The Best Exercises for Prediabetes

Welcome to another episode of the Diabetes Digital Podcast.

Today is part three of our Pre Diabetes series, and today we’re talking about the best exercise to prevent diabetes.

If you are somebody who already has diabetes, you’ll still want to listen in because the recommendations for people who are trying to prevent diabetes, who have pre diabetes are pretty similar to the recommendations for people who have diabetes as well.

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And we’re even going to go into a little bit of type 1 diabetes considerations and one simple step that you can do if you have type 1 diabetes to make sure that your blood sugar levels don’t go too low.

In this episode, we’re going to talk all about how exercise is very helpful for increasing insulin sensitivity.

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We’ll talk about the types of exercise that are recommended in the exact frequency and duration that’s recommended to do.

These exercises will even go into intensity levels because that’s a question that many people wonder how hard should I be going in the gym and ways to monitor progress.

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We’re even going to talk about a strategy for exercise that helps you slowly but surely build up on the exercise that you’re doing so you don’t create a plateau.

You definitely want to stay till the end because I feel like that’s when the guests has their best.

Tip for people who can get started today with one simple strategy that is evidence based that will help reduce your blood sugar levels and help improve your metabolic health.

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Yes, and our guest today is Jose Tejedo, who is an exercise physiologist.

He has a degree in exercise science and during his early years in practice, he worked alongside plant based physicians who treated metabolic conditions with a focus on type 2 diabetes.

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Jose Co founded the Type 2 Diabetes Evolution, a diabetes health platform that helps individuals manage and prevent prediabetes and manage type 2 diabetes through lifestyle modifications.

And with that, let’s jump in to the episode.

Welcome to the Diabetes Digital Podcast.

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I’m Wendy.

And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.

Through our telehealth platform, Diabetes digital.co, we offer accessible and personalized virtual nutrition counseling for people with diabetes and pre diabetes.

Visit diabetesdigital.co that’s Co to book your first appointment.

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We accept insurance and offer affordable self pay options.

Now let’s get into today’s episode just to get started.

Can you just explain for people who are listening who think that managing either diabetes or preventing diabetes is all about diet?

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Can you explain how regular exercise can help in preventing type 2 diabetes?

Yes, great question.

So I always say that if exercise was a pill, it would probably be the most powerful medication that we have ever seen in the history of humanity.

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Not just because of its positive effects on pre diabetes and type 2 diabetes, the prevention of those conditions.

It can even reverse insulin resistance, which is the underlying cause for both of them.

But it also has a plethora of benefits for other systems of the body like our our cardiovascular system, our pulmonary system, our skeletal system, muscular system.

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It truly is the pill that not many people are taking but everybody should take on a daily basis.

When we talk more about glucose homeostasis, it helps you increase blood glucose clearance because our muscles are basically glucose vacuums.

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They love sucking up glucose as long as they are activated.

So by going on a walk or by doing resistance training, you are activating that glucose vacuum and you’re sucking up all of that glucose from your bloodstream and bringing it down and pushing it into your muscle cells in order to be used as energy.

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And last but not least, the other one is it increases your insulin sensitivity at a muscular level.

So what does that mean?

It simply means that your cells respond better to the signals of insulin.

And for those listeners that might not know, insulin is a hormone that allows your cells to open up so glucose can go in into the cell.

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Again, it makes your cells more insulin sensitive.

And Jessica, can I go ahead and dive into the mechanism of how this happens?

A. 100% love mechanisms.

OK, so inside of our muscle fibers we have this tiny, there are basically boats that are known as glute 4 transporters, glucose transporters type 4.

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Now, they usually like hanging out in the middle of the cell, but when you contract your muscle fibers, this boats, this vesicles go from the innermost layer of the cell to the outermost membrane of the cell, and they facilitate the diffusion of glucose from the bloodstream and into the cell.

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So that is how your muscle cells become more insulin sensitive.

They respond better to the signals of insulin and hence that leads to better blood glucose homeostasis if you’re trying to prevent or even reverse insulin resistance.

Amazing.

And I’m wondering is there a type of exercise that is more effective than another type?

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Because often times I think people think of, oh, I have to just focus on cardio and maybe don’t do any strength training.

Is cardio better?

Is strength training better?

Is it a balance?

Great question.

So just like you mentioned, there’s two forms of exercise.

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We have cardiovascular training, also known as aerobic training, and then we have resistance training.

