It is well-known that exercise, even leisurely walking, improves blood sugar levels. This is true for those with type 2 diabetes, pre-diabetes (also known as impaired fasting glucose), and for those whose blood sugars are in the normal range. A recent small study suggests that 15 minutes of walking after meals may be superior to 45 minutes of walking once a day. For some patients, a prescription to walk 15 minutes after meals might be an attractive option when weighed against a 45 minute slog… and it might just be more effective anyway.
It makes intuitive sense that exertion after meals is better than collapsing onto the couch. And with the many side effects and potential harms of medications for diabetes, lifestyle changes are always of prime importance. With recent speculation that Januvia may be associated with a slight increased risk of pancreatic cancer, and past medications such as Avandia being associated with overall increased cardiovascular risk, medication should be the treatment of last resort for diabetes after diet and exercise have been optimized.
The study followed ten 60 year-olds with elevated blood sugars considered to be in the pre-diabetes range. The conclusion:
Both sustained morning walking (45 minutes) and postmeal walking (15 minutes, 3 times a day) significantly improved 24-h glycemic control relative to the control day (P < 0.05). Moreover, postmeal walking was significantly (P < 0.01) more effective than 45 min of sustained morning or afternoon walking in lowering 3-h postdinner glucose between the control and experimental day.
The superior benefit of walking more frequently during the day, even if for small time periods, makes sense in the context of other knowledge about exercise. To give just one example of another recent study on the subject, published in PLOS One:
One hour of daily physical exercise cannot compensate the negative effects of inactivity on insulin level and plasma lipids if the rest of the day is spent sitting. Reducing inactivity by increasing the time spent walking/standing is more effective than one hour of physical exercise, when energy expenditure is kept constant.
Even fidgeting all day has been shown to improve one’s overall fitness, and those fidgety people out there are much less likely be overweight or obese. The cumulative exertion of small movements all day does add up to a significant expenditure of calories.
So it is no secret that exercise is recommended for those with diabetes who can tolerate it. Whether or not someone should exercise depends upon other health problems, and the advice of a physician should always be sought in terms of personal planning.
I can recall a 65 year-old man who, once diagnosed with early diabetes, began a program of two walks in the woods every day. I was amazed (and secretly jealous) that he had the dedication, time, and pleasure of this experience. He found moments of grandeur and peace in the forest, and even a secret fishing hole for his grandson. More importantly, with walking and diet changes he avoided the need for medications to prevent the consequences of diabetes.
Walk. Frequently. Fidget. Habitually.