Fitness Testing for Type 2 Diabetes

Exercise is as important as medication for diabetes management:

• Improves Insulin Sensitivity: Exercise makes muscle cells more responsive to insulin, helping clear glucose from blood more effectively
• Glucose Uptake: Muscle contraction during exercise pulls glucose into cells independent of insulin (GLUT4 translocation)
• Lowers A1C: Regular exercise can reduce A1C by 0.5 to 1.0 percentage points (equivalent to adding a diabetes medication)
• Cardiovascular Protection: Reduces heart disease risk, the number one complication of diabetes
• Weight Management: Supports weight loss which improves diabetes control
• Blood Pressure Reduction: Lowers blood pressure, common in diabetes
• Lipid Profile Improvement: Raises HDL cholesterol, lowers triglycerides
• Reduces Medication Needs: Many people can reduce or eliminate diabetes medications with sustained lifestyle changes (under physician supervision)

VO₂ max testing provides crucial data for diabetes exercise prescription:

• Assess Cardiovascular Fitness: Diabetes reduces cardiovascular fitness. Many people with Type 2 diabetes have 20 to 30% lower VO₂ max than age-matched non-diabetic individuals
• Individualized Exercise Zones: Generic heart rate formulas are inadequate. Testing reveals YOUR specific zones for optimal blood glucose management
• Zone 2 for Insulin Sensitivity: Moderate intensity (60 to 70% max heart rate) maximizes insulin sensitivity improvements and fat oxidation
• Safe Exercise Limits: Know how hard you can safely exercise, especially important if you have diabetic complications (neuropathy, retinopathy, cardiovascular disease)
• Track Improvements: Retest every 8 to 12 weeks. As diabetes control improves, VO₂ max often increases
• Detect Cardiac Complications: Unexpectedly low exercise capacity may indicate silent cardiac disease (common in diabetes) requiring further evaluation

Testing Process: 45 to 60 minute appointment. Choose equipment based on any neuropathy or joint concerns. Same day results with detailed heart rate zones.

Weight loss of just 5 to 10% can dramatically improve diabetes control:

• Precise Metabolic Rate: Know your exact daily calorie burn. Online calculators can be off by 300 to 600 calories
• Safe Weight Loss Targets: Create appropriate 300 to 500 calorie deficit for 0.5 to 1 pound per week loss
• Diabetes Impact: 5 to 10% weight loss can reduce A1C by 0.5 to 1.5%, improve insulin sensitivity, reduce medication needs
• Preserve Muscle: Adequate protein and proper deficit prevent muscle loss, which is crucial for glucose disposal and insulin sensitivity
• Adjust as Weight Changes: Retest RMR every 3 to 6 months. Metabolism decreases as weight decreases

Testing Process: 20 to 30 minute appointment. Fast for 4 to 5 hours. Same day results with personalized calorie and macronutrient recommendations.

VO₂ max plus RMR testing (save $25)

Most comprehensive approach combines both tests:

• Exercise Prescription: Heart rate zones for optimal insulin sensitivity
• Nutrition Targets: Precise calories for weight loss and diabetes control
• Address Both Factors: Exercise and weight loss have synergistic effects on diabetes

Based on American Diabetes Association guidelines:

• Aerobic Exercise:
  • • Minimum: 150 minutes per week moderate intensity (Zone 2)
  • • Spread over at least 3 days per week, no more than 2 consecutive days without exercise
  • • Post-meal exercise particularly beneficial (10 to 15 minute walk after meals blunts glucose spikes)
• Resistance Training: 2 to 3 days per week. Muscle mass is crucial for glucose disposal and insulin sensitivity. All major muscle groups, 2 to 3 sets
• Reduce Sedentary Time: Break up sitting every 30 minutes. Even light activity helps blood glucose control

For your safety during VO₂ max testing:

• Check Before Testing: Blood glucose should be 100 to 250 mg/dL ideally
• Below 100 mg/dL: Eat 15 to 30 grams carbs and recheck in 15 minutes before starting
• Above 250 mg/dL: Check for ketones. May need to defer testing if ketones present or feeling unwell
• Bring Glucose Tabs or Snacks: Fast-acting carbs in case of hypoglycemia during or after testing
• Medication Timing: Take usual diabetes medications as prescribed. Discuss timing with physician if on insulin or medications that can cause hypoglycemia
• Monitoring Equipment: Bring your glucose meter to check before and after testing

Discuss testing with your physician if you have:

• Cardiovascular Disease: Common in diabetes. May need cardiac stress test before exercise testing. Discuss with cardiologist
• Severe Peripheral Neuropathy: Reduced sensation in feet may affect balance and safety on treadmill. Bike or seated equipment preferred
• Autonomic Neuropathy: Affects heart rate response and blood pressure regulation. May need medical stress test first
• Proliferative Retinopathy: Avoid vigorous exercise until treated. May contraindicate maximal testing
• Recent Laser Eye Surgery: Wait 3 to 6 months before vigorous exercise
• Nephropathy (Kidney Disease): Generally not a contraindication, but discuss with physician
• Foot Ulcers or Wounds: Defer testing until healed

Important medication information:

• Insulin: Increased risk of hypoglycemia during/after exercise. May need to reduce pre-exercise dose (consult physician). Monitor glucose carefully
• Sulfonylureas (glyburide, glipizide): Can cause hypoglycemia with exercise. Monitor closely
• Metformin: Does not cause hypoglycemia. Safe for exercise
• GLP-1 Agonists (Ozempic, Mounjaro): Generally safe. May reduce appetite affecting food intake
• SGLT2 Inhibitors: Stay well hydrated during exercise
• Beta-Blockers: Lower heart rate response. Zones will be based on YOUR medicated response

Monitor multiple markers with your healthcare team:

• A1C: Every 3 months. Target typically below 7% (individualized)
• Fasting Glucose: Daily monitoring per physician protocol
• Continuous Glucose Monitor: If using CGM, track patterns and exercise effects
• Body Weight: If overweight, target 5 to 10% loss
• Blood Pressure: Goal typically below 130/80 mmHg
• Lipids: Cholesterol panel every 6 to 12 months
• VO₂ Max: Retest every 8 to 12 weeks to track fitness gains
• Exercise Log: Track weekly minutes of Zone 2 training

With sustained lifestyle changes, many people achieve diabetes remission:

• Definition: A1C below 6.5% without diabetes medications for at least 3 months
• Keys to Success: 10 to 15% weight loss, regular exercise (150+ minutes per week), improved diet
• Timeline: Typically requires 6 to 12 months of consistent effort
• Medication Reduction: Under physician supervision only. Never stop medications without medical approval
• Continued Monitoring: Even in remission, continue glucose monitoring and healthy lifestyle

Share your testing results with:

• Endocrinologist or Primary Care Physician: Manages overall diabetes care and medications
• Certified Diabetes Educator (CDE/CDCES): Provides diabetes self-management education
• Registered Dietitian: Uses RMR data to create diabetes-appropriate meal plans
• Exercise Physiologist or Certified Diabetes Exercise Specialist: Uses VO₂ max zones to design workout programs
• Pharmacist: Reviews medications and timing around exercise

VO₂ Max Test: $250

RMR Test: $75

Performance Pack (Both): $300

Fit Evaluations
311 Soquel Ave
Santa Cruz, CA 95062

Behind Hindquarter restaurant (second entrance off Dakota St.)

Phone: 831-400-9227
Email: info@fitevals.com

Call to discuss your diabetes management and whether physician clearance is recommended.