When we talk about aerobic training, we’re talking about walking, jogging, running, biking, dancing, any kind of activity that elevates your heart rate, but you can maintain for a sustained period of time.

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When we talk about resistance training, that basically it’s just lifting weights against the force of gravity or using resistance bands, which is basically creating force against the resistance of the elastic band, right?

Both of those are considered resistance training.

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I would say that if you’re trying to prevent or reverse insulin resistance, your best bet is a combination of both.

Combination exercise of resistance training two to three times per week and aerobic training daily would be one of the best things that you can do.

6:32

Do things like reformer Pilates count?

Because I’m really into that, because you mentioned just like weights and resistance bands, but is there other types like yoga, Pilates, things like that?

All of those are fantastic forms of body weight training.

I mean, when you’re doing Pilates, when you’re doing yoga, you are definitely exerting some, some force on your muscles and you’re also activating your cardiovascular system.

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So just by doing yoga, by doing reformer Pilates, you are already combining those forms of exercise.

Now to your question, Wendy, when it comes to how long you should be doing them, the recommendation is about 150 minutes for aerobic training per week.

7:15

So if you break that down day by day, you’re talking about what, 2022 minutes per day, which can be very easy to go on a walk just for 20 minutes a day.

What are you talking to?

A friend walking the dog, meditating, something like that, right?

But the trick here is to be consistent with it.

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So find a time of the day where you can actually go outside or go under treadmill and go in that 20 minute walk.

Now, when it comes to resistance training, one of the best things that you can do is create a routine that keeps you consistent with going to the gym to about two to three times per week or so at a minimum.

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And that routine that you’re doing should be, should be something that you have planned in advance that because it’s not just about showing up to the gym and doing some Dumbo curls and then going back home.

You actually have to create a routine with a series of exercises, what which is known as a splits, right?

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You have to split your upper body, lower body, and maybe a full body workout on different times of the day.

Each split should have about 5 movements that hits every muscle group.

And then you’re supposed to be doing maybe two to three sets for 12 reps each exercise.

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So again, a trained professional like a fitness trainer can definitely help you build that routine, but you have to stay consistent with resistance training at a minimum of two to three times per week.

Yeah, just mentioned Pilates, which is typically seen as like more low intensity and yoga as well.

8:40

I feel like in the fitness world, especially when it comes to diabetes, pre diabetes, it’s like the harder you go, the better.

That’s what’s promoted.

And so I’m wondering how intensity plays into all of this.

Like for someone who doesn’t like really intense exercising or fears that they might get hurt or something like that, is that OK?

9:02

Or should they challenge themselves a little bit when it comes to the intensity of the exercise?

Well, when it comes to intensity of the exercise, it’s always going to be very subjective, right, according to your fitness levels.

But here’s one thing that that I would like to say, regardless of the intensity, we’re talking from the lowest intensity walking to the highest intensity high intensity interval training, any form of intensity is going to have beneficial effects on your metabolic health.

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So whether you’re going to do yoga or Pilates and you consider that very intense, fantastic, go for it.

If it even if it’s not intense for you, that is moving your muscles, that is exerting power on your muscles, that is putting some strain on your cardiovascular system and that is what is creating the benefit at a metabolic level.

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You mentioned going in with a plan, which is something I typically have never done.

When I lift weights, I just kind of go with the flow, whatever I’m feeling the moment.

I’m wondering, do you think it’s better to write down like, OK, today this is what I’m going to be doing?

10:07

And also, how do you recommend people monitor their progress with exercise to make sure that it is effectively working towards preventing diabetes?

Yeah, OK, So great questions.

I studied exercise for the last 15 years of my life, and if I don’t follow a plan, I’m going to fall through the cracks and I’m not going to follow through with what I’m supposed to be doing and I’m not going to see results.

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So you actually have to write down what you plan on doing on Monday, on Wednesday and on Friday and go for it.

You actually have to plan it through.

If you are not familiar with planning an exercise routine, you might need the help of a fitness trainer.

But it’s probably the most important thing that you should do if you actually want to see results.

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Because if you just show up to the gym doing whatever you feel that day, you’re not going to create that progression of muscle building that we’re looking for when you’re doing resistance training, right?

When you’re doing resistance training, we want to break down the muscle in order to build it again.

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So our muscle fibers can become denser, larger, and can they can absorb more glucose, right?

But if you’re just showing up and you don’t have a plan to progress, then we’re planning to fail basically, right?

