If you're motivated to exercise because you want to lower your blood sugar levels, the best course of action is to combine aerobics and weight lifting, according to a recent study in the Journal of the American Medical Association. Combining both forms of exercise is more beneficial to a diabetic than sticking to just one, according to the research.

"We can now look at individuals with diabetes right in the face and tell them, 'This is the best exercise prescription for you,' " lead study author Dr. Timothy S. Church, who directs preventive medicine research at Pennington Biomedical Research Center at Louisiana State University, told The New York Times.

In the JAMA study, participants who did both aerobic and weight training lowered their hemoglobin A1C from 7.7% to 7.3%, a significant reduction.

"Never underestimate the power of exercise," says Dr. Suzanne Steinbaum, DO, a preventive cardiologist at Lenox Hill Hospital in New York City. "In the past, it's been shown that aerobic activity and weight training both can significantly improve diabetes. It makes sense to use both of them together."

So how should diabetics get moving in order to get healthier?

  • Be sure to choose a form of exercise that you enjoy or you won't stick with it, says Stanley Mirsky, MD, an endocrinologist at Lenox Hill Hospital and the author of "Diabetes Survival Guide." Exercising with a friend makes it fun, rather than boring or tedious. And don't think you have to do the whole routine at once. Take two or three shorter walks in a day.
  • You should aim for at least 150 minutes per week of aerobic exercise and about half hour of weight training three days per week, Mirsky says. Work up gradually to 45 minutes of aerobic exercise.
  • Looking for a form of exercise that takes no skill at all? Walking is wonderful aerobic exercise, says Caroline Bohl, MS, RD, CDE at the Naomi Berrie Diabetes Center at NewYork-Presbyterian Hospital/Columbia Medical Center in New York City. Bike riding and swimming are also recommended.
  • For older people with arthritis, both yoga and tai chi are recommended, as are non-competitive golf and non-competitive tennis, Mirsky says.
  • If you're new to weight training, it may help to make an appointment with a personal trainer to set up a program that you can eventually do on your own. But if you can't afford a trainer, start out by using light weights (2 or 3 pounds) or even cans that weigh 2 or 3 pounds, Bohl says. Start by doing some bicep curls, and work your way toward using heavier weights.
  • Need more reasons to combine aerobics with weight training? Exercise can lower your blood pressure and your cholesterol level and reduce your risk of stroke and heart attack, Mirsky points out. Walking two miles a day means you'll be up to 25 percent less likely to be depressed as someone who does not exercise, and 40 percent less likely to fracture a bone, he says. But the big benefit to diabetics is that it lowers blood sugar. "Exercise is really invisible insulin," Mirsky says.

Sources:
"Effects of Aerobic and Resistance Training on Hemoglobin AIC Levels in Patients With Type 2 Diabetes" by Church, Timothy S., Blair, Steven N., Cocreham, Shannon, Johannsen, Neil, Johnson, William, Kramer, Kimberly, Mikus, Catherine, Myers, Valerie, Nauta, Melissa, Rodarte, Ruben, Sparks, Lauren, Thompson, Angela, Earnest, Conrad. Journal of the American Medical Association. JAMA 2010.  
http://jama.ama-assn.org/content/304/20/2253.abstract

"Exercise: For Type 2 Diabetes, 2 Types of Training." Rabin, Roni Caryn. The New York Times. 24 November 2010.
http://www.nytimes.com/2010/11/30/health/research/30exercise.html