moderate-intensity walking, arm ergometer, and leg ergometer preferred as aerobic activities Regular aerobic exercise may also prevent the onset or delay the progression of peripheral neuropathy in both type 1 and type 2 diabetes Proper care of the feet is needed to prevent foot ulcers and lower the risk of amputation 6.

Keep feet dry and use appropriate footwear, silica gel or air midsoles, and polyester or blend socks not pure cotton. Manage with appropriate footwear and choice of activities to reduce plantar pressure and ulcer risk Moderate walking is not likely to increase risk of foot ulcers or reulceration with peripheral neuropathy May cause postural hypotension, chronotropic incompetence, delayed gastric emptying, altered thermoregulation, and dehydration during exercise 6.

With postural hypotension, avoid activities with rapid postural or directional changes to avoid fainting or falling. With cardiac autonomic neuropathy, obtain physician approval and possibly undergo symptom-limited exercise testing before commencing exercise With blunted heart rate response, use heart rate reserve and ratings of perceived exertion to monitor exercise intensity Individuals with mild to moderate nonproliferative changes have limited or no risk for eye damage from physical activity.

With moderate nonproliferative retinopathy, avoid activities that dramatically elevate blood pressure, such as powerlifting. Individuals with unstable diabetic retinopathy are at risk for vitreous hemorrhage and retinal detachment. Avoid activities that dramatically elevate blood pressure, such as vigorous activity of any type.

Avoid vigorous exercise; jumping, jarring, and head-down activities; and breath holding 6. Cataracts do not impact the ability to exercise, only the safety of doing so due to loss of visual acuity. Exercise does not accelerate progression of kidney disease even though protein excretion acutely increases afterward 6 , Greater participation in moderate-to-vigorous leisure time activity and higher physical activity levels may actually moderate the initiation and progression of diabetic nephropathy — All activities okay, but vigorous exercise should be avoided the day before urine protein tests are performed to prevent false positive readings.

Both aerobic and resistance training improve physical function and quality of life in individuals with kidney disease. All activities okay, but exercise should begin at a low intensity and volume if aerobic capacity and muscle function are substantially reduced.

Doing supervised, moderate aerobic physical activity undertaken during dialysis sessions may be beneficial and increase compliance Exercise should begin at a low intensity and volume if aerobic capacity and muscle function are substantially reduced.

Individuals with diabetes are more prone to structural changes to joints that can limit movement, including shoulder adhesive capsulitis, carpal tunnel syndrome, metatarsal fractures, and neuropathy-related joint disorders Charcot foot In addition to engaging in other activities as able , do regular flexibility training to maintain greater joint range of motion 10 , Stretch within warm-ups or after an activity to increase joint range of motion best Most low- and moderate-intensity activities okay, but more non—weight-bearing or low-impact exercise may be undertaken to reduce stress on joints.

Do range-of-motion activities and light resistance exercise to increase strength of muscles surrounding affected joints. Avoid activities with high risk of joint trauma, such as contact sports and ones with rapid directional changes.

Targeted behavior-change strategies should be used to increase physical activity in adults with type 2 diabetes. For adults with type 2 diabetes, Internet-delivered interventions for physical activity promotion may be used to improve outcomes.

Behavioral interventions can significantly increase physical activity in adults with type 2 diabetes , and A1C reductions produced by such interventions have been sustained to 24 months However, motivational interviewing is not significantly better than usual care , and other intervention factors associated with weight loss, such as number and duration of contacts, have been inconsistent or not associated with greater participation Wearing the device may prompt activity, and it provides feedback for self-monitoring.

Pedometer use in adults with type 2 diabetes increased their daily steps by 1,, but did not improve A1C Using a daily steps goal e. The positive findings for pedometers are not universal , however, and some individuals may require greater support to realize benefits.

Longer-term efficacy and determination of which populations can benefit from pedometers and other wearable activity trackers require further evaluation.

Given that the majority of individuals with type 2 diabetes have access to the Internet, technology-based support is appealing for extending clinical intervention reach.

For adults with type 2 diabetes, Internet-delivered physical activity promotion interventions may be more effective than usual care More evidence is needed regarding social media approaches, given the importance of social and peer support in diabetes self-management Physical activity and exercise should be recommended and prescribed to all individuals with diabetes as part of management of glycemic control and overall health.

