Diabetes and Exercise

Exercise helps you lose weight and/or stay at a healthy weight as well as improve your blood sugar. It also helps your heart stay healthy. For the person with diabetes, exercise is as important as diet and medication. You should get at least 30 minutes of physical activity that increases your heart rate 5 days a week.

It is important to design a lifelong home exercise routine. Walking is one of the easiest and most convenient options, but there may be others you enjoy. Exercise should be continuous and rhythmical. It should be done at a comfortable pace. “No pain, no gain” does not apply.

If you stick with a regular, consistent program, you can expect these rewards:

  • Increased insulin sensitivity
  • Lower blood sugar levels
  • More energy and endurance (stamina) throughout the day
  • Improved appearance
  • A slimmer, trimmer body
  • Better posture
  • Weight loss
  • Less body fat
  • Increased muscle tone
  • Decreased appetite following exercise
  • Lower heart rate and blood pressure
  • Stronger heart muscle and better blood flow: the more you use your heart muscle, the stronger it becomes
  • Better sleep at night
  • Stronger bones and a lower risk of osteoporosis
  • Better resistance to illness
  • Improved cholesterol
  • Lower stress, anxiety, boredom, frustration and depression

Recommended Exercise for Diabetes Management

The American Diabetes Association recommends two different types of exercise for managing diabetes: aerobic and strength training.

Aerobic Exercise

This exercise is done by using your arms and/or legs in a continuous, rhythmic movement in order to increase your heart rate (pulse).

Aerobic activities include:

  • Aerobics
  • Running
  • Dancing
  • Skating (ice or roller)
  • Biking/Stationary bike
  • Hiking
  • Swimming
  • Jogging/Walking
  • Rowing

Note: Moderate intensity means that you are working hard enough that you can talk, but not sing, during the activity. Vigorous intensity means you cannot say more than a few words without pausing for a breath during the activity.

These types of exercise can make all the muscles in your body stronger. Pick an aerobic exercise that you enjoy and set realistic goals. This way you will be more likely to keep doing it on a regular basis.

Strength Training

Strength training (also called resistance training) makes your body more sensitive to insulin and can lower blood sugar.

The American Diabetes Association recommends doing strength training exercises at least 2 times per week in addition to aerobic activity. Some people have higher blood sugars after doing strength training. It is a good idea to check your blood sugar before and after these exercises.

Below are examples of strength training activities:

  • Weight machines or free weights at the gym
  • Using resistance bands
  • Lifting light weights or objects like canned goods or water bottles at home
  • Exercises that use your own body weight to work your muscles (examples are pushups, sit ups, squats, lunges, wall-sits and planks)
  • Strength training classes
  • Other activities like heavy gardening that build and keep muscle.

Flexibility and Balance Training

Flexibility and balance training is recommended 2-3 times per week for older adults. This includes activities like yoga and tai chi to increase flexibility, muscular strength and balance.

Exercise in the Presence of Uncontrolled Blood Sugars

High Blood Sugar

For people with type 1 diabetes who have ketones in the urine and/or blood, exercise can cause blood sugar and ketones to go up further. Ketones are made when body fat is broken down for energy because glucose is not getting into the cells. Vigorous activity should be avoided when your blood sugar is high and there are ketones in your urine. Ketones are checked for using a strip that is dipped in your urine. You can exercise when your blood sugar is high as long as there are no ketones in your urine.

Low Blood Sugar:

In people 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 changed.

For people on these medicines, extra carbohydrate should be eaten if pre-exercise sugar levels are 100 mg/dL or less.

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 is usually needed in these cases.

Hints for a Successful Exercise Program

  • Talk with your doctor before starting any exercise program.
  • Set short- and long-term goals for yourself. Reward yourself when you meet them.
  • Exercise with music or in front of the television.
  • Wait one hour after eating before exercising.
  • Pick an exercise you like that fits into your lifestyle.
  • Exercise with a friend for both safety and motivation.

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
  • Nausea
  • Unusual shortness of breath
  • Sudden weakness
  • Severe or unusual fatigue or sleepiness
  • Severe discomfort of any kind

**Be aware that exercise can lower blood sugar quickly. Blood sugar should be monitored before and after all exercise routines.

In a medical emergency, call 911.