A recent study revealed that HIIT (high-intensity interval training) exercise was the most effective in helping people with weight-loss goals and for lowering blood sugars in those with type 2 diabetes.
Think you have to be able to flip tires and do pull-ups to perform a high-intensity workout? Think again!
High-intensity exercise is really more about what your heart-rate and muscles are doing, rather than exactly the type of exercise you’re doing, explains the study:
High-intensity interval training (HIIT) involves bouts of maximum or near-maximum effort, with only a short period of rest in between. For example, instead of running for an hour straight, a person might run 20-yard sprints for, say, 15 minutes with small rest periods in between. Depending on how much effort a person puts into their workout, HIIT can result in as many as 22 calories burned per minute.
Sprints? If you've never run sprints before and you're thinking, There's no way I can run fast enough to run a sprint! Keep in mind that a sprint can be whatever speed is fast in relation to your abilities.
Your sprint doesn't have to win races, it just has to be an intensity that you can only maintain for 20 yards (that's less than 30 seconds of sprinting!), followed by a 30 second rest period, then another sprint, and so on, for 15 minutes.
And that's it: 15 minutes of exercise. The intensity of your exercise, even though it was only for 15 minutes, has shown to pay-off in terms of burning body fat, calories, and overall blood sugar level improvements than compared to exercising by jogging at a steady pace you can maintain for 30 minutes or more.
With the rise in popularity of exercise programs like CrossFit and P90x, the old days of running for hours on a treadmill to get in shape are over, explains the study.
For the purpose of their meta-analysis, researchers from the University of Leicester and the National Institute of Health Research Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit collected 50 studies that analyzed the effects of HIIT and regular, continuous training.
The studies involved a total of 2,033 participants aged 21 to 68, with 1,383 of them undergoing a HIIT intervention. The fitness levels of the participants ranged from very active to sedentary but healthy to overweight or obese this last group had also developed metabolic syndrome or another chronic disease like cancer or heart failure.
The overall goal was to pool the available evidence linking HIIT to outcomes relating to type 2 diabetes [i.e. insulin resistance, blood glucose, and HbA1c], lead researcher Charlotte Jelleyman told Medical Daily in an email. Prior to our study the overall effect on these outcomes was unclear.
The researchers compared HIIT to other types of exercise and established the following results:
This study involved a meta-analysis of experimental research, allowing us to pull together evidence and establish cause and effect, lead researcher Charlotte Jelleyman said in a press release. We have demonstrated that HIIT conveys benefits to cardiometabolic health, which, in the cases of insulin resistance and aerobic fitness, may be superior to the effect of traditional continuous training.
Just remember: start at your own level. The intensity is rated based on what you personally can do. If it feels intense for you're intense enough that you would only maintain that level of intensity for a short burst followed by a short rest, then you've found a great intensity level! And you'll be surprised at how quickly your ability to push yourself improves!
Any additional exercise to what an individual is currently doing will be beneficial, explains Jelleyman said. Short bouts of exercise broken up with recovery periods is a manageable way of beginning an exercise training program and can be built on to longer or more intense bouts.

We're all told that exercise is great for our health, and as people with diabetes, it's even more important to incorporate an exercise routine into our daily lives. But what exercise does to our blood sugar is a whole different matter. Here, we'll sort out the mush and explain exactly how exercise impacts blood sugar, and what to do to prepare! Just a reminder to always consult your doctor before starting a new exercise routine (I am not a doctor).
What Happens to Our Blood Sugar When We Exercise?
When you exercise, especially during cardiovascular exercise (cardio), your body uses glucose as energy, whether or not you have an adequate amount of insulin in your body. If you do have insulin on board (IOB), then you're likely to experience hypoglycemia and will need to treat with fast-acting sugar. Remember to always check your blood sugar before and after exercise (it’s even better to wear a continuous glucose monitor during exercise).
