updated 9/25/2009 9:03:48 AM ET 2009-09-25T13:03:48

Here's something you should know about diabetes: Even if you already have it, you can control the disease and avoid many of its consequences.

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"If you come close to doing the right thing, there's no reason you shouldn't live out a normal life," says Gerald Bernstein, MD, an endocrinologist at Beth Israel Medical Center in New York City. "To me, normal means age 90."

And what's part of that "right thing" that Bernstein alludes to? You guessed it — walking. The combination of a healthy diet and regular physical activity such as walking can help you slim down — an important benefit because being overweight is a major risk factor for diabetes.

But walking fights diabetes in ways other than weight loss. Studies are just starting to show the preventive power of fitness. The famed Nurses' Health Study, for example, found that women who worked up a sweat more than once a week reduced their risk of developing diabetes by 30 percent. And Chinese researchers determined that people with high blood sugar who engaged in moderate exercise (and made other lifestyle changes) were 40 percent less likely to develop full-blown diabetes. "It wasn't really vigorous exercise, either," notes Richard Eastman, MD, former director of the diabetes division of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Md.

Why does walking have such protective effects? Besides helping you get rid of extra pounds, it actually increases the number of insulin receptors on your cells. Insulin helps blood sugar move into cells, where it needs to go. Otherwise, it just sloshes around in your bloodstream, gumming up the blood vessel walls.

If you've already been diagnosed with diabetes, regular walking can help control the progression of the disease. People who take insulin may be able to reduce the amount of medication they need, as physical activity enables their body to use insulin more efficiently.

As a bonus, regular walking can help keep your brain sharp. Scientists have observed that older people with diabetes sometimes have problems thinking clearly. In one study, physical activity appeared to stimulate just the type of brain activity that had become impaired. Some experts theorize that exercise-related brain activity could be part of the reason why some folks say they are able to solve sticky problems while they are ticking off minutes and miles on their treadmills.

For all of these reasons, walking may be one of the best diabetes therapies around. If you already have diabetes, walking helps you control the disease and avoid many of its consequences.

Before you begin a walking program, check with your doctor, especially if you already have diabetes. Your doctor can tell you whether you need to take any special precautions when you work out.

According to Bernstein, you must exercise for at least 30 minutes three times a week to enhance your body's use of insulin. If your goal is to lose weight, however, you would do well to walk five to seven times each week. But, of course, you will want to work up to that level slowly, especially if you have been sedentary. If you skip a day, don't try to make up for it by walking twice as fast or twice as far during your next workout. Vigorous exercise can actually cause blood sugar to rise, especially in people who have insulin deficiencies.

If you have diabetes, the timing of your walks can help regulate your blood sugar level. People with type 2 (noninsulin-dependent) diabetes may benefit from exercising before meals, which helps control appetite and promote weight loss. For those with type 1 (insulin-dependent) diabetes, it's best not to exercise on an empty stomach. These folks should plan their walks for about an hour or so after a meal, when blood sugar levels are at their highest.

There are times when exercise can send blood sugar plummeting. This reaction is most common among people who use insulin. Ask your doctor how much exercise you can tolerate before you need to replenish your store of carbohydrates. And carry a healthy snack — such as a piece of fresh fruit, dried fruit, or some peanuts or trail mix — for just this purpose.

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