Diabetes and Exercise

Diabetes and Exercise 

If you’ve been diagnosed with prediabetes or diabetes, your doctor has probably already encouraged you to start a regular exercise routine. But it can be hard to know how and where to get started. Let’s start with the basics.

Benefits of Exercise 

exercises to do with your kids

Exercise is important for everyone but becomes even more so if you have diabetes. Consistent exercise can lower blood sugar and improve A1C by helping your body more efficiently use insulin. 

And while it can help prevent or delay further complications from diabetes, it’s not all about your diabetes. Exercise has broader health benefits. It can help you feel better by improving your sleep and help you manage stress, lower your risk of heart disease and stroke, raise your good cholesterol, and control your blood pressure. Best of all, when you choose activities you enjoy, it can be fun! 

Getting Started with an Exercise Program 

There are two types of exercise that help your body use blood sugar. Experts advise both types of exercise for people with diabetes:

  • Aerobic exercise. This is a rhythmic, repeated, continued movement of large muscle groups for at least 10 minutes at a time. Examples include walking, biking, jogging, swimming, water aerobics, bicycling, tennis, basketball, cross country skiing and many other sports. These activities work your large muscles, raise your heart rate, and increase how much air your lungs can hold. Aim to do this for about 30 minutes on most days of the week. 
  • Strength training. This is when you use muscles to move weight or work against resistance. You can do this with free weights, machines, resistance tubing, or your own body weight. Aim for 2 to 3 sessions of resistance exercise each week, skipping a day in between each. Start with a weight or resistance level that you can do 8-12 repetitions of the exercise at. Then gradually increase resistance while still maintaining the same number of repetitions. Aim for 2-3 sets of the exercise. Examples include lunges, squats, wall pushups, plank or side planks, calf raises, and bicep curls. 

Interval Training

As you get more comfortable with your new exercise routine, you might incorporate interval exercise into your routine. Interval training alternates between higher and lower intensity exercises, raising your heart rate while building strength. Try a higher intensity exercise for 30 seconds followed by a 15 second rest period. In addition to the resistance exercises above, you might work in some of the following higher intensity exercises:

  • Jumping jacks 
  • Run in place 
  • Wall sits 
  • High Knees or butt kicks 
  • Mountain climbers 
  • Burpees

Choose 4-6 exercises and do each 2-3 times in this rotating fashion—30 seconds on, 15 seconds off. 

Adding Activity to Your Day

Four adults walking outdoors

If that sort of structured exercise works for you, that’s great. But exercising doesn’t have to require a lot of equipment or a gym membership. Find activities you enjoy doing and find small opportunities to move a little more each day:

  • Take the stairs instead of the elevator
  • Garden and do housework and yard work
  • Choose a parking space farther from the store
  • Take a work call while walking or walk to talk to a co-worker instead of calling
  • Ask a friend to join you for a walk instead of coffee.
  • Take a 10-minute walk around the block at lunch or after dinner 
  • Dance in the living room
  • Walk to a bus stop a little farther from your home or office
  • Do things you enjoyed as a kid – go sledding, ride a bike, or try roller blading (don’t forget important safety gear like a helmet)

Start out slowly. Try adding more movement to your daily routine. Every little bit helps. If you're having fun doing physical activities you really like, you'll be more likely to exercise each day.

A Goal to Shoot for

Talk with your healthcare provider about any limits you may have before starting an exercise program. Then aim for 150 minutes a week of physical activity. Don’t let more than 2 days go by without exercise. Walking 10 or 20 minutes every day is better than 1 hour just once a week. When you are sitting for long periods of time, get up for short sessions of light activity every 30 minutes.

Your main goal is to become more active. Even a little bit helps. Choose an activity that you like. Walking is one great form of exercise that everyone can do and can be done with friends. 

Lean on Your Care Team 

If you haven’t been active, talk with your healthcare team before you begin. People with diabetes and eye or foot problems may need to change certain exercises. If you have nerve damage from diabetes, you may not be able to tell if you’ve injured your feet during exercise.

Monitor your blood glucose before, during and after exercise.

Always check your blood sugar before you exercise and follow these guidelines: 

  • Lower than 100 mg/dL. Your blood sugar may be too low to exercise safely. Eat a small snack containing 15 to 30 grams of carbohydrates. 
  • 100 to 250 mg/dL. For most people, this is a safe pre-exercise blood sugar range. 
  • 250 mg/dL or higher. Use caution. Before exercising, test your urine for ketones — substances made when your body breaks down fat for energy. The presence of ketones indicates that your body doesn't have enough insulin to control your blood sugar. Take steps to correct the high blood sugar levels and wait to exercise until your ketone test indicates an absence of ketones in your urine.

Physical activity can lower your blood glucose too much and lead to hypoglycemia, which can occur during exercise, after, or much later. This is especially true if you take insulin or certain medicines. 

Make sure to monitor your blood sugar and watch for signs of hypoglycemia, which include:

  • Shakiness
  • Dizziness
  • Sweating
  • Hunger
  • Headache
  • Irritability
  • Pale skin color
  • Sudden moodiness or behavior changes
  • Clumsy or jerky movements
  • Trouble paying attention, or confusion
  • Tingling feelings around the mouth

If you are using continuous glucose monitoring, be aware that your readings may not be reliable if you are having a low blood sugar episode. They will need to be confirmed by finger-stick readings. Always carry glucose tablets or other treatments for low blood sugar during exercise. Drink plenty of fluids during exercise. Dehydration can affect your blood glucose levels.

Check Your Feet for Irritation

Wear cotton socks and well-fitted, comfortable athletic shoes. After exercise, look closely at your feet, including between your toes, for signs of irritation, broken skin, blisters, or other injuries. Use a mirror to check the bottoms of your feet. If you have consistent redness or rubbing on one area of your foot, consider getting refitted for a different pair of athletic shoes.

If you have pain, stop your activity until the pain goes away. If it comes back, call your healthcare provider right away.

For more tips on how to best manage your diabetes, team up with a Diabetes Care and Education Specialist for one-on-one or group support to address your questions and concerns and help set up a plan that works for you.