During cardio, the body used two sources of fuel: sugar and free fatty acids to generate energy. Sugar energy is released from the blood, liver, and muscles. During the first 15 minutes of exercise, sugar is released mostly from the blood (your blood sugar) and muscles, with fuel (glycogen) eventually being released from the liver. After about 30 minutes, energy is released from fat stores (free fatty acids). This is how exercise depletes sugar and glycogen stores, often resulting in a lag effect of low blood sugar. Physical activity can lower your blood sugar up to 24 hours after you work out, by making your body more sensitive to insulin, so be wary of post-workout lows.
A good way to prevent lows during and after exercise is to make sure your blood sugar is sufficiently level before you start and to have snack with some fat and protein before working out. It's also helpful to not exercise when your insulin is peaking (if you just ate breakfast and have dosed a meal bolus within the past 90 or so minutes). What some people with diabetes recommend is eating a low or no carbohydrate meal before exercising (as opposed to a moderate or high carb meal), so you have less insulin on board. There's less room for error, and the less active insulin you have in your body, the less likely you are to go low during exercise.
If your exercise routine is longer than several hours, reducing basal insulin post-exercise, and eating plenty of high fat and high protein foods can stave off lows for the next 24 hours.
Why Do Some People Suffer from Hyperglycemia When they Exercise?
Some people experience hyperglycemia as a result of exercise, and while this phenomenon is rarer, it does still happen. So, what gives? High blood sugar usually occurs during weightlifting or strength training. Weightlifting has been known to provoke the adrenal glands of the body, initiating the flight or fight response, which releases certain hormones and glucose in the bloodstream that can make your blood sugar skyrocket. Certain competitive events, such as races, also cause the body to release adrenaline, which has adverse effects on blood sugar, too.
When you're doing anaerobic activities, with short bursts of energy (during weightlifting, for example), the body releases huge amounts of adrenaline. That adrenaline signals your liver to release large amounts of sugar into your bloodstream, resulting in high blood glucose levels. In people without diabetes, their blood sugars fall naturally after a few hours, but insulin-dependent diabetics may sometimes require a post-workout insulin dose.
A good way to help prevent hyperglycemia during strength training and weightlifting exercises is to use a temporarily increased basal program during the duration of your workout and to avoid a high carbohydrate meal before starting. Test your blood sugar often, and do not exercise if you have or develop ketones, as this can make you very sick. You know your body best, and it's best when you listen to its cues!
Ultimately, the impact that physical activity has on your blood sugar will vary depending on the intensity of your exercise, the type of your exercise, how long you exercise, and many other factors, but one thing that we can all agree on is that exercise is great for people with diabetes. It can help you respond to insulin better, lower your risk for heart disease, help you lose weight, and will increase your confidence. Learn your body, and how exercise can best benefit you.
The importance of exercise when you have diabetes
For people who have diabetes or almost any other disease, for that matter, the benefits of exercise can't be overstated. Exercise helps control weight, lower blood pressure, lower harmful LDL cholesterol and triglycerides, raise healthy HDL cholesterol, strengthen muscles and bones, reduce anxiety, and improve your general well-being. There are added benefits for people with diabetes: exercise lowers blood glucose levels and boosts your body's sensitivity to insulin, countering insulin resistance.
Many studies underscore these and other benefits from exercise. Following are some highlights of those results:
In general, the best time to exercise is one to three hours after eating, when your blood sugar level is likely to be higher. If you use insulin, it's important to test your blood sugar before exercising. If the level before exercise is below 100 mg/dL, eating a piece of fruit or having a small snack will boost it and help you avoid hypoglycemia. Testing again 30 minutes later will show whether your blood sugar level is stable.
It's also a good idea to check your blood sugar after any particularly grueling workout or activity. If you're taking insulin, your risk of developing hypoglycemia may be highest six to 12 hours after exercising. Experts also caution against exercising if your blood sugar is too high (over 250), because exercise can sometimes raise blood sugar even higher.
Because of the dangers associated with diabetes, always wear a medical alert bracelet indicating that you have diabetes and whether you take insulin. Also keep hard candy or glucose tablets with you while exercising in case your blood sugar drops precipitously.

Are you looking to add some supplements to your overall diabetes wellness plan or are you concerned about a deficiency?
There are a few things you should know.



