Diabetics can exercise to help burn blood sugar and improve metabolism (handling and processing of nutrients).  A diabetic needs to understand the right kind of exercise that will improve his health.  There are two basic kinds of exercise for a diabetic.  One is aerobic exercise and the other is a weigh-lifting program. 

The point of aerobic exercise for a diabetic is to burn blood sugar.  Dr. Bob Gibson is mentioned many times on this web site.  Dr. Bob was a MD internal medicine, orthomolecular doctor, MD psychiatrist, chiropractor, and healer 65 years.  He was a diabetic who lived to 108 years with only 1 side effect 2 years before he passed away.  He treated diabetics over 50 years.  He recommended 1-3 thirty minute walks a day.  He advised if you wanted to run, to run at an easy pace and walk whenever you needed.  Another method is to walk fast.  Also, Dr. Bob felt walking up stairs as an exercise or walking stairs during daily activity was excellent conditioning for diabetics.  He said lifting half your body weight every step was a great form of exercise.   

Dr. Bob advised for a type II diabetic over age forty, not to reach a pace that will result in your heartbeat exceeding 130 beats per minute.  Dr. Bob said 100-110 would work.  If you go higher, such as 110-120 beats per minute, then take short rests.  Once you push your body into higher ranges you are adding a lot of extra stress.  The stress of exercise can activate cortisol, the stress hormone.  Cortisol's main job is to provide blood sugar and control blood pressure during stress.  The blood sugar provided by cortisol can add to the blood sugar load. This can be dangerous for a diabetic by resulting in hard to control blood sugar surges. “The glucocorticoids are 21-carbon steroids, with many actions; the most important of which is to promote gluconeogenesis.  Cortisol is the predominant glucocorticoid in humans.  (Ref. Robert K. Murray, MD, Ph.D., Daryl K. Granmer, MD, Peter A. Mayes, Ph.D., D.Sc., Victor W. Fodwell, Ph.D., Harper’s Biochemistry, 25^th Edition, Appleton & Lance, Stanford, Connecticut, 2000, Page 575.)”   Also, “gluconeogenesis, the synthesis of glucose from non-carbohydrate sources, such as fat and protein. (Oxford Dictionary of Biology.)” Thus, as the chemistry books explain, cortisol’s primary job is to promote the production of blood sugar from the synthesis of fat and protein.  Cortisol is the body’s stress hormone and is released in response to stress.  Too much stress from exercise can activate cortisol and promote gluconeogenesis.  Thus, exercise may result in blood sugar spikes!  Check with your doctor before beginning any exercise program and discuss with him what would be your maximum heartbeat. 

Type I diabetics need to be careful about aerobic exercise. The stress of exercise can lead to out of control blood sugar surges. Stress can activate cortisol and secretion of cortisol can lead to rapid rises in blood sugar.  A type I should consider doing aerobics at low intensity levels.  This will reduce the strain of the exercise.  A type I diabetic is not interested in burning fat like a type II.  Therefore a lower intensity aerobics workout will still increase fitness and burn blood sugar without adding dangerous risk.  Check with your doctor on any exercise program.  Probably 30 minute walks are enough aerobic exercise for a type I diabetic.  A type I may want to increase intensity by a faster pace.  This should not be done until you have built up your stamina and consulted with your doctor.  The key point, type I diabetics cannot afford too much stress, it may lead to out-of-control blood sugar. 

Type II diabetics can consider weightlifting.  One reason is weightlifting burns fat to gain more muscle.  Muscle cells are more efficient than fat cells and burn more calories.  This means muscle cells are more insulin sensitive than fat cells. Gaining more muscle will improve metabolism.  Another reason for weightlifting is muscle weighs more than fat and this means the body will work harder to move muscle.  This will result in more calories burned to move muscle versus fat.  By lifting weights you will be adding muscle and gaining these benefits. 

Type I diabetics are usually underweight or medium build.  They are also susceptible to wasting and breakdown in the body.  Their body is catabolic; meaning it is breaking down more than normal.  So a type I diabetic can benefit by putting on muscle, which is anabolic (growth stimulating) and counteracts catabolic processes, but they do not want to overdo.  A type I should consider using weights that tire him after 15-30 repetitions.  He should not use heavy weights, to avoid strain that can lead to skyrocketing blood sugar.  Dr. Bob advised no more than 2 or 3 sets per body part.  The workout should be about 30 minutes.  45 minutes is the maximum.  The body secretes anabolic (growth stimulating hormones) hormones for about the first 30-45 minutes of a workout.   After 45 minutes the workout can become catabolic, meaning you are breaking down muscle tissue instead of regrowing it.  This can even lead to a loss of muscle, instead of gaining muscle, which a type I diabetic does not want to happen.  Thus, workouts too long can be detrimental for diabetics. If a type I wants to challenge himself occasionally, he might do the last couple sets of the workout at a little more intensity.  It is essential not to overdo it.  You should discuss with your doctor what is a safe routine.  If the weights you use are too heavy or the workout is too intense you can strain your body.  

