Women with Diabetes – Benefits and Barriers to Exercise
By Julia Kenney
If done safely, every person with diabetes can benefit from exercise, but there are unique advantages for women. Unfortunately, women with diabetes face barriers to exercising regularly.
Women with diabetes are superheroes – so many of them work hard to manage their diabetes, in addition to other health needs, and managing a career and family. On top of this, women with diabetes have to find the time and energy to exercise regularly to follow recommendations by the ADA Standards of Care.
At this year’s ADA Scientific Sessions, researchers discussed the benefits of exercise in preventing and managing diabetes and improving pregnancy health outcomes in women. They also highlighted the barriers that women uniquely face to maintaining an exercise routine.
Why exercise?
Exercise has proven beneficial for people with type 1 and type 2 diabetes. Dr. Jane Yardley, associate professor at the University of Alberta, explained that people with type 1 diabetes who exercise regularly will live longer, develop fewer complications, manage their weight, and improve their mental health.
Exercise has similarly positive effects in people with type 2 diabetes, and can even help prevent the onset of type 2 diabetes and prediabetes.
Disparities in exercise
Despite the proven benefits of staying active, not all people are able to maintain a consistent exercise routine. Dr. Carlos Crespo, professor at the Oregon Health and Science University School of Public Health, explained that barriers to exercise include lack of time, safety, cost, access to facilities, age, and a lack of outdoor spaces.
These barriers lead to significant disparities in exercise – women have lower levels of physical activity than men, and research indicates that rates of activity are lowest among Black and Mexican-American women.
Crespo described the following barriers that women with diabetes face, especially women of color:
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Lack of social support
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Mental health
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Access to childcare
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Access to safe public spaces
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Income
Women with diabetes face the unique challenge of managing their blood sugar while exercising. Physical activity can cause dangerous lows, particularly for women with type 1 diabetes. Many women with type 1 diabetes experience a fear of hypoglycemia and fluctuating glucose levels when trying to establish an exercise routine. Women with type 1 diabetes tend to be less active than both those without diabetes and men with type 1 diabetes.
To mitigate exercise challenges for women with type 1 diabetes, Yardley said the best way to be active is to find a group of people who understand the disease and its challenges. This can make exercising more comfortable and inclusive for women with diabetes. She also urges more research on exercise in women with diabetes, as diabetes exercise guidelines are largely based on research in young, fit men.
Exercising during pregnancy
Researchers also discussed the benefits of exercise during pregnancy, which can lead to health benefits for both mother and baby. Exercise during pregnancy can decrease weight gain and other complications that occur during pregnancy. Dr. Samantha Ehrlich, a reproductive epidemiologist at University of Tennessee college of education, health, and human sciences, explained that clinical guidance on exercise for pregnant women with diabetes is lacking.
Pregnant women with gestational diabetes or obesity should consider the following general exercise guidelines to improve their health:
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Do at least 150 minutes of moderate-intensity exercise a week (i.e. walking)
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Consider walking for at least 30 minutes daily, taking at least 3,000 steps during this time
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Consider a combination of strength and cardio training
Research shows that a sedentary lifestyle raises the risk for complications. Fortunately, this also means that with any additional movement, even light activity, pregnant women can improve their health.
Exercise during pregnancy has also been shown to lead to healthier babies in women with obesity and/or gestational diabetes. Dr. Amy Valent, assistant professor of obstetrics and gynecology at the Oregon Health and Science University, explained that exercise in pregnant women with obesity has proven to improve life-long health outcomes (lower body fat, normal body size, less c-sections, etc.) in their soon-to-be-born babies and even in their future grandchildren.
This is due to a process called prenatal programming where events during a pregnancy can have a lifelong impact on the child. Dr. Linda May, associate professor of anatomy at East Carolina University School of Dental Medicine, said, “Babies are born healthier because of that exercise exposure.”
While research on exercise in women with diabetes is promising, more research is needed to solidify clear, specific exercise guidelines for pregnancy in women with diabetes.
For more information about gestational diabetes and managing diabetes during pregnancy, check out our articles on:
