Day: August 24, 2025

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

It is never easy to live with diabetes, and the condition demands vigilance in terms of diet and exercise, medicines and emotional health. Though there is conventional care on how to keep sugar levels in check, most are resorting to natural methods of keeping healthy. Mindfulness is one of such processes; it is all about living in this moment. Recent studies highlight the benefits of mindfulness-based interventions for diabetes, showing that they can help reduce stress, improve emotional balance, and even support better blood sugar control. By integrating mindfulness into daily routines, individuals with diabetes may find new ways to manage their condition more effectively and enhance their quality of life.

Understanding Mindfulness-Based Interventions

Mindfulness-Based Interventions (MBIs) is a sort of treatment method which uses the practice of mindfulness to encourage both mental and physical well-being. The concept of mindfulness suggests conscious present attention in a non-judgmental, accepting and objective way.

Key Components of MBIs:

• Presence: Being fully aware of the present, of thoughts and feelings, of body and surroundings.
• Non-judgement and acceptance: Perceiving situations without judgment or attempting to alter them and being accepting of thoughts and emotions.
• Self-regulation of attention: Train the power to remain focused and shift attention onto the present-focus without distractions.
• Emotional regulation: Learning to have a new attitude to their thoughts and their distressing feelings: openness and acceptance.
• Practices of mindfulness meditation include: Sitting meditation, body scan, mindful movement (i.e., walking meditation or gentler yoga), and breathing exercises.
• Informal mindfulness: A daily use of mindfulness as in mindful eating or mindful brushing of teeth.

Common Forms of MBIs:

• Mindfulness Based Stress Reduction (MBSR): An eight-week inpatient group session that focuses on meditation and mindfulness activities to mitigate stress.
• Mindfulness-Based Cognitive Therapy (MBCT): Derived out of MBSR but with some inclusions of cognitive therapy based on preventing relapse in cases of depression.
• Dialectical Behavior Therapy (DBT): Uses mindfulness as an element of a comprehensive therapy that focuses on emotional control.
• Acceptance and Commitment Therapy (ACT): Is a larger approach to behavioral change of which mindfulness is a module.

How MBIs Are Delivered:

·       Comprises guided meditation practice, homework practice, and group discussions of experiences.

·       In general, structured group sessions occur 2-2.5 hours a week over 8 weeks.

·       Comprises guided meditation practice, homework practice, and group discussions of experiences.

·       Practices such as body scans gradually lead the attention to various parts of the body.

·       Places greatly focus on experience and developing meta-awareness (being aware of being aware).

MBIsassist a person in achieving the mindful state that helps individuals better manage their emotions, ruminate less, and deal with stress and mental disorders. They are valid across health care, educational, and work environments and can be applied to most populations and situations.

Psychological Benefits of Mindfulness in Diabetes

The psychological benefits of mindfulness in diabetes management are notable and multifaceted. Here are the key points:

• Minimizing stress: Carrying the emotional baggage and stress that comes with dealing with diabetes is reduced with mindfulness. Mindfulness can reduce stress levels, which have been shown to adversely affect the blood glucose levels.
• Better Emotional Regulation: Mindfulness leads to enhanced control of emotions thus patients can control anxiety, depression and diabetes-related distress more easily. This results in a better mood and more consistent diabetes control.
• Improved Self-Care and Adherence: Mindfulness interventions lead to improved self-management of diabetes and adherence behaviors like medication compliance, healthy eating habits, and physical exercise by creating greater self-insight and self-motivation.
• Decrease in Diabetes Distress: Diabetes distress, one of the emotional demands of managing diabetes, decreases by mindfulness practice, which enhances quality of life.
• Positive Thinking and Psychological Well-being: Practicing mindfulness can help enhance positive thinking and psychological well-being during the disease.
• Potential gains in the levels of Depression and Anxiety: Research shows that mindfulness decreases levels of depression and anxiety in a person with diabetes, which also adds to mental well-being.
• Promotion of Glycemic Control through Psychological Process: When stress and emotional changes are minimized through mindfulness this improves blood glucose levels leading to improved diabetes management overall.