The recovery period after the workout is vital to anyone, even more so for a type I diabetic.  The body needs protein after a workout to help grow muscle.  Lack of high quality protein can result in a workout having a catabolic effect.  “The capacity of muscles to degrade branched chain amino acids increases three to five fold during fasting and in diabetes (Ref. Robert K. Murray, MD, Ph.D., Daryl K. Granmer, MD, Peter A. Mayes, Ph.D., D.Sc., Victor W. Fodwell, Ph.D., Harper’s Biochemistry, 25^th Edition, Appleton & Lance, Stanford, Connecticut, 2000, Page 733.)”  The branched chain amino acids are important amino acids found in high concentration in muscle tissue.  They are lost three-to-five times more in diabetics than non-diabetics.  Diabetics should consider protein and protein supplementation to replace these lost amino acids.  Consider a protein malt 1 to 3 hours after you finish your workout.  This will supply the muscles with protein and carbohydrates. The body needs protein in order to grow muscle and carbohydrates to supply the energy for muscle growth.  Without protein the body might catabolize itself from the workout.  Dr. Bob advised eating protein 1-3 hours after workouts.  He said this was the window for eating protein.  Dr. Bob recommended the most optimal time to eat protein was 1 and ½ hours after a workout.   In addition, even when using low carbohydrate protein shakes, some diabetics still have blood sugar spikes from drinking them.  Dr. Bob advised adding 5 grams of multi-fiber (the body needs many different kinds of fiber and this is why multi-fiber is advised) to protein shakes because fiber helps stabilize insulin surges.  However, in the case of blood sugar spikes from drinking protein shakes, he strongly advised 5-10 grams of multi-fiber supplement to aid in controlling the roller coaster blood sugar surges.    

It has also been shown scientifically that a supplement called HMB reduces or stops muscle from breaking down.  For this reason, Dr. Bob advised HMB after a workout for any diabetic, but in particular for a type I diabetic.  In the book, “Younger at Last,” written by national best selling author Steven Lamm, M.D., he recommends “a minimum of 3 grams a day of HMB for both men and women.  Remember, although HMB can help to produce incredible gains in muscle mass, taking it without exercising negates its purpose.  To reap its benefits, you need to give your muscles the workout they require.”  Dr. Bob advised you take ½ your HMB after your workout.  He advised take it with your protein recovery drink.  He advised take the other ½ dose of HMB, with a meal including protein, at another time of the day or evening, after the workout.  Studies have shown these doses to be safe.  For further information on safety read Steven Lamm’s book.  Additionally, Dr. Bob advised supplementing creatine monohydrate, for diabetics and non-diabetics, 1 hour before a workout on an empty stomach.  Creatine monohydrate is a supplement that increases energy to the muscles, which results in reduced fatigue and more energy available in muscles.  This will allow you to train more intensely, thereby boosting your short-term muscle power and long-term muscle growth.  Furthermore, Dr. Bob advised you need to cycle creatine monohydrate for it to remain effective. He said cycle it 6 weeks and then stop for 2 weeks.  Then continue this cycle of 6 weeks taking it and 2 weeks off creatine monohydrate.  There are other forms of creatine supplementation.  Dr. Bob advised using the “monohydrate” form.  These supplement suggestions are for type I and type II diabetics. 

The intensity of the workout should be guided by what is called your "target heart rate."  This is the method type I and type II diabetics can use to determine the intensity of the workout.  Diabetics need to consult with their doctor on what target heart rate they should use, but remember type I diabetics need to workout less intensely then type II diabetics.  The target heart rate is the mathematical age-adjusted maximum heart-rate formula.  This

means subtracting your age from 220; the result is your theoretical maximum heart rate.  For example, if you are forty years old, then your age adjusted maximum heart rate is 220 subtract 40 equals 180.  The moderate zone of exercise is considered 50-60 percent of the maximum heart rate.  This is the rate you should start out an exercise program.  By keeping your heart rate relatively low as you start out exercise, it ensures you are going at an easy pace, with only slight breathlessness.  After your endurance levels build up you might increase your heart rate zone.  Type I diabetics and older diabetics might need to stay at an easy pace.  Before increasing heart rate for workouts, consult with your doctor.  It is vital for type I diabetics and older diabetics not to strain, as this may stress the body, resulting in physical problems and skyrocketing blood sugar.  Type II diabetics need to be careful when moving up the heart rate zone.  This increase should only occur when you are exercising regularly and you can keep up a good pace for twenty to twenty five uninterrupted minutes.  Then the next target zone, according to Dr. Bob, would be 70% percent your maximum heart rate.  It is vital to check with your doctor before making changes from an easy pace to a higher intensity. 

