Cycling could be quite an exciting and rewarding activity. It is suitable for most adults and may have some unique benefits when living with metabolic disorders and diabetes. Though stationary cycling may have similar effects to non-stationary cycles, cycling outdoor may have additional benefits like greater stress reduction, an opportunity to discover new places, and even make new friends.
Diabetes is a significant health problem globally. About 10% urban population is living with diabetes. There are two distinct types of diabetes, each posing unique health challenges. Type 1 diabetes (T1D) is an autoimmune disorder causing the destruction of insulin-producing beta cells in the pancreas and thus insulin deficiency. Less than 10% of all those living with diabetes live with T1D, typically treated with insulin.
Type 2 diabetes (T2D) is quite different than type 1 diabetes. It is a lifestyle disorder, also commonly called a disease of obese people. 90% of all those diagnosed with diabetes are living with this condition.
It is treated with lifestyle modification, weight loss, dietary changes, and oral drugs. In T2D, there is faulty insulin secretion and insulin resistance. It means that the body does not respond well to insulin.
Is it safe to cycle in diabetes?
Yes, cycling is safe when living with diabetes. However, one should be careful when starting since lots would depend on the age, the severity of diabetes, pre-existing comorbidities.
In the case of young individuals with T1D and with no other comorbidities, there would be a greater need to monitor blood glucose levels. Since too much exertion increases the risk of hypoglycemia. Therefore, one may need to check blood glucose, at least before and after each cycling session. There would also be a need for correcting the dosage of insulin therapy.
In the cases of T2D, in the absence of other ailments, the risk of hypoglycemia is minimal. Most people with T2D can tolerate physical exertion quite well and may need only minor corrections in treatment. Therefore, most would perhaps not require any adjustment to therapy in the early stages. However, those with severe T2D and on insulin therapy would need precautions similar to T1D.
However, the need to adjust treatment is not a reason not to cycle. On the contrary, the benefits of physical activity like cycling far outnumber the risks.
Further, it is worth knowing that one may even participate in professional cycling with the right kind of planning. For example, the company Novo Nordisk has a professional cyclist team, and all its team members are living with type 1 diabetes [1].
Why cycling? Can it help manage diabetes?
People living with any type of diabetes will benefit from cycling. However, benefits may be much more significant in T2D. Studies show that lifestyle interventions may even help achieve remission in mild to moderate T2D without medical drugs.
Bicycling has some unique benefits over other types of exercises like jogging, running, or playing football. It is low impact exercise. It means that it does not cause harm to the joints. It may be especially good for older adults with joint disorders.
American Heart Association (AHA) recommends 30 minutes of moderate-intensity exercise a day for five days a week, though 60 minutes would be more beneficial [2].
It is essential to understand that the benefits of cycling would not be limited to diabetes or weight loss. It may help reduce the risk of almost every other non-communicable disease. Thus, it is excellent for cardiovascular, respiratory, and even brain health.
Studies show that cycling combined with weight loss could be quite good for those living with diabetes, as it may lower the need for medications and even insulin. In addition, even casual commuting using a cycle may help improve metabolic indicators [3], [4].
Overweight or obese individuals need to understand that cycling is good for weight loss as it helps burn calories without causing too much strain on the joints. However, exercise alone may not be enough. It is because most people can replenish burnt calories quite quickly. Thus, overweight individuals should always combine cycling with dietary measures.
Calculating intensity of sports
One would often read that moderate or high-intensity exercise is good for health. But, how to calculate the intensity of exercise?
Moderate exercise has a target heart rate of 50% to 70% of maximum heart rate reserve (HRR), and above 70% is high intensity (mostly 70% to 80%).
To calculate exercise intensity, let’s say for an adult of 40 years, one needs to minus the age from 220. It means 220-40=180. Thus 180 is the maximum or upper limit of heart rate. Now measure the resting heart rate (usually between 70 to 80). So, if the resting heart rate is 80, then for a 40-year-old person, HRR would be 180-80=100.
This number 100 is the heart rate reserve (HRR) for that particular individual. It means that 50% intensity exercise would be 50% of HRR plus resting heart rate. Which, in this case, is above 130 beats per minute. In this particular case, 130 to 150 heart rates would be moderate-intensity exercise.
These days, it would be a good idea to invest in a health band or smartwatch to keep an eye on the heart rate. One should start exercising with a lower target like that of 50% intensity.
Starting with cycling, planning, and tips
To begin with, one should decide on the type of cycling one wants to start. This decision will also affect the kind of bike to buy.