Vitamin D is a nutrient that is vital for many physiological functions. It is a fat-soluble vitamin that promotes the appropriate absorption of calcium in the body, and thus plays a central role in bone health. It is also involved in many other processes, including neuromuscular and immune system functions and various inflammatory pathways. As such, vitamin D deficiency is relevant in a variety of health conditions, including bone disorders, cancers, and diabetes.
Vitamin D and Type 1 Diabetes
It is known that many different cell types can be affected directly by vitamin D, including the pancreatic beta cells (which secrete insulin), as well as immune cells
Research has shown that lower than adequate levels of vitamin D are associated with an increased risk for developing various autoimmune conditions, including type 1 diabetes. Also, adequate vitamin D levels may help support glucose metabolism by several mechanisms, including direct effects on pancreatic beta cells, as well as by improving insulin sensitivity.
In fact, a recent study conducted on youth with type 1 diabetes revealed that
Patients under vitamin D supplementation exhibited a better metabolic control and a lower insulin requirement than not supplemented children, suggesting a role of vitamin D treatment in glycemic control and insulin sensitivity.
More research is needed to fully elucidate the mechanisms underlying the positive effects on vitamin D in helping to prevent type 1 diabetes, as well as in improving glycemic control. However, achieving optimal vitamin D levels, especially in those predisposed to developing type 1 diabetes, as well as in those with type 1 diabetes appears to be a reasonable strategy for prevention and improved outcomes in these patient populations.
Vitamin D and Type 2 Diabetes
Numerous studies have demonstrated that patients with obesity, metabolic syndrome, and type 2 diabetes are more likely to be deficient in vitamin D as compared to healthy controls. Among those with type 2 diabetes, it is estimated that approximately 20% are deficient in vitamin D.
Also, among patients with type 2 diabetes, lower levels of vitamin D are linked to worse glycemic control as compared to those with normal vitamin D levels. A recent literature review highlights that more investigation into the efficacy of vitamin D supplementation in this population is needed. As of now, the experts suggest that vitamin D supplementation could be effective at improving glycemic control in vitamin D deficient or non-obese type 2 diabetes patients.
Vitamin D Supplementation
Vitamin D deficiency is a widespread and global issue that can usually be prevented. Vitamin D can be found in a few food sources, such as fatty fish, some organ meats, egg yolks, or fortified products (e.g., milk). Alternately, it can be taken orally as a supplement and is also produced in the body in response to sunlight.
Although it is important to get enough vitamin D, too much vitamin D can also be harmful. Experts explain that, Vitamin D toxicity can cause non-specific symptoms such as anorexia, weight loss, polyuria, and heart arrhythmias. More seriously, it can also raise blood levels of calcium which leads to vascular and tissue calcification, with subsequent damage to the heart, blood vessels, and kidneys.
The specific recommended upper limits differ based on age and other factors. Thus, it is important to consult with a healthcare provider about supplementing vitamin D and how to do so safely. They may perform testing for vitamin D deficiency and advise you concerning the specific supplementation recommendations for you, if needed.
Summary
It has been shown that adequate vitamin D levels may help protect against the development of type 1 and type 2 diabetes, although the exact reasons for this are not entirely understood yet. Furthermore, adequate vitamin D intake may help improve glycemic control in patients with diabetes. For patients with diabetes or those at risk for developing the condition, it is reasonable to talk to a healthcare provider about further testing for vitamin D deficiency and discuss the need for the appropriate supplementation.

If you have type 2 diabetes, you know that certain foods particularly foods that are high in carbohydrates can send your blood glucose (sugar) level through the roof. But did you know that there's a long list of other factors, such as too little sleep, illness, even monthly menstrual cycles, that can sabotage your best efforts to stabilize your blood sugar?
High on that list, though you may not be aware of it, is stress.
Whether it's related to work, to relationships, or to some other aspect of your life, research has continually shown that emotional stress can cause blood sugar to surge, according to the American Diabetes Association (ADA). And because consistent management of blood sugar is the key to living a healthy life with type 2 diabetes, it's important to understand how stress affects you and to find healthy ways to cope when mental distress mounts.