So I recommend apps on the on the apps store where you just type, oh, exercise routines or something like that.

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Download whatever plan they got and actually follow it through.

It’s even better if a trained professional can help you through to achieve the goals that you want.

Which brings me to your next question is how do we know?

How do we gauge if we’re actually achieving what we want to achieve when it comes to metabolic health?

11:48

We can look at some biomarkers, some blood blood glucose, for example.

Fasting blood glucose would be one of them.

Now, if you’re just trying to prevent this condition, it’s likely that you’re not checking your fasting blood glucose daily.

Maybe you’re just checking it once a year when you go to the doctor.

But that is a number to look at fasting blood sugar.

12:05

Another one would be your A1C.

Sorry, let me backtrack a little a little bit.

Fasting blood sugar should always be below 100 milligrams per deciliter in order to be considered outside of the danger zone, outside of the pre diabetes range.

If you’re consistently waking up with fasting blood sugar above 126 milligrams per deciliter, then that would be that would be considered type 2 diabetes, right?

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So if you are trying to prevent this condition through exercise, keep track of your fasting blood sugar daily or every other day to make sure that you’re on that safe zone that we’re looking for it for.

For somebody without diabetes, you’re looking at 75 to 99.

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OK, When we look at your A1C, which is done most likely every year for somebody that doesn’t have diabetes and just goes to the doctor for the annual checkup, you want your A1C to be below 5.6%, to be outside of the pre diabetes range, outside of the type 2 diabetes range.

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And if you have type 2 diabetes, which means that your A1C is higher than 6.4, you’re going to try to push it to that pre diabetes range between 5.6 to 6.4 and then eventually get you off completely.

The pre diabetes range.

Again, that is not just through exercise, but type 2 diabetes is a multifactorial disease.

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So there is multiple things that go into the reversal of insulin resistance.

It’s not just exercise, it’s also diet, it’s hydration, it’s a stress levels, it’s proper sleep and so on.

But since we’re just talking about exercise, it’s important to focus on those two numbers, A1C and fasting blood sugar.

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Now, are the exercise recommendations different for people that have pre diabetes compared to diabetes or would you say they’re about the same or is there anything that you should consider, you know, in particular?

I would say that the recommendations are going to be the same.

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They are going to be recommended to do some form of aerobic training and some form of resistance training.

But of course it’s going to be started at their fitness level.

So again, when you’re starting a routine through a fitness professional, a fitness trainer and exercise physiologist, they’re going to do a series of testing just to make sure that the program that they’re building for you is set for your fitness level and your standard, something that you can actually do and complete.

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But the recommendations would be the same for everyone.

I really hope that people who listen to this, even if they don’t have diabetes, everybody starts doing a combination exercise, cardiovascular and resistance training every single week.

And what about type 1 diabetes?

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Because I know that there are folks who listen who have type 1 and maybe they are scared to exercise because they don’t want their blood sugars to go too low.

They’re on insulin.

Is there anything in particular that people with type one should keep in mind when exercising?

14:58

Yeah, I would say Type 1 and insulin dependent type 2, both of those groups would have to pay attention to their blood glucose before they start exercising.

Now, like I said earlier, exercise is a fantastic insulin sensitizer, which means that that insulin that you just injected is going to be much, much more powerful.

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So you run the risk of dealing with hypoglycemia, lower blood sugar levels.

So it’s important to start your exercise routine at a level that is at least 100 milligrams per deciliter, OK?

And also you have to make sure that you’re not trending downwards really fast.

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People who are type one or, or insulin dependence type 2, they usually have CGMS and they understand when they’re trending down, downwards, which means that very soon they’re going to crash and they’re going to need to put some carbohydrate into their bodies in order to bring them back up.

So when you’re exercising and you are insulin dependent, you want to have some form of fast acting carbohydrate close to you in case you reach those dangerous levels.

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But never get to those dangerous levels.

Always prevent.

Prevent as much as you can.

So maybe having a snack like 15 grams of carbohydrates before you exercise is like a good place to start.

Fantastic Medjool date, for example, contains or Two of them contain about 15 grams of carbohydrate or about half a banana is also 15 grams of carbohydrate.

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If you consume that when you’re trending downwards, it’s going to bring you back up.

A lot of people make the mistake of eating too much and then they get on the blood sugar roller coaster.

They get high and then they go super low.

They correct, they go super high and then super low.

So like you mentioned, Jessica, it’s very important to just do it at 15 grams increments of carbohydrate content.