Impact on Glycemic Control and Physical Health

Mindfulness-based interventions have demonstrated a positive impact on glycemic control and physical health in people with diabetes. Key findings include:

• Glycemic Control: Mindfulness has been demonstrated to produce a large reduction in an important measure of long-term control of blood glucose levels, hemoglobin A1c (HbA1c). Meta-analyses show decreases in HbA1c of approximately 0.25-0.3 per cent. One trial showed similar effects to that of first line diabetes treatment metformin. This is an advancement in improved overall blood sugar control.
• Physiological Effects: Mindfulness triggers an increase in the activity of the parasympathetic nervous system and decreases sympathetic tone and anxiety hormones such as cortisol and markers of inflammation. These modifications improve insulin resistance and autonomic health along with cardiovascular health, which promotes diabetes prevention and management.
• Stress and Emotional Regulation: Mindfulness reduces stress and enhances emotional self- control; hence, reducing stress-developed glucose variations in blood. This causes more balance in blood sugar levels.
• Physical Health Advantages: Mindfulness meditation plus physical activity has resulted in small changes in body weight, blood pressure, and other metabolic indicators that are relevant to the care of diabetes.
• Self-Management: Enhances self-care behavior to diabetes, like medication adherence, proper diet, and physical exercise, all of which result in improved quality of life and glycemic control.

Mindful Eating and Lifestyle Habits

Mindful eating and lifestyle habits play a crucial role in managing diabetes effectively. Here are the main points on how mindful eating contributes to diabetes management and supports healthier lifestyle habits:

Mindful Eating in Diabetes

• Receptivity to the Eating Experience: Mindful eating is being in touch with the full sensory experience of eating: taste, texture, smell, appearance, as well as internal hunger and satiation.
• Emotional Awareness: It will assist them in understanding whether they are eating out of hunger or emotions such as stress, boredom, or habit and will help curb emotional or stress eating.
• Better Blood Glucose Levels: Mindful eating enhances balanced meals, portion control, and slowing down which can help prevent blood glucose spikes and control blood glucose levels.
• Non-Restrictive Focus: Mindful eating involves not just counting calories or carbohydrates but an amicable approach to food that can be sustained with less effort in the long term.

Lifestyle Habits Related to Mindful Eating

• Preventing Meaningless Eating: Awareness of unique sensory experiences and recognition of satiation cues leads to the reduction of meaningless eating that is also relevant in the management of diabetes.
• Analysis: Greater attention while eating helps in making decisions that are healthier towards the control of diabetes, e.g., incorporating non-starchy vegetables, lean proteins, and quality carbohydrates.
• Environmental Changes: To prevent distraction during meals (turn the TV, turning off electronics) to be able to concentrate on eating mindfully.
• Meal Timing and Nutrient Sequencing: Dinner (or the food we eat at the end of the day) is particularly noteworthy because what we eat and when we eat can have a moderate effect on blood glucose.
• Combining with physical activity: Mindful eating is more effective combined with regular physical activity in promoting good overall metabolic health and diabetes prevention and management.

You may also like to read: Role of Exercise in Diabetes Management

Long-Term Outcomes and Limitations

• Emotional well-being Sustained psychological benefits: Long-term studies report significant effects of MBIs on the emotional well-being including reductions in depression, anxiety, and diabetes-related distress. These psychological advantages are effective in the long term, which leads to a better quality of life among individuals with type 2 diabetes.
• Glycemic Control: Multiple meta-analyses revealed that MBIs have the potential of decreasing hemoglobin A1c (HbA1c) by an average of 0.3 percent; this is considered clinically significant. In some studies, these glycemic improvements have been maintained long-term. Although there is no definite evidence of a large effect on long-term fasting blood glucose or HbA1c levels. Such variability can be the result of a variety of study design, population differences, intervention type, or adherence.
• Physical Health Outcomes: MBIs are connected to decreasing body weight, stress, blood pressure, and depressive and anxiety symptoms. These enhancements apply to cardiovascular health, which is worse in diabetes. Nevertheless, the durability of physical health measures is low and inconclusive.
• Implications on Diabetes Self-Management: MBIs improve attention control, emotion regulation and self-awareness and these factors align with positive lifestyle choices in diabetes management like medication adherence, diet and exercising. These high rates can increase long-term control of the disease and fewer complications.

Limitations and Challenges

• Heterogeneity of Interventions: The nature of mindfulness interventions is vastly diverse, drawing a conclusion across assessment of several studies can be difficult.
• Quality of Studies and Design: The methods of the studies are flawed because the sample size is modest, the follow-up is too brief, or the availability of the control.
• Cultural and Contextual factors: Effectiveness can be influenced by cultural, social, and individual differences not captured in the current research.
• Long-Term Follow-Up: Most studies rely on short- and intermediate-term outcomes; long-term follow-up research is required to provide more information on long-term effects and mechanisms.
• Unreliable Changes in Physical Markers: Psychological ones are more evident, but the biomarkers (fasting glucose and cholesterol levels) do not change reliably.