That's especially true right now when the novel coronavirus is top of mind and everyone's stress level is sky-high. In addition to heightening health worries, the COVID-19 pandemic comes with immense economic and daily living stressors. Whether you've lost your job, are working from home, helping your kids with e-learning, or quarantined by yourself, it's natural to feel stress.
As if stress weren't bad enough on its own, it can contribute to irregular blood-sugar levels.
The Effect of Stress on Blood Sugar
Stress triggers an increase in the body's levels of the fight-or-flight hormone cortisol, as if you were under attack, explains Roger McIntyre, MD, professor of psychiatry and pharmacology at the University of Toronto in Canada. In response, the body releases extra energy into the bloodstream in the form of glucose. (That way, in case you are under attack, you have the fuel necessary to fight or flee.)
When chronically heightened, cortisol works against glucose control even in people who don't have diabetes, Dr. McIntyre says. Yet people with diabetes are unable to properly process and store that glucose because of insulin resistance, meaning that glucose accumulates even more in their blood in times of stress.
Everyone gets stressed out at times, but it's important to understand that there's a difference between short-term (acute) and long-term (chronic) stress, he says. While life's inevitable acute stressors getting stuck in traffic, bickering with a family member cause a temporary rise in blood sugar, it's the factors that can lead to chronic stress, such as an unhappy marriage, a cruel boss, or the COVID-19 quarantine, that can cause serious damage.
What's more, stress can start to undo the routines you put in place to manage type 2 diabetes. You may start to eat more, change your behavior, or exercise less, says Renata Belfort De Aguiar, MD, PhD, an assistant professor of medicine in endocrinology at the Yale School of Medicine in New Haven, Connecticut. Campbell agrees: Not only does long-term stress cause chronic high blood sugar but it can affect how you take care of yourself. This includes both your physical and mental self.
Diabetes is even considered to be an independent factor in the development of depression, according an analysis published in June 2019 in Preventive Medicine Reviews. That means that if you take two otherwise identical people, the one with diabetes is significantly more likely to struggle with depression.
Is It Only 'Negative Stress' That Affects Blood Sugar?
Even positive life changes can cause blood sugar to swing, says Amy Campbell, RD, a certified diabetes care and education specialist, and a contributor to DiabetesSelfManagement.com. Planning a wedding, moving to a new city, getting a job promotion such happy stressors can also send your fight-or-flight hormones into overdrive.
A past review cited the definition of stress as the physiological or psychological response to an external stimulus, regardless of whether that stimulus is good or bad. That means that if you experience a significant change in your life whether it's positive or negative it's a good idea to keep an extra-close watch on your blood sugar.
10 Ways to Maintain a Healthy Balance
It's not possible, of course, to eliminate all of life's headaches. But you can take steps to gain better control over both your blood sugar levels and your stress levels. Start here:
1. When Stress Strikes, Closely Monitor Your Blood Sugar
When you're stressed, you should be monitoring and checking your sugars to see if the stress is having an effect or not, Dr. Belfort De Aguiar says. Simply being aware that stressful situations can affect blood sugar can prepare you to make adjustments. When you're under a lot of stress, that's when you want to be really on top of your blood sugar, Campbell says. It's the time to hone your self-care behaviors.
2. Fill Your Doctor in on Big Life Changes
If a stressful situation is causing your blood sugar to swing, your healthcare team needs to know. Says Campbell, Your doctor may temporarily change your diabetes medication or put you on a higher dose. If necessary, he or she can even make a referral to a mental health professional. Right now, increasingly more primary care physicians, psychologists, and other healthcare professionals are offering telehealth services (covered by insurance the same way in-person appointments are) so that you can get the help you need while maintaining social distancing practices.
3. If Possible, Eliminate Long-Term Stressors for Your Health's Sake
McIntyre says that too much stress can be a warning that something needs to change. Since long-term stressors affect your long-term blood sugar levels and can cause damage to your overall health, they're even more worthy of a reevaluation. Is it your job that's tipping you over the edge? If so, he suggests that you have a conversation with your boss on how to improve your work environment, apply for a transfer, or even start the hunt for a new job.
