There is no defined exercise program that is known to maximize cardiometabolic control or positive health outcomes in people with diabetes. However, there are three important points that I want to emphasize:

• Both aerobic and anaerobic exercise are associated with many health benefits in people with diabetes (see section Why Exercise with Diabetes);

• As long as it is done safely, both aerobic and anaerobic exercise should bring forth the same general health benefits in diabetics as it does in people without diabetes and a combination of both types of exercise is generally recommended;
• Any form of exercise is better than no exercise at all. Studies have found that diabetics undertaking just moderate amounts of activity were at appreciably lower risk for early death compared with diabetics who were less active.

If you run into fitness regimens that promise maximum reduction of HbA1c levels or total insulin needs I assure you that these are not based on validated scientific information or studies. Responses to exercise vary between people and even within the same person on different days. They are dependent on factors such as our nutritional management and sleep quality. It is highly unlikely that there will ever be an exercise program that will elicit optimal cardiometabolic control in every person with diabetes equally.

As someone with diabetes, what was important for me to learn is that because of their different nature, the different types of exercise lead to different physiological adaptations. This means that the type of exercise we choose to do will have a deciding role on our insulin and nutritional management strategies before, during, and after that exercise session.

These are extremely important topics that form some of the cornerstones of the framework I created and developed and am now sharing at Dr-Dias.com.

More important than just thinking about how much we can decrease our HbA1c levels or reduce our insulin needs is to think about how we can maximize the chances of making physical activity part of our daily routine. I can highlight two things that are going to make this easier:

• Choose enjoyment
  
  

We are more likely to feel motivated to exercise if we enjoy or have an interest in a particular kind of physical activity. So, aiming to do what we like doing the most is in general a good strategy. If that is going outside for a run or playing football with friends, or going to the gym to lift some weights, all are absolutely fine.

• Choose accessibility
  
  

If you are unsure about what kind of exercise you would like to do, look around you. Evaluate what the nature or the infrastructure around where you live or work can offer. If you are the type of person that doesn’t enjoy exercising alone, check out the sports clubs or groups that are active in your area. Making the act of exercising logistically easier and more fun are excellent ways to help turning exercise routine.

A training plan should be tailored to your goals. Do you want to exercise primarily for reducing fat mass and improving body composition? Or just to keep your body and mind active? Perhaps you are looking to boost your fitness levels and sports performance? Maybe run a half-marathon? Your goals are the most important aspect to keep in mind in terms of developing a training plan that is tailored to you.

As someone with diabetes, what we must have is a guidebook that complements our training plan. A guidebook from which we learn and apply the diabetes management tools that ensure we are exercising safely and effectively.

The two most important goals of this guidebook should be:

• Avoiding excursions into hypoglycemic territory;
• Keeping you safe and far away from any risk of entering diabetic ketoacidosis.

Understanding how exercise affects our insulin and nutritional needs, and apply the proper management strategies before, during, and after each exercise session is critical to keep exercise safe. It is the also the way to extract the most health and fitness benefits out of each exercise session – that is the third goal of our guidebook.

In practice, what this means is that someone with diabetes will need to manage a workout session differently than someone without diabetes. For instance, someone with diabetes might plan to pause midway during a 60 minutes-long run to ingest an energy gel, whereas someone without diabetes runs the 60 minutes non-stop without even thinking about ingesting carbohydrates.

This doesn’t mean however that the duration or intensity of an exercise session needs to be fundamentally different for people with diabetes.

In fact, my coach draws the same training plan for me and all his non-diabetic athletes who have similar levels of fitness and performance goals. We all put in the same amount of time and relative intensities in each exercise session.

What I do that is fundamentally different to the athletes who don’t live with diabetes is that I strategize my insulin and nutritional management in light of what type of training sessions I need to accomplish that day or week.

These strategies is what I am now sharing with you at Dr-Dias.com and I am sure they will be an important part of your guidebook.

In general, people with diabetes can follow the same exercise recommendations as people without diabetes.

As long as there is proper insulin and nutritional management before and during the activity, there is not a strict limit for how much someone with diabetes can exercise.

I personally have completed two Ironman distance triathlons, each one taking over 10 hours, and many training sessions longer than 5 or even 8 hours.

As a diabetic, what is important is to learn and understand the fundamental principles that enable us to exercise safely and effectively. Equipped with this information, we go through the process of keep acquiring and expanding our knowledge about our own bodies. Learning what works best for us and what doesn’t. This way we can gradually develop individualized strategies that enable us to exercise safely for longer periods of time or at higher intensities.

As someone with diabetes, it can be incredibly daunting to exercise. Personally, it took me two years since my diagnosis of type 1 diabetes to find the courage to do it.

One of my goals at Dr-Dias.com is to show you that this fear can be overcome.

The approach I have developed and am now sharing at Dr-Dias.com not only addresses the fundamental physiological principles that are key to keep our blood glucose levels within a safe range, but it also addresses the key principles of neuroscience that will help you harnessing the power of your mind.