July 29, 2022 – Chances are this story is about you. How can I know?

First, a little motivational reality: Nearly two in five American adults — 96 million of us — have prediabetes, according to the latest US government estimate.

As its name suggests, prediabetes is a kind of metabolic purgatory. This means you have chronically high blood sugar and are on the road to type 2 diabetes if you don’t get it under control.

And type 2: about 37 million Americans live with it every day. This means that approximately 130 million people in the United States have problems removing glucose from their bloodstream.

If that sounds terrible, well, it is. Chances are you’ll be caught in this web because so many American adults are. Luckily, there’s a proven way to avoid all the mess.

Exercise is the simplest, cheapest and most accessible preventative/management medicine you can take.

The more you move and the more often you do it, the more your body can control the flow of glucose into and out of your bloodstream.

All it takes to figure it out is four quick and easy lessons

Lesson 1: Blood Sugar Basics

A healthy 150 pound adult comes a teaspoon of sugar – 4 grams – swirling in their blood at all times.

This fact is amazing, considering how much sugar the average American consumes per day (17 teaspoons) and how important this tiny supply is for our survival (the brain occupies 60%).

So where is this all going?

Your body uses it for energy. Your muscles and liver store it in the form of glycogen. Anything left over is converted to fat.

It works in reverse when you go a few hours between meals. Your body keeps your blood levels stable by taking some of this glycogen from your muscles and liver, turning it into glucose, and returning it to your bloodstream.

During this time, your body primarily uses fat for fuel while you’re at rest, which helps preserve that stored glycogen for when you really need it: during exercise.

This is why physical activity is a key element in controlling blood sugar. Now, the first question many people ask is, “What exercise should I do?” Another way to ask, “What’s the best exercise to manage my blood sugar?” »

The quick answer is: all movement is positive. The longer answer is: different types of exercise help you control your blood sugar in different ways. Ditto with different intensities within each category.

And we’ll get to all of that. But let’s start with a simpler question: what is the less how much exercise you can do while getting a measurable benefit?

Lesson 2: A small movement can go a long way

Spencer Nadolsky, DO, is a board-certified family physician who specializes in treating patients with obesity and type 2 diabetes. He is also a former Division I college heavyweight wrestler and the founder of LiftRx, an online strength coaching company.

So when Nadolsky talks to his patients about exercise, you’d expect him to focus on resistance training.


“I try to make them work,” he says. Why walk? “It’s not too taxing, most patients can start right away and progress quickly.”

The “get started right away” part is crucial. They do not need individual instruction, special equipment or a structured training program.

The benefits come right away, according to the American College of Sports Medicine. In his recent stand on exercise and type 2 diabetes, he notes that any type of physical activity increases the transport of glucose out of the blood into the muscles.

Exercise also has a profound effect on your body’s response to insulin, the hormone most responsible for controlling blood sugar. Insulin sensitivity remains elevated for up to 72 hours after exercise.

A 2016 study found that walking 11 miles a week was enough to prevent prediabetes from becoming full-blown type 2 diabetes. If you walk at a moderate pace (4 mph), you can cover 11 miles in just under 3 hours. That’s 30 minutes a day, 5-6 days a week.

Although a little exercise is good, more is better. A long-term study on preventing type 2 diabetes found that the more participants exercised, the lower their risk.

But at some point, “doing more” ceases to be a realistic option. Even if you can tolerate the repetition, you end up running out of hours in the day.

Fortunately, there is another option, one that helps you control your blood sugar in a fraction of the time.

Lesson 3: Harder work yields faster results

Martin Gibala, PhD, published his first study of high-intensity interval training (HIIT) in 2005, when he was an assistant professor of exercise science at McMaster University in Hamilton, Ontario.

He is now chair of the department, thanks in part to the dozens of HIIT studies he has published since then. He is also the author of The One-Minute Workout: Science Shows a Way to Get Fit Smarter, Faster, and Shorter.

You can find a number of ways to do HIIT workouts. For example, after a short warm-up, you can go really hard on a stationary bike for 30 seconds, cool down at a slower pace for 60 seconds, and repeat several times. In just 10 minutes you can get a pretty good workout.

And you don’t even have to go hard. As Gibala explains in his book, the interval while walking – moving faster, then slower – offers more fitness benefits than just walking at your normal pace.

HIIT helps you manage blood sugar in two important ways:

1. It offers significant discounts in less time.

In a 2012 study, Gibala’s team showed that a single HIIT workout improved glycemic response after meals in people with type 2 diabetes.

The same is true over time. When testing hemoglobin A1c (average blood sugar over the past 3 months), high intensity intervals lowered blood sugar at least as good as traditional cardiobut with much shorter workouts.

As a bonus, in people with type 2 diabetes, HIIT can be better reduce body weight and body fat.

2. HIIT uses more muscle fibers.

When you do cardio at a steady pace, you primarily use the smaller, slow-twitch muscle fibers. But when you go hard and fast, you also recruit the larger, fast-twitch fibers.

Using more total muscle mass means you use more total energy, much of which comes from the glycogen stored in those muscles. Your muscles then pull glucose from your blood to replace the glycogen.

Over time, says Gibala, your muscles increase the amount of glycogen they hold in reserve, even if the muscles don’t necessarily increase in size.

How about building bigger muscles?

Lesson 4: Lifting gives you room to grow

Nadolsky once joked that he doesn’t lift weights to look better. It does this to create more space to store carbohydrates. (As its online followers know, dietary carbs are broken down into glucose and other sugars during digestion. The storage form of these carbs is the glycogen in your muscles and liver.)

Although it takes time to build bigger muscles, the process offers benefits right away.

Strength training, like any other type of exercise, will sensitize your muscles to insulin, says Nadolsky. This means your muscles will be ready to pull more glucose from your bloodstream within hours of your workout.

With months of consistent lifting, people with type 2 diabetes will typically increase muscle size and strength, improve blood pressure and insulin sensitivity, and increase bone mineral density, all about 10% to 15%.

But you don’t have to limit yourself to just one form of exercise. “Long term, all have benefits,” says Nadolsky. “My advice is to get a mix of all of that.”

Your weekly mix can include two workouts combining strength training and HIIT, and two longer cardio sessions. Or you can walk 5 or 6 days a week, but on 2 or 3 of those days vary your walking speed between a faster and slower pace.

For blood sugar management, some exercise is always better than no exercise. More exercise brings more benefits. But regular exercise is best of all.