4. Cut Back on Short-Term Stressors That Can Accumulate
Minor annoyances have only a minor effect on your blood glucose level, but when the annoyances are strung together day after day, that effect can mount, McIntyre says. Be mindful of little things that consistently get under your skin and try to avoid or reduce how often you run into them. For example, if you're realizing that your highly trafficked commute to work drives you crazy, search for a route with less gridlock, or try getting an earlier start to beat the rush.
5. Arm Yourself With (Healthy) Quick Fixes
The toll stress takes on your health largely depends on how you react to it, Campbell says. Identify things that help you cool off, and keep them ready-to-go in your back pocket. Maybe you treat yourself to a massage or a manicure, she says. Or maybe you just talk to someone. Okay, a professional massage might not be possible at the moment, but maybe you have a significant other who can lend a hand. Focusing on your breath is another simple way to calm your mind and body, wherever you are. If you have an Apple device, open the free Breathe app, and let it help you slow and deepen your breath.
6. Practice Mindfulness to Promote a Feeling of Calm
Whether you choose deep-breathing exercises, meditation, or yoga, mindfulness techniques are designed to help you reduce stress.
A short-term randomized controlled trial of 60 people with type 2 diabetes found that those who used mindfulness-based stress reduction techniques saw improved fasting blood sugar and A1C (two measures of blood sugar management) and lower levels of anxiety and depression. Researchers published those results in 2018 in the Journal of Diabetes Research.
Explore a variety of relaxation techniques, Belfort De Aguiar suggests, to find one that works for you. If you have trouble winding down, apps such as Headspace and Calm (which offer free trials) are popular, budget-friendly options for learning how to practice mindfulness.
7. De-Stress by Working It Out on a Regular Basis
Physical activity is crucial for people with type 2 diabetes for many reasons. In particular, exercise lowers blood sugar by increasing insulin sensitivity (meaning that the insulin does a better job of processing glucose), according to a joint position statement from the American College of Sports Medicine and the American Diabetic Association. But a good workout is also a great way to blow off steam and rein in stress levels.
Even a quick walk can help — says Campbell, Not only will getting out and walking remove you from a stressful situation, but it can help improve your mood. (During COVID-19, just be sure to keep your six feet of social distancing space.)
A study published in June 2018 in the Journal of Exercise Rehabilitation shows that any form of regular movement, regardless of exercise limitations, reduces feelings of stress.
8. Seek Support in Reducing Stress
Living with type 2 diabetes can be intrinsically stressful. Called diabetes burnout, overwhelm and fatigue caused by blood sugar testing, carb-counting, insulin administration, doctor visits, and other facets of diabetes management can negatively affect both physical and emotional health, according to the ADA.
Take advantage of your support circle. A family member, friend, or other source of support who will listen to you can make a big difference in the way you manage stress, Campbell says, adding, You can also talk to a counselor or join an online support community. The ADA recommends diabetes support groups as a way to connect with people who understand what you're going through and to share management and coping advice. Check out The ADA Mental Health Provider Referral Directory to find nearby groups that, when the pandemic is over, you can join in person.
9. Stay Organized to Improve Your A1C and Lower Stress
Staying organized about all the aspects of your care doctor's appointments, at-home blood-glucose monitoring, medication schedules can help with overall diabetes management. According to past research, maintaining solid organizational practices are linked to lower chronic cortisol levels, and finding a diabetes-management routine that works for you will also reduce the risk of health complications.
10. Recharge Your Batteries by Getting a Good Night's Sleep
Plenty of research shows that lack of adequate sleep can lead to emotional strain for example, a study published in the Journal of Neuroscience shows that sleep deprivation is a contributing factor to anxiety disorders. What's more, poor sleep may cause blood sugar levels to swing: In a large study published in Diabetes Care, people with type 2 diabetes who slept less than 4.5 hours per night had higher blood sugar levels than those who slept 6.5 to just over 7 hours a night. Sleeping too much (more than 8.5 hours) was also associated with higher blood sugar. Getting enough sleep can help your diabetes management, Campbell says. If you're not sleeping well at night, discuss the matter with your doctor.