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Another question I have, and this is more specific because you mentioned like the idea of monitoring and progress and, you know, building muscles.

What are your thoughts on progressive muscle overload?

And also can you explain if you’re familiar with that, which I’m assuming you are, like what that is for people who don’t know?

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Because maybe that’s like an easy, simple place for people to start.

It sounds complicated, but I’d love to hear your thoughts on how to simplify it.

So progressive muscle overload is basically what I alluded to when we were talking about creating an exercise routine where you are actually progressing on your muscle building journey by slowly but really increasing the amount of weight that you are lifting or the intensity of the exercises through more sets or more repetitions.

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Because our muscles become used to the stimuli that they are receiving.

And at some point they’re going to stop growing and you’re probably going to see a plateau on the benefits of exercise.

So you always have to change your routine every month or so, so your muscles don’t become used to that load that they’re currently receiving.

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Hence the word progressive overload.

And that way you can consistently see the benefits of exercise day after day, day after day, nonstop for the rest of your life.

Makes sense?

Yes.

So how would somebody put that into action who’s like, OK, maybe that’ll help me like with a framework to go into the gym and keep it more simple by having a little structure, like how would you start that?

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So again, if you are very new to exercising, I would highly recommend the help of a trainer that can allow can help you create an exercise routine that you’re going to follow for the next month.

All you have to do is show up to the gym, do what that routine says, and then after a month or two months of doing it, go back to your trainer, change the routine again, new exercises, new movement, new weight, new range of sets, new range of repetitions and then do it all over again and so on.

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But you need a plan.

That is the reason why I’m saying that showing up to the gym and just doing what you feel like that that day can be a little bit dicey when it comes to actually seeing progression on your on your journey of muscle building.

And for people who can’t like let’s say they don’t have access to a trainer, is there like an app that you recommend or another like any other place to start or should they just wing it?

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Like what do you think?

Yeah, so nowadays you can find so much information online.

So start with YouTube.

Go to YouTube and type ideal body resistance training for somebody that is your age, right?

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And there’s usually gonna be somebody teaching about progressive overload, about how to set up a proper split, a lower body, upper body, full body workout.

You’re gonna have to equip yourself with the knowledge first before you jump into the action.

I truly believe that once people start understanding the concepts behind of what they’re doing, whether it’s exercise, whether it’s dieting, then everything falls into place and they’re actually able to follow through with whatever plan they have ahead of them.

20:10

So it always has to do with knowledge 1st and then then action.

You can Google it, you can go to YouTube, you can come to me and I can help you out.

Follow our Instagram I also talk about exercise all the time about how to set up proper routines.

Something that I started doing recently is showing the workouts that I do at the gym and showing the workouts that I do at home for both types of options for people.

20:34

I love that.

How would someone go about figuring out what the best routine is for them in terms of enjoyment?

Because with working out, you know, I find that a lot of people force it because they feel like they should be working out, but it’s not something they’re necessarily enjoying.

20:50

And then maybe they do it for a month and then they fall off.

So for someone who is very new to movement, what are some ways to kind of troubleshoot to figure out like what am I actually going to be able to sustain?

That’s a great question and I would say you have to treat it like an ice cream shop.

21:07

Sometimes when you go into the ice cream shop, you don’t know the 28 flavors that are there and maybe you just go for vanilla, but you don’t know that you’re going to like chocolate more, right?

So if you’re just starting on exercise, you have to try different modalities and then you’re going to find out what you like the most and then that is going to be the one that you stick to.

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For example, I love exercising.

I have tried multiple modalities of exercise, multiple flavors of ice cream, and I recently found out Jiu jitsu.

Jiu jitsu is an art, a martial art, and that now is my favorite flavor of ice cream.

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I go for it every single maybe.

I go 5 * a week to practice jiu jitsu and there’s no other exercise in the history of my life that I have enjoyed as much as that one.

So it just becomes super easy for me to be intrinsically motivated to go to my jiu jitsu lessons because it’s something that I enjoyed, but I wouldn’t have known that I liked it so much unless I tried it.

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So again, if you go to a gym that offers multiple classes, I highly recommend that you try different ones to see what you like the most.

Different machines, different cardio machines.

It’s all about trying it out to find out what you like the most and that is going to allow you to stick to the plan.

22:22

So you are an exercise physiologist, but you’re also you eat plant based and or vegan and that is a combination that I maybe I do see it, but maybe a little bit less because oftentimes, you know, people who are focused on exercise, a stereotype is like they’re eating, you know, they’re trying to get all this protein and meat and things.

