If you have diabetes, exercise is one of the most important things you can do to keep it under control and reduce your risk of complications.
“Everyone with diabetes should be including some form of activity or exercise in their lives. Life gets busy, but this is something that needs to be prioritized for your diabetes and overall health and well-being,” said Jordan Wagner, a diabetes educator with Banner - University Medicine.
Exercise can help:
- Lower your blood sugar levels since your muscles use glucose for energy. Regular exercise helps maintain stable glucose levels over time.
- Improve your sensitivity to insulin so you can use it more effectively, control blood glucose levels better and lower your risk of diabetes complications. “Think of insulin like a key that opens a locked cell in the body and allows glucose to enter to be used for energy. If someone is more sensitive to insulin, less of an insulin response is needed from the pancreas or injection,” Wagner said.
- Increase blood flow, which is often slower or limited in parts of the body in people who have diabetes.
Beyond blood sugar control, exercise helps maintain a healthy weight, reduces the risk of heart disease, improves mood and boosts overall energy levels.
Incorporating regular exercise into your routine can provide these benefits and significantly enhance your diabetes management. “Make exercise fun,” Wagner said. “When you enjoy what you are doing while exercising, it will make it easier to turn it into a habit.”
The right way to exercise for your fitness level
You need to be careful to choose the type and intensity of exercise that meets your needs and fitness level. If you’re just starting out with exercise, you’ll want to choose gentle activities that bring health benefits. Here are some good options:
- Walking: This simple, accessible exercise helps improve heart health, manage weight and regulate blood sugar levels. Start with short walks and gradually increase the length as you build stamina.
- Swimming: This full-body workout is easy on the joints, so it’s a great choice if you have joint issues or arthritis.
- Cycling: This gets your heart rate up without putting too much strain on your joints.
As you build strength and endurance, you might be ready for more of a challenge. Here are some intermediate-level options:
- Jogging: A step up from walking, jogging increases cardiovascular fitness and helps maintain a healthy weight. It's a good way to challenge yourself while controlling your intensity.
- Strength training: Weightlifting or resistance exercises help build muscle mass and improve your strength. Strength training increases your metabolism and supports weight management. Start with lighter weights and increase as you become more comfortable.
- Group fitness classes: Aerobics, spinning or dance classes offer a structured way to exercise and stay motivated. They bring variety, and you can adapt them to your fitness level so you stay engaged and challenged. “Exercise with groups can be fun and increase a sense of community and belonging. This is very important, as depression and anxiety are more common among people living with diabetes,” Wagner said.
- Team sports: Engaging in team sports can improve your fitness, help manage diabetes and keep you motivated.
If you’re already experienced with exercise and looking for more challenging workouts, consider these high-intensity options:
- Running: This high-impact activity can further improve your cardiovascular health and stamina.
- Weightlifting: Advanced weight training involves lifting heavier weights or performing complex movements to build muscle strength and increase overall fitness.
- High-intensity interval training (HIIT): HIIT involves alternating between short bursts of intense activity and periods of rest. This type of workout improves cardiovascular fitness, burns calories and builds muscle in shorter workouts.
It’s best to incorporate both cardio and strength training as part of your fitness routine. “Many people are unaware that strength training exercises can increase blood sugars at first. If you have blood sugar above 300mg/dL, you should treat this high glucose according to your doctor’s recommendations first. Once your glucose level is below 180mg/dL, you can safely begin strength training,” Wagner said.
Consult with your health care provider before starting or modifying an exercise program if you have diabetes.
What to know about exercising with type 1 and type 2 diabetes
You’ll need to take certain factors into consideration when exercising if you have diabetes, especially if you have type 1 diabetes:
- Before starting exercise, check your blood sugar. Exercise may cause it to drop (hypoglycemia) or rise (hyperglycemia). Depending on your levels and the type of exercise, you may need to adjust your insulin dosage or eat a small snack to maintain balance. Regular monitoring before, during and after exercise helps keep your blood sugar levels within a safe range.
