Exercise benefits people with diabetes and those at risk for diabetes by helping manage weight, by improving blood sugar levels, and by improving heart health. For a person with diabetes, exercise is just as important as diet and medication. In fact, the American Diabetes Association recommends at least 30 minutes of physical activity that increases the heart rate five days per week.
“Healthy diet and exercise are likely as strong as any medication I will ever prescribe for diabetes, and should be continued forever,” says Michael Heile, MD, a family medicine doctor at TriHealth’s Family Medical Group.
It is important to design a lifelong exercise routine that is both attainable and enjoyable. Walking is one of the easiest and most convenient options, but you may want to explore new options, too! You should exercise at a comfortable pace and do not overexert yourself. If you adhere to a steady, regular program, you can expect these outcomes:
- Increased insulin sensitivity (insulin works better)
- Lower blood sugar levels
- Increased energy and endurance throughout the day
- Weight loss with increased muscle tone
- A healthier heart and lower blood pressure
- Better sleep at night
- Stronger bones and a lower risk of osteoporosis
- Better resistance to illness
- Improved cholesterol, heart rate, and blood pressure levels
- Lower stress, anxiety, boredom, frustration and depression
The American Diabetes Association recommends two different types of exercise for managing diabetes: aerobic and strength training.
This exercise is done by using your arms and/or legs in a continuous, rhythmic movement in order to increase your heart rate. Examples include running, dancing, biking, swimming and walking. Be sure to pick an aerobic exercise that you enjoy and set realistic goals.
Strength training (also called resistance training) makes your body more sensitive to insulin and can lower blood sugar.
In addition to aerobic activity, the American Diabetes Association recommends doing strength training exercises at least two times per week, but not two days in a row. Examples of strength training include using weight machines, free weights and resistance bands, and doing body weight exercises such as push-ups, lunges and sit-ups. Lifting items around the house such as canned goods or water bottles works, too.
Precautions for Exercising with Diabetes
- Always consult with your doctor before beginning any exercise program to be sure it is medically safe to exercise and review principles noted below.
- Exercise can lower blood sugar suddenly, but in the case of strength training, it can increase blood sugar levels. Be sure to monitor blood sugar levels before and after all exercise routines to better understand how your body responds to exercise and to prevent any severe deviations.
- Those with Type 1 diabetes should also test for ketones in their urine (if blood sugar is severely or unexplainably high) before exercising and should avoid vigorous activity/exercise when ketones are elevated. You can likely exercise when your blood sugar is high as long as there are no ketones in your urine and blood sugar is not severely high.
- For those taking insulin and/or medications such as glipizide or glyburide (insulin secretagogues), exercise can cause low blood sugar if medication dose or carbohydrate intake is not adjusted appropriately. Extra carbohydrates should likely be consumed if pre-exercise blood sugar levels are under 100 to 120 mg/dL.
- Low blood sugar is less common in diabetic patients who are not treated with insulin or insulin secretagogues, and no preventive measures for low blood sugar are usually needed in these cases.
- Stop exercising and call 911 immediately if you have any of these symptoms during, or even several hours after, exercise:
- Lightheadedness or dizziness
- Rapid heart beat
- Chest discomfort
- Jaw, arm, or upper back discomfort
- Unusual shortness of breath
- Sudden weakness
- Severe or unusual fatigue or sleepiness
- Severe discomfort of any kind