Specific recommendations and precautions will vary by the type of diabetes, age, activity done, and presence of diabetes-related health complications. Recommendations should be tailored to meet the specific needs of each individual. In addition to engaging in regular physical activity, all adults should be encouraged to decrease the total amount of daily sedentary time and to break up sitting time with frequent bouts of activity.

Finally, behavior-change strategies can be used to promote the adoption and maintenance of lifetime physical activity. Duality of Interest. No potential conflicts of interest relevant to this article were reported. This position statement was reviewed and approved by the American Diabetes Association Professional Practice Committee in June and ratified by the American Diabetes Association Board of Directors in September Sign In or Create an Account.

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Volume 39, Issue Previous Article Next Article. TYPES OF EXERCISE AND PHYSICAL ACTIVITY. BENEFITS OF EXERCISE AND PHYSICAL ACTIVITY. PHYSICAL ACTIVITY AND TYPE 2 DIABETES. PHYSICAL ACTIVITY AND TYPE 1 DIABETES.

PHYSICAL ACTIVITY AND PREGNANCY WITH DIABETES. Article Information. Article Navigation. Position Statement October 11 Colberg ; Sheri R.

Corresponding author: Sheri R. Colberg, scolberg odu. This Site. Google Scholar. Ronald J. Sigal ; Ronald J. Jane E. Yardley ; Jane E.

Michael C. Riddell ; Michael C. David W. Dunstan ; David W. Paddy C. Dempsey ; Paddy C. Edward S. Horton ; Edward S. Kristin Castorino ; Kristin Castorino. Deborah F. Tate Deborah F.

Diabetes Care ;39 11 — Get Permissions. toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. B Prolonged sitting should be interrupted with bouts of light activity every 30 min for blood glucose benefits, at least in adults with type 2 diabetes.

C The above two recommendations are additional to, and not a replacement for, increased structured exercise and incidental movement. B Adults with type 2 diabetes should ideally perform both aerobic and resistance exercise training for optimal glycemic and health outcomes.

C Children and adolescents with type 2 diabetes should be encouraged to meet the same physical activity goals set for youth in general. B Insulin users can exercise using either basal-bolus injection regimens or insulin pumps, but there are advantages and disadvantages to both insulin delivery methods.

C Continuous glucose monitoring during physical activity can be used to detect hypoglycemia when used as an adjunct rather than in place of capillary glucose tests. Table 1 Suggested carbohydrate intake or other actions based on blood glucose levels at the start of exercise.

Pre-exercise blood glucose. Carbohydrate intake or other action. Initiate mild-to-moderate exercise and avoid intense exercise until glucose levels decrease. View Large. Table 2 Suggested initial pre-exercise meal insulin bolus reduction for activity started within 90 min after insulin administration.

Exercise intensity. Exercise duration. C Individuals with diabetes or prediabetes are encouraged to increase their total daily incidental nonexercise physical activity to gain additional health benefits. C To gain more health benefits from physical activity programs, participation in supervised training is recommended over nonsupervised programs.

Table 3 Exercise training recommendations: types of exercise, intensity, duration, frequency, and progression. Flexibility and Balance. Type of exercise Prolonged, rhythmic activities using large muscle groups e. C Pregnant women with or at risk for gestational diabetes mellitus should be advised to engage in 20—30 min of moderate-intensity exercise on most or all days of the week.

C Exercise-induced hyperglycemia is more common in type 1 diabetes but may be modulated with insulin administration or a lower-intensity aerobic cooldown.

C Some medications besides insulin may increase the risks of exercise-related hypoglycemia and doses may need to be adjusted based on exercise training.

C Exercise training should progress appropriately to minimize risk of injury. Table 4 Exercise considerations for diabetes, hypertension, and cholesterol medications and recommended safety and dose adjustments.

Exercise considerations. B Physical activity done with peripheral neuropathy necessitates proper foot care to prevent, detect, and prevent problems early to avoid ulceration and amputation.

B The presence of autonomic neuropathy may complicate being active; certain precautions are warranted to prevent problems during activity. C Vigorous aerobic or resistance exercise; jumping, jarring, head-down activities; and breath holding should be avoided in anyone with severe nonproliferative and unstable proliferative diabetic retinopathy.

