• What is diabetes?
  • How the body breaks down sugar
  • When blood sugar regulation goes awry
  • Who’s at risk for type 2 diabetes?
• Diagnosing diabetes
  • Recognizing the symptoms
  • Tests for diabetes
  • Diagnosis and beyond
• Managing your diabetes: An overview
  • Monitoring blood sugar
  • A team approach
• SPECIAL BONUS SECTION: Weight-loss strategies for diabetes
• Medications for diabetes
  • Oral medications
  • Insulin
  • Other injectable medications
  • Combination therapy
• Alternative treatments for diabetes
• Short-term complications
  • Hypoglycemia
  • Other diabetic emergencies
• Pregnancy and diabetes
  • Gestational diabetes
• Long-term complications
  • Eye disease
  • Nerve damage
  • Kidney disease
  • Damage to the feet and legs
  • Cardiovascular disease
• Resources
• Glossary

The importance of exercise

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:

• Exercise lowered HbA1c values by 0.7 percentage point in people of different ethnic groups with diabetes who were taking different medications and following a variety of diets—and this improvement occurred even though they didn’t lose weight.
• All forms of exercise — aerobic, resistance, or combined training — were equally good at lowering HbA1c values in people with diabetes.
• Resistance training and aerobic exercise both helped to lower insulin resistance in previously sedentary older adults with abdominal obesity at risk for diabetes. Combining the two types of exercise proved more beneficial than doing either one alone.
• People with diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counterparts, and those who exercised three to four hours a week cut their risk even more.
• Women with diabetes who spent at least four hours a week doing moderate exercise (including walking) or vigorous exercise had a 40% lower risk of developing heart disease than those who didn’t exercise. These benefits persisted even after researchers adjusted for confounding factors, including BMI, smoking, and other heart disease risk factors.

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Diabetes is serious!! I can't believe HMS is still promoting calorie control for weight loss. The scholarly literature is replete with evidence that a) calorie control is useless for weight control and b) exercise has not been demonstrated in controlled studies to produce weight loss. So how to lose weight? After years of failure I defied conventional wisdom and began a high fat, low carbohydrate diet (really, really low! Not some "35% carb diet" that HMS promotes). How did it work? Within 18 months I was 23.7 BMI and in all that time I never thought about portions, timing, or counting calories. Did it last? That was six years ago. I'm the same today and I eat when and as much as I want, always. Side benefits? Trigylcerides dropped from around 300 to typically less than 100. Last BP was 112/70. Can I maintain this? Indefinitely!

Congratulations on losing weight and keeping it off. For most people, maintaining a new weight is much harder to do than losing it. What the literature actually says about weight loss is that 1) reducing daily calorie intake is what matters, 2) how you do that doesn't much matter, and 3) different strokes for different folks. In head-to-head studies comparing different types of diets, all seem to work equally well (or equally poorly, depending on your point of view) over the long term. Some people respond well to a moderate-carbohydrate diet, others to a low-fat diet, and others, like yourself, to a higher-fat, higher-protein diet. - Harvard Health Publications