In the book, "Younger At Last," it describes the heart rate monitor.  "The heart rate monitor, when you can strap one around your chest, you now have the most precise gauge of exactly how hard your heart is working when you exercise. A simple three-part device, the monitor consists of a lightweight chest belt, a transmitter, and a watch like receiver worn on the wrist.  On the inner side of the chest belt are two electrodes that sense the heart's electrical signals, relaying that information to the transmitter.  From there the data is continuously sent to the wrist monitor via an electromagnetic field.  The monitor provides visual readouts such as heart rate and pre-selected target training zones for exercise.”

The high-tech monitor is the single most important tool an exerciser can use today.  By keeping within an age-related heartbeat boundary, (Diabetics are a special case due to the chronic stress of diabetes.  Their heart rate zone should be determined by their doctor and the importance of an easy pace to eliminate any chance of strain.  Strain in a diabetic can result in skyrocketing blood sugar.  This note is from the author of this article "Exercise Program for Type I and Type II diabetes.") called your target heart rate, you can accurately and easily regulate the intensity and quality of your aerobic workout. 

There are many companies making heart rate monitors.  However, I have been a long time fan of the Polar Heart Rate Monitors (Polar Electro Inc., 99 Seaview Boulevard, Port Washington, NY 11050; phone 1-800-2271314) and recommend them to all my patients.  The monitors are used by world-class athletes who want precision in their training as well as by patients recovering from heart attacks who want to be sure that they don't push themselves to hard. A basic model called the Polar Excel sells for approximately 100 dollars." 

In type II diabetes it might be beneficial to include 5-10 negative reps per body part.  Negative reps gain muscle faster.  However, type II diabetics must be careful not to strain and therefore must not exceed the 10 negative reps per body part.  Also the recovery period is important for a type II diabetic.  He should follow the same program as a type I diabetic.  This is having a protein shake, with 5-10 grams of multi-fiber mixed in, 1 to 3 hours after the workout and take the supplement HMB in conjunction with the protein shake.  He can consider using creatine ½-1 hour before a workout, on an empty stomach.  These ideas are merely guidelines.  YOU SHOULD CONSULT WITH YOUR DOCTOR BEFORE STARTING ANY EXERCISE PROGRAM AND DISCUSS WITH HIM ANY CHANGES YOU MAKE IN YOUR EXERCISE PROGRAM. 

In conclusion, diabetes is a catabolic condition of the body breaking down more than normal.  Exercise, when properly done, such as not to exceed 45 minutes of weight lifting, not to strain, not to go above your target heart rate, and so on, is usually anabolic.  Anabolic processes balance catabolic processes and this is why exercise is advisable for diabetes.  Also supplementation can aid the anabolic processes.  This is why Dr. Bob advised using creatine, HMB and protein shakes – use easily digested protein supplements such as whey.  This does not mean meat, poultry, fish or dairy products for your post-exercise protein.  Read the articles "Type I & II Diabetics Need Additional Protein,” and “Atkins Diet/High Protein Diet/in Type I & II Diabetes” for more information. 

Exercise can improve the diabetic condition when properly done.  When not done properly it can be catabolic, a condition dangerous to diabetes. 

Warning - Consult with your doctor before beginning any exercise program.  Have your doctor determine your target heart rate before you begin any exercise program.  There are many factors in each diabetic, which may result in a target heart rate much different for each diabetic. 

Remember – Do not exceed 100 heartbeats per minute without checking with your doctor.  The older, more out of shape, heavier, length of time a diabetic, and so on, your doctor may even limit your target heart rate to 90 beats or less.  Thus, before beginning an exercise program, consult with your doctor and determine your target heart rate.  Be safe! 

Type II 

1.      Aerobics

a.       1-3 thirty minute walks (3 thirty minute walks can benefit the body more than 1 walk of 1 and ½ hour – less strain dividing up the exercise).

b.      Walking up stairs.

c.       Vigorous exercises, such as jogging or aerobics, using “target heart rate”.

d.      Consult with your doctor for your target heart rate – monitor your heart rate during exercise. 

2.      Weightlifting – 4 times a week may be optimal.

a.       30-45 minutes.

b.      8-12 reps per set, 1-3 sets per body part – to gain muscle and burn fat.

c.       15 reps to burn fat – not optimal, since muscle gain is not emphasized during high reps.

d.      Consider weightlifting system invented by Sisco & Little.   You can find their books, from Barnes and Noble on the Internet.  They use a system called “static contraction”.  The scientific name for static contraction is “sustained contraction”.  This method can gain large amounts of muscle, in short periods of time.  The workouts can last as little as 5-10 minutes.  By discovering a system of exercise that increases blood flow to the muscles rapidly, rapid muscle gain is possible.  The forms of exercise are posture positions, with no movement.  You only hold the positions 6 seconds!  Thus 10-12 exercises involve about 1 minute of lifting!  This helps keep strain to a minimum.  Also by not involving range-of-motion, stress is further decreased 

3.      Recovery

a.       Consider protein shake 1-3 hours after exercise.

b.      Consider HMB with recovery drink, 1 to 1 ½ grams.  A second supplementation of 1 to 1½ grams of HMB with a meal containing protein.  The second time you supplement HMB, consider supplementing it with a meal that is after the workout.

