Exercise is a cornerstone in the management of diabetes and the prevention of diabetic complications. When combined with a nutritious diet and medication (if prescribed), regular exercise provides significant benefits for individuals with diabetes. These include:

• Lowering glucose (blood sugar) levels. Diabetes is characterized by the inability to produce or efficiently use insulin, a hormone that regulates glucose. Too much or too little glucose in the bloodstream can result in a variety of medical complications. Muscles use glucose for energy during exercise. The increased blood flow during exercise expands blood vessels and allows more glucose and oxygen to enter the muscles. The body taps into its blood glucose reserves during and after activity to fulfill this energy requirement, reducing blood glucose levels for several hours after exercise. The degree of reduction depends on the duration and intensity of the exercise session.
  
  
• Reducing insulin resistance (a condition in which the cells have a diminished response to insulin). Insulin resistance occurs when the body produces a sufficient amount of insulin but is unable to detect its presence or use it efficiently. Dysfunction in using insulin impairs control of glucose, which can be very dangerous. Insulin resistance is a key component of type 2 diabetes and gestational diabetes. People with type 1 diabetes who become sedentary and overweight can develop insulin resistance, a condition known as double diabetes.
  
  
• Reducing high blood pressure. Elevated blood pressure occurs when the tension of the blood in the walls of the arteries is greater than normal. It is a major risk factor for developing the cardiovascular problems common to people with diabetes.
  
  
• Improving cholesterol (a substance similar to fat that is present in all humans) profile. Studies indicate that regular physical activity helps improve total cholesterol in three ways:
  
  
• Increases high density lipoprotein (HDL) cholesterol. Commonly referred to as “good” cholesterol, HDLs travel freely throughout the bloodstream and do not cling to the walls of arteries. HDLs help prevent heart disease and stroke by carrying cholesterol away from the arteries, back to the liver and out of the body.
  
  
• Reduces low density lipoprotein (LDL) cholesterol. Also known as “bad” cholesterol, LDLs cling to artery walls and hinder blood flow to body parts.
  
  
• Reduces triglycerides (fatty material that circulates through the blood or is stored as fat tissue). Elevated triglyceride levels in the blood increase the risk of plaque buildup and heart disease.
  
  
• Promoting weight loss and management. Adhering to a regular exercise program helps patients achieve and maintain a healthy body weight. Research has demonstrated that it is almost impossible to maintain weight loss without an exercise program. Internal belly fat (fat that lies deep within the abdomen) has been linked to insulin resistance, type 2 diabetes and double diabetes. Frequent physical activity can dramatically reduce fat deposits in the midsection.
  
  
• Reduce dietary restrictions. Many people with diabetes need to limit the amount of food and calories they can eat each day. Because exercise burns calories (units of energy or heat) people with diabetes who participate in regular physical activity are generally able to eat more, control glucose and still maintain a healthy body weight.
  
  
• Relieve stress. Excess stress can raise blood glucose levels. During exercise, the body releases special hormones called endorphins, which induce feelings of relaxation and well-being. These endorphins counteract the effects of stress and lower glucose levels.

Exercise in people with diabetes can also help fight:

• Diabetic angiopathy. Disease that affects the blood vessels. Regular exercise can help reduce excess glucose and body weight, both of which lead to increased risk of angiopathy in people with diabetes.
  
  
• Diabetic neuropathy. Nerve damage that is caused by diabetes. Though the exact cause of neuropathy remains unknown, research indicates that diabetic patients with poor glucose control are more likely to develop this condition than those who regulate their glucose through exercise and nutrition. Exercise and diet in people with prediabetes can reduce neuropathic pain and possibly even reverse nerve damage, researchers have found.
  
  
• Diabetic nephropathy. A kidney disease that is caused by diabetes. It is the most common cause of chronic kidney failure in the United States. Regular physical activity is key in the prevention of this disorder because of the resulting improved glucose control and weight loss or maintenance. For patients undergoing dialysis, exercise has been found to increase effectiveness of sessions and to reduce side effects.
  
  
• Diabetic retinopathy. An eye disease in which the small blood vessels in the retina become swollen and leak fluid. Patients who control their glucose levels and body weight through consistent exercise are less likely to develop retinopathy and other eye conditions.
  
  
• Skin disorders and foot problems. Exercise helps prevent these common diabetic complications by improving circulation and glycemic control.
  
  
• Periodontal disease. Reducing hyperglycemia through physical activity can help prevent dental conditions.