Practical Tips for Patients

Here are practical mindfulness-based tips for patients with diabetes to help manage their condition effectively:

• Begin Small with Mindfulness Practice: Start with minimal time of mindfulness meditation, such as 5-10 minutes a day and then take it forward as you get increasingly comfortable with the practice.
• Breath Awareness: Pay simple attention to breath. When cravings or stress occur bring your attention back to breath.
• Eat Mindfully: Eat slowly, savor and enjoy every bite and pay attention to the experience of what you are eating, the taste, feel, smell. Listen to your hunger and fullness volumes before meals and during meals.
• Set Up an Eating Free environment: This means no screens and multitasking during mealtimes to help stay present and make food choices aware.
• Body Scan Meditation: Practicing body scan meditation will help improve body recognition, lower stress and improve connection to physical cues like hunger or satiety.
• Practice Mindfulness to Cope with Stress: Putting stress into perspective with mindfulness can help curb feelings of overwhelm and help to address blood sugar and stress levels.
• Incorporate Mindful Movement: Participate in body movements that are light with awareness like walking yoga or tai chi to promote mental state and physical fitness.
• Remain consistent with self-care: Apply mindfulness to develop a humane approach to diabetes treatment practices such as taking medication, blood sugar measurement, and physical activity.
• Find Support: Join mindfulness groups or diabetes education programs that also apply mindfulness to acquire more advice and social support.
• Be Patient and Judgmental- Mindful progress is a gradual process. Handle setbacks with compassion and wonder and instead of judgment.

Final Thoughts

In summary, mindfulness-based interventions have positive effects on diabetes, going beyond reducing stress, to instead providing substantial benefit to mental and physical health. Specifically, mindfulness can be used as a tool to reduce anxiety levels and enhance emotional sturdiness, along with healthier lifestyle choices and better blood sugar levels. Although it should not be a substitute to medical care, making practices, such as meditations, mindful eating, or stress awareness, a part of daily life can help people become more in control of their health. Incorporating mindfulness as a holistic practice, individuals with diabetes can live better and develop enduring equilibrium.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Diabetes is a very prevalent chronic disease globally with millions of people of all ages being victims of this condition. One of the main ways to treat the disease is with the use of medications and diet; however, changes in lifestyle are also instrumental in keeping the condition under control. Of all of these, exercise works as a potent and yet natural measure to control blood sugar and help heart health as well as overall wellbeing. Knowledge of how exercise helps in the management of diabetes may help people to be more proactive in combating diabetes and minimizing complications of the disease.

Why Exercise Matters for People with Diabetes

Exercise is very important for people with diabetes because it helps control blood sugar levels and reduces the risk of severe health complications associated with diabetes. Here are the key reasons why exercise matters for people with diabetes:

• Enhances blood sugar regulation: Exercise aids muscles in utilizing blood sugar (glucose) more accurately, which increases insulin sensitivity and reduces blood sugar levels. It has been reported that regular exercise regimes can lower blood sugar to same extent as diabetes drugs. This is possible up to 2 days after exercising.
• Increases muscle mass and muscle energy use: The larger the muscle mass, the easier the body uses blood sugar as energy, thereby assisting with sugar management. Resistance regular exercise develops muscle and enhances insulin sensitivity which are especially useful in type 2 diabetes.
• Lowers Blood Pressure: The regularity of exercising lowers blood pressure by promoting a longer stroke volume which in turn increases blood flow. This shields individuals with diabetes against heart disease that is a standard complication.
• Aids in Weight Management: Exercise and particularly when added to healthy eating aids in weight loss and weight maintenance. This lowers insulin resistance and can even bring diabetics with type 2 diabetes to remission.
• Means to Enhance Overall Well-being: Exercise helps to boost energy, mood, sleep and mental well-being because it releases endorphins. It also aids flexibility of joints and stress reduction thus leading to higher quality of life.
• Various Kinds of Exercise Are Advantageous: Aerobic (e.g. walking, cycling, swimming) and resistance training (e.g. weightlifting, bodyweight exercises) are both beneficial. Combining both types has maximum benefits, but any regular exercise will be beneficial HIIT is effective as well.
• Considerations Regarding Safety: Patients with diabetes must measure their blood glucose before and after their workout to prevent hypoglycemia, especially when taking insulin or other blood sugar decreasing drugs.