4.      Before Workout

a.       Consider supplementing creatine monohydrate on an empty stomach, ½ - 1 hour before a workout.  Cycle it – 6 weeks supplement it, then stop its use for 2 weeks, keep repeating this cycle. Dr. Bob advised not to drink acidic juice such as orange juice, when you supplement creatine monohydrate 

Warning - Consult with your doctor before beginning any exercise program.  Have your doctor determine your target heart rate before you begin any exercise program.  There are many factors in a diabetic, which may result in a target heart rate much different for each diabetic. 

Remember – Do not exceed 100 heartbeats per minute without checking with your doctor.  The older, more out of shape, heavier, length of time a diabetic, and so on, your doctor may even limit your target heart rate to 90 beats or less.  Thus, before beginning an exercise program, consult with your doctor and determine your target heart rate.  Be safe! 

Type I 

1.      Aerobics

a.       1-3 thirty minute walks (3 thirty minute walks can benefit the body more than 1 walk of 1 and ½ hour – less strain dividing up the exercise).

b.      Consult with your doctor for your target heart rate – monitor your heart rate during exercise. 

2.      Weightlifting – Dr. Bob advised to workout every other day.  One or two days off, between exercise, is important because a type I diabetic burns a lot of fat.  The interval helps recovery.

a.       30-45 minutes

b.      15-30 reps per set - 1-3 sets per body part.

c.       Do not overdo – can result in strain, which can result in diabetic stress and blood sugar spikes, (use light low-intensity weights – 15-30 reps).  The interval is necessary because type I burn up a lot of fat.

d.      Consider weightlifting system invented by Sisco & Little.   You can find their books, from Barnes and Noble on the Internet.  They use a system called “static contraction”.  The scientific name for static contraction is “sustained contraction”.  This method can gain large amounts of muscle, in short periods of time.  The workouts can last as little as 5-10 minutes.  By discovering a system of exercise that increases blood flow to the muscles rapidly, rapid muscle gain is possible.  The forms of exercise are posture positions, with no movement.  You only hold the positions 6 seconds!  Thus 10-12 exercises involve about 1 minute of lifting!  This helps keep strain to a minimum.  Also by not involving range-of-motion, stress is further decreased. 

3.      Recovery

a.       Consider protein shake 1-3 hours after exercise.

c.       Consider HMB with recovery drink, 1 to 1 ½ grams.  A second supplementation of 1 to 1½ grams of HMB with a meal containing protein.  The second time you supplement HMB, consider supplementing it with a meal that is after the workout. 

4.      Before Workout

a.       Consider supplementing creatine monohydrate on an empty stomach, ½ - 1 hour before work out. Cycle it – 6 weeks supplement it, then stop its use for 2 weeks, keep repeating this cycle.  Dr. Bob advised not to drink acidic juice such as orange juice, when you supplement creatine monohydrate. 

Warning - Consult with your doctor before beginning any exercise program.  Have your doctor determine your target heart rate before you begin any exercise program.  There are many factors in a diabetic, which may result in a target heart rate much different than a healthy non-diabetic. 

Remember – Do not exceed 100 heartbeats per minute without checking with your doctor.  The older, more out of shape, heavier, length of time a diabetic, and so on, your doctor may even limit your target heart rate to 90 beats or less.  Thus, before beginning an exercise program, consult with your doctor and determine your target heart rate.  Be safe! 

Note – In order for these nutritional ideas to be successful, you must use supplements of the highest quality. Dr. Bob often said, “almost all supplement companies produce poor quality.”  You can consider the product page of this web site. Almost all the products met Dr. Bob’s approval.  Since he passed away we have attempted to keep the same high standards.   

WARNING: DO NOT STOP ANY TREATMENT OR MEDICATION YOU CURRENTLY USE.  CONSULT WITH YOUR DOCTOR BEFORE STARTING THE USE OF SUPPLEMENTS.  

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The Food and Drug Administration has not evaluate any of the statements contained on this web site.  The information contained in this article is not intended to diagnose, treat, cure or prevent any disease.  Remember each person’s body is different and will react differently to various herbal, vitamin and mineral supplements.  Therefore, any supplementation must be administered on an individual basis.  Use the information found on this web site as precisely that: Information.  You and your doctor must make any final decisions.  This information is not meant to replace any doctor and patient consultation.  This information should in no way replace your personal physician’s advice.

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