The Wrong Way to Deal With Stress When You Have Diabetes
Food, alcohol, self-pity: These unhealthy coping mechanisms do more harm than good. When we're stressed out, we turn to unhealthy food comfort food and we may start eating a lot of sweets, Belfort De Aguiar says. These are the wrong ways to cope with stress.
Also, find ways to reach out and find social connection with your loved ones. Campbell also warns against keeping your emotions bottled up inside. Be sure to share your stress, she says, even it just means having someone listen to you vent.
Often, starting a workout program for type 2 diabetes isn’t the problem; staying with the routine is. Try these tips from diabetes experts to keep you going strong.
There's no doubt that regular exercise is beneficial for people managing diabetes. At the most basic level, exercise increases insulin sensitivity, research shows, which affects weight and blood sugar levels.
While a pandemic may seem like an inopportune time to start prioritizing physical activity, it's anything but. The Centers for Disease Control and Prevention (CDC) reports that people with underlying health conditions, including those with diabetes are at higher risk for severe illness from COVID-19, especially among those whose condition isn't well managed. Thus, there's no better time to put your health first.
Why Exercise Is Important for Type 2 Diabetes Management
Insulin is a hormone made by your pancreas, and your body needs it to deposit glucose, which is the body's main source of energy, into your cells, says Jill Weisenberger, RDN, CDCES, who's based in Newport News, Virginia, and is the author of Diabetes Weight Loss — Week by Week. Exercise helps train the body to use insulin better long term, Weisenberger says.
Exercising can be as simple as taking a walk the trick is continuing to take those steps regularly to help you manage type 2 diabetes. Regular physical activity can help boost your weight loss efforts, and even a small amount of weight loss just 5 to 10 percent of your body weight can improve your A1C, according to John Hopkins Medicine.
Regular exercise can help reduce blood pressure and cholesterol levels, which helps lower your risk of heart disease, says Matthew Corcoran, MD, CDCES, an endocrinologist with Shore Physicians Group in Northfield, New Jersey, and founder of the Diabetes Training Camp in Lancaster, Pennsylvania.
How Much Exercise Do People With Diabetes Need?
According to the American Diabetes Association (ADA), most adults with type 1 and type 2 diabetes need at least 150 minutes of moderate-to-vigorous exercise every week, spread over a period of at least three days, with no more than two consecutive days of inactivity.
If you're physically fit and engage in high-intensity or interval trainings, you only need 75 minutes per week, notes the ADA.
It's also important to incorporate resistance training two to three days a week, with at least one day in between workouts. You should also avoid prolonged sitting by getting up and moving or stretching for a couple of minutes every half-hour.
People with type 2 diabetes who incorporated both aerobic and strength-training exercises into their routine experienced improved blood sugar control after just 12 weeks, according to a study published in February 2015 in the Journal of Sports Medicine and Physical Fitness. Participants also reported increased energy levels and improved self-esteem.
How to Stick With Your Exercise Plan
Knowing the many benefits of exercise doesn't always make it easy to keep up with your workout plan. If you're having trouble staying motivated, try these seven tips to maintain your momentum and make exercise a permanent part of your diabetes management routine:
1. Take Baby Steps When Beginning an Exercise Routine
If you're a couch potato who suddenly runs 5 miles on your first day of exercise, you'll be sore on day two perhaps with blisters on your feet and ready to throw in the towel. Instead, if you're not used to being active, the ADA recommends starting slowly by walking 10 minutes each day at a comfortable pace. As your fitness levels improve, aim to add three to five minutes to your walking routine each week, until you reach a goal of 30 minutes of brisk walking, five days a week.
2. Choose a Physical Activity You Enjoy Doing
You're also more likely to stick with your exercise plan if it's fun, invigorating, and suits your abilities. For example, if you don't enjoy walking on a treadmill, it will be hard to stay motivated to step on it and stay on it every day. Yet, if you like walking briskly outside, as long as you have the proper gear for the weather, you're likely to make time for it every day, Weisenberger says. Trying new activities can also keep fitness fresh and exciting, Weisenberger notes.