- Generally, a mix of aerobic exercises like walking or swimming and strength-training exercises like weightlifting can be a good choice. Be cautious with high-intensity workouts since they can cause rapid changes in blood sugar levels. Have a plan for managing blood sugar fluctuations and carry fast-acting carbohydrates like candy or special edible gels at all times.
Aim for at least 150 minutes of moderate-intensity exercise per week, spread over several days. Monitor your blood sugar levels regularly to help you understand how different activities affect your glucose levels so you can adjust your routine as needed.
Managing insulin levels
Before you start your workout, check your blood sugar levels so you understand where they are and if any adjustments are needed. If your blood sugar is too high or too low, you may need to address that before you start physical activity.
Prepare so you can keep your blood sugar levels stable. Depending on how long and how intensely you exercise, you may need to reduce your insulin dosage or time it differently to prevent low blood sugar (hypoglycemia) during exercise. If you use a continuous glucose monitor (CGM), you can use real-time data to make decisions.
Limit rapid or regular-acting insulin before exercise. “Having larger amounts of these types of insulin in your body while exercising greatly increases the risk of low blood sugars. If possible, avoid doses of these insulins for three hours before exercise. If that’s not possible, take breaks to monitor your glucose levels and perhaps eat a snack if you’re trending low,” Wagner said.
When you’re exercising, watch for symptoms of low or high blood sugar:
- Low blood sugar can cause dizziness, sweating, shakiness or confusion. If you have these symptoms, stop exercising and consume fast-acting carbohydrates like glucose tablets or juice. “It’s a good idea to bring money with you while exercising,” Wagner said. “If you’re out jogging or you’re not by your home and a low blood sugar takes place, having a few dollars with you to quickly purchase a snack or juice could be lifesaving.”
- High blood sugar may cause thirst, a need to urinate often or fatigue. If you have these symptoms, monitor your levels more closely and adjust your insulin or carbohydrate intake.
If you use a CGM, the real-time blood glucose readings can help you track how exercise is affecting your glucose levels. You can use this information to make decisions about insulin adjustments or carbohydrate intake during your workout. If you notice a trend towards low blood sugar, you might need to reduce your insulin temporarily or consume more carbohydrates.
After you exercise, check your blood sugar levels to make sure they are in a safe range. This can help you see how your body responded to your workout so you can adjust future exercise sessions.
Jordan notes that anyone can now buy CGMs at the pharmacy from Dexcom and Abbott. “They are geared toward people with type 2 diabetes and people who are not using insulin,” he said.
Refuel with a balanced snack or meal that includes carbs and protein to build energy stores and help your muscles recover. Drink plenty of water and keep checking your blood sugar levels for a few hours after you exercise since physical activity can have effects on glucose levels for a while.
Tips for working exercise into your diabetes management routine
When you’re exercising with diabetes, it can help to:
- Set realistic goals: Begin with small steps and slowly build up your activity level. You might want to start with 10 to 15 minutes of walking and increase as you become more comfortable. That helps you stay motivated and reduces the risk of injury or burnout.
- Find activities you enjoy: Participating in activities you love makes it easier to stick with a regular exercise habit.
- Create a routine: Set aside times for exercise each week and treat them as appointments. Consistency is key, so try to fit exercise into your daily schedule, whether it’s before work, during lunch breaks or in the evening. Creating a routine helps build a habit and makes it easier to balance exercise with your responsibilities.
- Track your progress: Use apps, fitness trackers or a journal to record your workouts, track your physical activity levels and monitor your blood sugar. With tracking, you can see how you’re improving, adjust your goals and understand how exercise affects your blood glucose levels.
The bottom line
If you have diabetes, exercise can help you manage your blood sugar. Plus, it provides a lot of other health benefits. Be sure to start slowly and increase your duration and intensity as your fitness improves.
Your health care provider, endocrinologist or an expert at Banner Health can help you create an exercise plan that works for you and is best for managing your diabetes.