Key Benefits of Exercise in Diabetes Management

Key benefits of exercise in diabetes management include:

• Enhances Blood Sugar Control: Exercise improves insulin sensitivity and uptake of glucose by muscles thus ensuring lower blood sugar levels and controlling glucose up to 24-48 hours after exercise. This is critical in controlling diabetes type 1 and diabetes type 2.
• Creates Insulin sensitivity: Exercise leads to insulin sensitivity, which is the fundamental issue in diabetes type 2 since it helps the body to respond positively to insulin.
• Reduces HbA1c: The interval average of blood glucose (HbA1c) level is reduced by about 0.67 percent through regular exercise, equating to some diabetes drugs.
• Facilitates Weight Control: Physical activity aids in weight loss and weight maintenance and decreases metabolic demands to provide greater control of diabetes. It also decreases central fat that is affiliated with metabolic risk.
• Enhances Vascular Health: Exercise reduces blood pressure, improves HDL and LDL cholesterol and blood triglyceride levels, and reduces the risk of cardiovascular disease, which is elevated in individuals with diabetes.
• Develops Muscle Mass and Strength: Weight based exercising increases the mass of muscles, which also has a positive outcome in insulin resistance as well as glucose metabolism.
• Boosts Mental Health and Well-being: Through the release of endorphins, exercise lessens stress levels, enhances mood, induces sleep, and diminishes signs of anxiety and depression.
• Aids in Prevention of Diabetes: In people who have pre-diabetes and those who are at risk, physical exercise is very effective in reducing the chances of developing diabetes type 2. Diets with regular exercise can help lower incidence by up to 74-46 percent in clinical trials.
• Varied Types of Exercise: It is best to combine aerobic work (walking, cycling, swimming), athletic training, and even dancing or walking sports. The routine is made sustainable by consistency and fun.

Overall, exercise is a cornerstone of diabetes management for its multifaceted benefits on glucose control, cardiovascular health, weight management, and overall quality of life.

Types of Exercise Recommended for Diabetes

The best exercises suggested to those with diabetes are a collection of aerobics, resistance, flexibility, and balance exercises. The most significant ones are the following categories and examples:

1. Aerobic Exercise
   • Walking (brisk walking is especially beneficial)
   • Cycling
   • Swimming and water aerobics (low impact on joints)
   • Running or jogging (if appropriate)
   • Aerobic dance or fitness classes (e.g., Zumba)
   • Team sports like basketball, soccer, tennis
     Aerobic exercises improve cardiovascular health, lower blood sugar, and help with weight management.
2. Resistance Training (Strength Training)
   • Weightlifting with free weights or machines
   • Resistance band exercises
   • Bodyweight exercises (push-ups, squats)
     Resistance training builds muscle mass, which improves glucose uptake and insulin sensitivity. It complements aerobic exercise in diabetes control.
3. Flexibility and Balance Exercises
   • Yoga
   • Tai Chi
   • Pilates
     These improve flexibility, balance, and stress reduction, helping especially older adults with diabetes avoid falls and better manage blood sugar.
4. Low-Impact and Seated Exercises
   • Aquatic exercises are good for joint issues or neuropathy
   • Specific calf muscle exercises (like soleus push-ups) can help lower blood sugar even when seated.
5. High-Intensity Interval Training (HIIT)
   • Alternating periods of high- and low-intensity exercise (e.g., sprinting and walking)
     HIIT can be effective in improving blood sugar and fitness in people with type 2 diabetes.

General guidelines indicate that one should exercise at least 150 minutes weekly of moderate-intensity aerobics, performed on most days, and added two or three sessions of resistance training. Balance training and flexibility exercise are advised regularly, particularly those at old age.

You may also like to read: Importance of Carbohydrate Counting in Diabetes

Best Times to Exercise for Blood Sugar Control

The best times to exercise for blood sugar control in people with diabetes are generally:

• Afternoon and Evening: Afternoon or evening exercise has shown to provide greater benefit in insulin resistance and blood sugar regulation. In a study by Anderson, the work conducted moderately vigorous physical activity at noon to midnight cutting down insulin resistance and hepatic fat content significantly as compared to earlier in the day. Midday and evening exercise regimens performed better than a morning or all-day strategy at reducing insulin resistance with an 18 and 25 per cent lower rate of reduction respectively.
• Three to Dosto Hours After Eating (Post-Meal): This is an ideal time to work out as the glucose level is elevated and ready to be burnt. Exercise after meals may be able to reduce after-meal blood sugar spikes, as well as long-term cardiovascular risks. This schedule is viable in the control of glucose levels after a meal.
• Morning Exercise: This is not an advantage, but morning exercise may be appropriate to those who want to work out in the morning or must attend other activities in the daytime. It is reported that fast exercise in morning can enhance insulin sensitivity of a day, helping to manage weight and decrease food consumption. In the case of individuals with type 1 diabetes, training in the morning may enhance risks of hypoglycemia less than training later in the day.
• Timing Should Accommodate Personal Routine and Chronotype: A consistent time schedule is the most important thing to adhere to in long-term equivalents. The chronotype (being a morning or an evening person) also has an impact on exercise preference and metabolic reactions. Selecting a time that suits one better helps to sustain physical activity.
• Safety precautions: Insulin users or users of blood sugar-lowering drugs should measure their blood sugar before any exercise to avoid hypoglycemia, irrespective of the time of exercise.

Precautions and Safety Tips

Here are important precautions and safety tips for exercising with diabetes:

• Medical Approval: Seek doctor approval before commencing and changing an exercise regime especially when you have heart disease, neuropathy, retinopathy, kidney problems, or you use insulin or a drug that can cause hypoglycemia. Your physician can prescribe exercise advice and can modify the drugs.
• Start at Low Pace: When starting or after a hiatus, start at low and slow pace to prevent injury and over-fatigue yourself.
• Monitoring Blood Sugar: Monitor blood sugar levels before, during (long instance only), and after exercise especially in cases where you are taking insulin or other medications that reduce blood sugar as this could result in hypoglycemia. Use quick-energy carbohydrates to correct low blood sugar.
• Hydrate: Before, during and after physical activity, drink lots of water to avoid dehydration.
• Use Good Quality Footwear and Care: Wear proper shoes that fit your feet well and have good support. Wear socks made of moisture-absorbing materials to keep your feet and feet dry. Check feet daily, it you have neuropathy.
• Warm Up: Cool Down: 5-10 minutes warm up and cool down to gear up the muscles and minimize the chances of injury.
• Sporting in Safe Areas: Never sport in areas with extreme climate conditions, sport either indoors in the slightest weather extremes.
• Wear a medical ID bracelet or tag indicates you have diabetes in case of an emergency.
• Take Note of Your Body: Do not exercise when you are in pain, dizzy, lacking breath or weak. Remedy any strange symptoms with your doctor.
• Practice Constantly: The benefits will persist with regular physical activities over time and at the same time.

By taking these precautions, exercise becomes safe and effective in management of diabetes.

Would it also help to give some specific advice on how to manage blood sugar before/during/after what types of exercise? The key precautions and safety tips of exercising with diabetes are as follows:

• Check with your physician before undertaking or modifying an exercise program, particularly when you have heart disease, neuropathy, retinopathy, kidney problems, or are on insulin or some medications that may cause low blood sugar. Your doctor can recommend certain changes or exams
• To avoid injuries, start the exercise gradually in case you are new or returning after long absence. Start with activities such as walking that have low impact.
• Pre-check and post-check sugar levels to avoid hypoglycemia, especially during long exercise sessions in case of insulin or lowering of glucose medications. Respond to low blood sugar with carbohydrate snacks.
• Avoid dehydration before, during and after exercise.
• Use well-fitting shoes and socks that are moisture-wicking. Check your feet each day especially in case you have nerve damage (neuropathy).
• Before exercise, warm up properly and after exercise cool down to prepare your muscles to reduce injury.
• When the weather is too cold or hot, avoid exercising in extreme temperatures, consider an indoor exercise.
• Wear a medical ID bracelet or tag when you have diabetes to identify you in case of emergency.
• Stop exercising at any time when you feel any pain, dizziness, shortness of breath, or faintness. Check with your medical expert about unusual symptoms.
• It is best to have consistent exercise schedules to remain beneficial and safe.

Making these precautions will make exercise an effective and safe part of diabetes and complications management.

Bottom Line

Exercise is much more than a fitness workout it is a component of effective diabetes management. Exercise has many benefits, which include but are not limited to better control of blood sugar levels, increased insulin sensitivity, healthy cardiac functioning and robust mental health maintenance. The solution is to make it safe and fun and tailor exercise plans to health requirements. Regularly exercising will allow people to take more control of their condition and minimize their chances of developing complications and create a healthier future.