22:45

So can you talk about that for our plant based listeners because it’s a question we get all the time.

A like do you have an amount of protein that you recommend for your clients, especially as they are trying to do more resistance training and trying to increase their lean muscle mass that’s going to help with insulin sensitivity?

23:04

That’s number one.

Number two, what are some of the sources of plant based protein that you typically go for?

Fantastic question.

Because I think that that is the biggest misconception of a plant based diet.

A lot of people ask me, OK, where where am I going to get my, my protein from, right?

23:22

Because if you’re, you know, if I’m not going to be eating meat or fish or eggs, where’s the protein coming from?

And that is where the Diana who we haven’t talked about Diana is the registered dietitian in this team.

She usually talks about where to get protein in your plant based whole food diet.

23:40

And for people that don’t know, you can get protein literally from all food groups in a plant based diet, which is vegetables, fruits, whole grains, legumes, nuts and seeds.

But the ones that have the most is legumes and whole grains.

Those two will give you all the protein that you need as long as you’re building a proper plant based whole food diet.

24:01

You got to do it with the help of a dietitian in order for you to meet those targets.

Now the targets are going to vary from person to person, age, biological sex, level of exercise, their goals.

If they’re trying to build muscle mass, it could be 1.2g per kilogram of body weight.

24:20

If they’re just trying to maintain, that’s going to change.

So it’s going to be very, very personalized when it comes to to the intake of protein.

But the main point here is that you can get all the protein you need from plant based whole food sources.

24:36

And if you’re someone like me that exercises a lot and does a lot of resistance training and you need that extra supplementation, you can go ahead and have some plant based protein powder on a smoothie which would add 25 grams to your day.

So it’s very easy, very easy to reach your requirements on a plant based diet.

24:56

Great.

Thank you.

Now for people, I know you mentioned working with you.

So if people do want to work with you, what are the services that you offer and how can people connect with you?

OK, so we love giving free information to people.

You can find us on Facebook, on TikTok, on Instagram and YouTube and their type 2 diabetes revolution.

25:20

In all of those platforms, you’re going to find daily videos from myself and Diana talking anything and everything diabetes, type 2 diabetes, plant based nutrition, exercise.

So I would highly recommend that you start there.

Now, every month or so, we offer free workshops where people can come in and we dive a little bit deeper into how to implement our method, our method of eating a plant predominant diet, exercising more, how to plan it, how to build those habits and how to do it in a consistent manner for you to actually see the results that you want to see.

25:55

So I would say start by following us on social media channels and, and you’re going to get, you’re going to get a lot of value there.

I love it and I also want to leave listeners with one thing that they can get started with today.

26:13

From your perspective, it can be a simple exercise, a simple activity.

If people are like OK this sounds amazing, but I just don’t know the first move to make.

What do you recommend?

Walking after meals for 15 minutes.

26:29

That is the simplest thing that you can do that will actually have a gigantic effect on your blood sugar levels.

I recently read a research paper on a crossover trial that was following 60 subjects.

26:46

They split the group in half.

Thirty were told to exercise just one time a day for 45 minutes walking and the other thirty were told to exercise for 15 minutes walking after breakfast, lunch and dinner.

The group that exercised for 15 minutes after their meals.

27:04

So a fantastic improvement, much better than the other group on their A1C values and their fasting blood sugar.

Three months down the line and six months down the line.

So I don’t think it can.

It can get simpler than putting your shoes on after you eat and going on a 15 minute walk.

27:20

That’s so motivating.

Thank you so much, Jose.

This was an incredible episode.

I’m sure people, I’ve learned a lot and definitely we recommend that folks go to your Instagram, go to your TikTok, watch all your content and work with you.

We appreciate your time.

27:36

Thank you so much.

Thank you for having me Jessica and Wendy.

I appreciate it.

Thanks for joining us for today’s episode.

If you’re interested in nutrition counseling with one of our expert dietitians to help improve your pre diabetes or diabetes, visit us at diabetesdigital.co.

27:53

Also, if you found our conversation helpful, do us a favor and rate and review this podcast on iTunes, plus share with someone who might find this helpful.

You can also connect with us on Instagram at Diabetes Digital dot.

Co and TuneIn every Wednesday for practical, inclusive, and culturally humble diabetes 3DS insights.

28:13

We’ll catch you later.

Bye.Close