Exercise is important for everyone. But for people with diabetes, it is one of the best ways to manage their illness, even for thin diabetics who tend to be less active. Humans have muscles for a reason—they were meant to use them in active ways. Regular exercise improves glucose tolerance (so blood sugar can be controlled better with less medication) and lowers cholesterol and blood pressure. It reduces the risk of life-threatening complications of diabetes. It reduces stress. It strengthens muscles, bones, and the heart, and it keeps joints flexible. It can also help people feel happier and more energetic because it causes the brain to produce natural "feel good" chemicals called endorphins.

However, people do not have to run marathons or ride a bike for hours to get enough exercise. Lots of little activities can add up to big benefits as well. For example, take the stairs or choose a parking space farther from the door to the mall or school. Vacuum the house, garden or mow the lawn, wash the car, walk the dog—they all count as physical activity, especially if done vigorously. All it takes is a minimum of thirty minutes daily, all at once or in two or three parts.

People who have been inactive for a long time should see a doctor first and get an OK to exercise. They should explain what kinds of exercise or activities they want to try. Some might be offlimits because of diabetes. For instance, for people with diabetes who have numbness or less sensation in their feet, swimming or biking might be better than walking or running. For a person with abnormal growth of blood vessels in the retina, called diabetic retinopathy, strenuous activity might cause bleeding in the eye or cause the retina to detach, which is a very dangerous condition. A softer kind of exercise would be better.

Both aerobic exercise and strength training are beneficial to people with diabetes (and to everyone else). Aerobic means "with oxygen," so aerobic exercises such as walking, swimming, or biking at a faster than normal pace get the heart pumping and oxygen flowing through the body to burn calories. Strength training with weights—even small ones—builds muscles, and bigger muscles burn more fat faster.

In any case, people are more likely to continue exercising if they enjoy it. They should also seek out a qualified exercise specialist for learning how to lift weights, use exercise equipment, or do other unfamiliar activities.

Also important is to check with a doctor about the best times to exercise. People who take insulin might need to adjust their doses or wait a while after injecting their insulin before exercising.

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