One may choose road cycling racing, cyclocross, mountain biking, track cycling. Some of these cycling sports might be pretty demanding and high-intensity exercise.
However, one does not essentially need to engage in high-intensity sports. Casual cycling will work for most. It could be used for commuting, though not necessarily.
Once the decision about the type of biking to engage has been made, the next step would be to create a plan. For example, one may start from as little as 30 minutes for three days a week and slowly progress to 60 minutes five days a week. At the same time, increasing the average speed of cycling on a weekly basis.
How much cycling is good for health would depend on the type of cycling chosen and exercise intensity. Even 30 minutes of high-intensity exercise five times a day is quite good. On the other hand, one may ride for much longer if riding casually and may even ride for few hours (at a slower pace) at weekends or if time permits.
When riding, it is vital to keep an eye on intensity. It would be better to start with moderate intensity of 50 to 70%. Additionally, one may cycle for longer hours if the goal is also a weight loss.
Further, it would be good to combine moderate-intensity cycling with high intensity. For example, one may start with moderate intensity but finish cycling with increased intensity. It is because high intensity may improve basal metabolic rate, thus having more prolonged benefits.
Precautions when cycling with diabetes
When starting cycling and living with diabetes, the type of precautions would depend on two factors: if a person is on insulin or not, secondly, if there are other comorbidities.
Precaution for those on oral hypoglycemic agents
Those not on insulin are generally those living with T2D. Most of these would have mild to moderate diabetes. And, perhaps a majority of these individuals would be above the age of 30 and either overweight or even obese.
Most living with T2D would be on metformin alone or metformin and one more medication. Generally, there would not be any need to reduce medications or change dosages in the early stages. In the absence of other health issues, not many additional precautions are needed. Most T2D medicines do not cause hypoglycemia.
One may need to check glucose levels more frequently, like before and after cycling. After few months, one may see a decline in fasting blood glucose levels and may require changes in medications.
Precautions for those on insulin
All cases of T1D and severe T2D that do not respond to oral drugs are treated by insulin. Even moderate exercise may cause severe changes in blood glucose levels in some. Needless, to say that those on insulin should never forget to carry glucose tablets or sugary drinks with themselves. Moreover, one should be good at identifying the symptoms of hypoglycemia, as it could be life-threatening.
However, it does not mean that cycling is not suitable for T1D or those on insulin. On the contrary, insulin is an excellent anabolic hormone. Moreover, those living with T1D often have normal body weight, and many are physically quite fit.
Thus, the only precaution to take is keeping a close eye on blood glucose levels and adjusting insulin dosage accordingly.
Those living with comorbidities
Over the years, diabetes affects peripheral nerves and the cardiovascular system. In addition, many may be living with autonomic neuropathy, and in such cases, the body may not respond adequately to physical stress.
Those living with heart disease or kidney problems should always consult a doctor before starting cycling.
In most cases, comorbidities are not a contraindication and just a reason to take extra caution. Cycling may even help reduce the severity of neuropathies and help boost cardiovascular health. However, the approach to cycling should be more cautious, and the intensity of exercise should be increased more gradually. Untrained bodies with comorbidities may even start with low-intensity casual cycling.
Final words
To conclude, cycling could be one of the healthiest and engaging activities for those living with diabetes. In addition, it may help manage diabetes. As low-impact sports, it is suitable for various age groups.
There are many types of cycling sports, from casual cycling, commuting to mountain biking. One can adjust the intensity of cycling according to the age, experience of cycling, severity of diabetes, and presence of comorbidities.
References
- 1. All-Diabetes Pro Cycling Team | Type 1 Diabetes | Team Novo Nordisk. Accessed October 15, 2021. https://www.teamnovonordisk.com/
- American Heart Association Recommendations for Physical Activity in Adults and Kids. www.heart.org. Accessed October 15, 2021. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
- Panter J, Ogilvie D. Cycling and Diabetes Prevention: Practice-Based Evidence for Public Health Action. PLOS Medicine. 2016;13(7):e1002077. doi:10.1371/journal.pmed.1002077
- Rasmussen MG, Grøntved A, Blond K, et al. Associations between Recreational and Commuter Cycling, Changes in Cycling, and Type 2 Diabetes Risk: A Cohort Study of Danish Men and Women. PLOS Medicine. 2016;13(7):e1002076. doi:10.1371/journal.pmed.1002076
Dr. Preet SB is an MD (general physician) and was awarded a fellowship in diabetes. He has a particular interest in metabolic or lifestyle disorders. He frequently writes about preventing and managing metabolic disorders through lifestyle changes.
