Even though managing diabetes often involves medications and mindful eating, physical activity also plays an equally powerful role. In a recent Instagram post, American board-certified gastroenterologist Palaniappan Manickam mentioned five exercises that can significantly support blood sugar control. His recommendations focus on simple, practical strategies that can be incorporated into daily life without requiring extreme routines.
One of his top suggestions is walking after every meal. A 10-20 minute walk, he explained, helps muscles use glucose immediately, reducing blood sugar spikes and across age groups. He also emphasised the importance of building muscle through resistance training, noting that “the muscles are the biggest glucose sink in our body.” Strength training two to three times per week, including exercises such as squats, push-ups, and resistance-band movements, can improve fasting blood sugar levels over time.
He further described calf raises as a simple move with a “big metabolic impact,” explaining that it “activates one of the largest glucose-using muscles.” Because it can be done almost anywhere, he recommends completing 50 to 100 repetitions throughout the day.
Beyond these, he highlighted the value of zone 2 cardio, which is a steady, conversational-pace exercise such as brisk walking, cycling, or slow jogging for improving fat and glucose metabolism and reducing insulin resistance. Short bursts of intense but controlled activity also made the list, as these sessions are time-efficient and train muscles to absorb glucose more effectively.
Summing up his advice, Dr Manickam said, “It is not what you do, it is how consistently you do it.” He added that movement beats perfection, timing matters, and that small daily efforts often produce better outcomes than occasional intense workouts.
Dr Pranav Honnavara Srinivasan, senior consultant surgical gastroenterologist at Fortis Hospitals , tells indianexpress.com, “These modalities orchestrate distinct, highly complementary metabolic adaptations. A brisk post-prandial walk rapidly mitigates glucose spikes through non-insulin-dependent pathways; the mechanical contraction of skeletal muscle directly translocates GLUT4 transporters to the cell membrane, clearing glucose independent of insulin.”
Conversely, Dr Srinivasan notes that resistance training cultivates enduring insulin sensitivity by inducing muscular hypertrophy, effectively expanding the body’s primary metabolic sink for glycogen storage. Zone 2 cardio operates at a profound cellular level, augmenting mitochondrial density and efficiency. This sustained, moderate-intensity exertion optimises lipid oxidation and metabolic flexibility, ensuring the body transitions seamlessly between fat and carbohydrate utilisation.
“Together, these form a tripartite defence: acute glucose clearance, expanded storage capacity, and enhanced cellular metabolic machinery, offering a comprehensive strategy for glycemic regulation as corroborated by global endocrinological research,” states Dr Srinivasan.
Dr Srinivasan explains, “The gastrocnemius and the underlying soleus muscle possess a remarkable physiological profile. Predominantly composed of Type I slow-twitch fibres, the soleus relies almost exclusively on oxidative metabolism to sustain . Recent pioneering physiological research reveals that activating the soleus,even while seated, can exponentially elevate local oxidative metabolism, drawing heavily on circulating blood glucose and lipids. In real-world applications, this translates to a profound dampening of postprandial glucose excursions. This targeted activation requires minimal exertion yet yields disproportionately substantial metabolic dividends.”
For individuals navigating prediabetes or Type 2 diabetes, the physiological consensus unequivocally prioritises consistency over absolute intensity. “The insulin-sensitising effects of a single bout of exercise typically attenuate within 24 to 48 hours. Therefore, a consistent, daily cadence is paramount to maintaining a steady state of heightened metabolic receptivity. While incorporating higher intensity yields , it should never supersede the fundamental requirement of regular, sustained movement,” states Dr Srinivasan.
However, rigorous precautions are indispensable. Patients must undergo thorough cardiovascular stratification to preclude silent ischemia before initiating vigorous regimens. Dr Srinivasan mentions, “Those with peripheral neuropathy require meticulous podiatric vigilance to prevent undetected microtrauma, while individuals with proliferative retinopathy must strictly avoid manoeuvres that exponentially spike intraocular pressure, such as heavy resistance lifting or the Valsalva manoeuvre. Ultimately, a meticulously tailored, consistent regimen crafted with clinical oversight remains the most efficacious intervention.”
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