E Exercise does not accelerate progression of kidney disease and can be undertaken safely, even during dialysis sessions. C Regular stretching and appropriate progression of activities should be done to manage joint changes and diabetes-related orthopedic limitations.

Table 5 Physical activity consideration, precautions, and recommended activities for exercising with health-related complications.

Health complication. All activities okay. Consider exercising in a supervised cardiac rehabilitation program, at least initially. Exertional angina Onset of chest pain on exertion, but exercise-induced ischemia may be silent in some with diabetes. Hypertension Both aerobic and resistance training may lower resting blood pressure and should be encouraged.

Some blood pressure medications can cause exercise-related hypotension. Ensure adequate hydration during exercise. Avoid Valsalva maneuver during resistance training.

Myocardial infarction Stop exercise immediately should symptoms of myocardial infarction such as chest pain, radiating pain, shortness of breath, and others occur during physical activity and seek medical attention. Restart exercise after myocardial infarction in a supervised cardiac rehabilitation program.

Start at a low intensity and progress as able to more moderate activities. People taking insulin or insulin secretagogues oral diabetes pills that cause your pancreas to make more insulin are at risk for hypoglycemia if insulin dose or carbohydrate intake is not adjusted with exercise.

Checking your blood glucose before doing any physical activity is important to prevent hypoglycemia low blood glucose. Talk to your diabetes care team doctor, nurse, dietitian, or pharmacist to find out if you are at risk for hypoglycemia.

This may be:. Check your blood glucose again after 15 minutes. If you want to continue your workout, you will usually need to take a break to treat your low blood glucose.

Keep in mind that low blood glucose can occur during or long after physical activity. It is more likely to occur if you:. If hypoglycemia interferes with your exercise routine, talk to your health care provider about the best treatment plan for you.

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Revision Received:. Get Permissions. toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. Often, a person may do some combination of all three of these exercise types during the week. Some workouts, like metabolic conditioning , intentionally incorporate aspects of all three to target the way your body uses and stores energy.

But are there specific exercises, frequencies, and durations that you can focus on in order to get the most out of your workouts? Read on for our research-backed tips.

In fact, walking is one of the most effective things you can do for your metabolic health. Studies have shown that walking for even just 2 minutes after eating a meal can help lower your postprandial post-meal glucose response, though walking for about minutes is even better for glycemic regulation — all of which can prevent your body from developing insulin resistance [2].

Other research in obese women found that walking minutes 3 times per week for 12 weeks resulted in weight loss and improved insulin sensitivity [3]. Interestingly, even just standing up throughout the day can reduce your postprandial glucose levels by about 9.

The takeaway to keep in mind is that living a sedentary life — i. Within 2 hours of a meal, try getting at least 2 but ideally minutes of walking outside, every day. Squats also require core stabilization — another bonus. Although research on squats and insulin resistance is limited, one study found that engaging in resistance or strength training exercises in general for less than one hour per week was associated with a lower risk of metabolic syndrome , independent of aerobic exercise [5].

Start by doing squats until you can comfortably do 3 sets of Repeat these 3 sets of 10 squats at least times per week. After that, you can add weight dumbbells or a weighted backpack , but be sure to have a foundation and proper form before adding on any extra weight.

Swimming is one of the best aerobic exercises you can do. Research also shows that swimming can improve your insulin sensitivity. One study performed on both healthy participants and individuals with metabolic syndrome found that a swimming routine that consisted of 4 sessions per week at 15, 30, 45, and 60 minutes respectively for 3 months helped reduce HOMA-IR, which is an insulin resistance score [8].

Start by incorporating minute swimming sessions into your week and work your way up to an hour. You can mix one or two swimming sessions per week with walking, jogging, cycling, or other aerobic activities. Burpees combine a pushup and a jump in one movement.

One review looked at 50 studies that examined the effects of HIIT on markers of metabolic health including glucose regulation and insulin resistance [9].

In both groups, there was a reduction in insulin resistance after the HIIT workout. Participants at risk of or with type 2 diabetes had reductions in fasting glucose levels. Start by doing burpees for 30 seconds making sure to give it your all and resting for 30 seconds, and doing at least sets.

Keep doing this for about 10 minutes. If you want to switch things up, alternate burpees with exercises like mountain climbers, high knees, and jumping jacks. Repeat this HIIT-style workout times per week, and gradually increase the time per workout to minutes.