Diabetes and Exercise Guidelines

Regular activity is a key part of managing diabetes. When you are active, your cells become more sensitive to insulin, and the insulin can work more effectively. Exercising consistently can lower your glucose and improve your A1C. Overall, this may help reduce diabetes medications or doses, improve cardiovascular health, and improve blood circulation and healing. Research has shown that sitting too much is harmful to your health. Take every opportunity to get up and move every 30 minutes.

Types of exercises in Diabetes

There are three types of exercises:

1. Aerobic strengthens your heart and lungs. (Examples: walking, swimming, biking, dancing, water aerobics)

2. Strength Training strengthens your muscles and maintains bone density. (Examples: lifting free weights or using machines, resistance bands, situps/pushups)

3. Stretching helps prevent injury and improves flexibility. It is recommended before and after an exercise routine. (Examples: yoga, Pilates)

Benefits of exercise in Diabetes

The American Diabetes Association recommends 150 minutes of moderate-intensity aerobic activity per week. An easy way to structure an exercise routine is to break it into 30 minutes per day, five days per week. Muscle-strengthening activities that involve all muscle groups are recommended two or more days per week. For older adults, balance and flexibility exercises are important and recommended.

In addition to lowering your glucose and A1C, exercise has many other health benefits:

  • Lowers your blood pressure and cholesterol
  • Reduces your risk for heart disease and stroke
  • Helps you maintain or lose weight
  • Helps you sleep better
  • Relieves stress and reduces symptoms of depression
  • Strengthens your muscles and bones
  • Improves mood

Planning an exercise program for diabetes

  • Always check with your doctor before beginning an exercise program. Autonomic or peripheral neuropathy can increase risks for injury during exercise.
  • Glucose monitoring will be important to help you determine your body’s glucose response to different activities. Always have your meter and supplies available.
  • If you have neuropathy, check your feet before and after your exercise routine.
  • Make sure your shoes and socks fit properly to prevent a foot injury.
  • If you have a foot injury, try upper body exercises or chair exercises to allow your foot to heal.
  • If you have eye problems, avoid vigorous exercise that may increase eye pressure. Ask your eye doctor how you can exercise safely.
  • Wear medical identification.
  • Always have plenty of water available.
  • Take your phone if exercising alone and tell a family member or friend where you will be.
  • Always have glucose tablets or rapidly acting carbohydrates available to treat low glucose.

Choosing the right exercise in diabetes

  • Choose the exercise you like. Walking is considered an excellent activity for most people with diabetes.
  • If you are unable to walk, have balance issues or other medical issues that prevent you from standing for too long, consider upper body exercises seated in a chair.
  • Consider what motivates you. Does music energize you? Or, does wearing a step counter or fitness watch or logging your time and distance encourage you?
  • If you have not been active recently, you can begin with five or 10 minutes of activity per day. Increase your activity sessions by a few minutes each week. Over time, your fitness will improve.
  • Seek out friends or neighbors to join you, or take a fitness class to help you stay motivated. Include your children, and turn exercise into family time.
  • Your glucose will need to be monitored before, during, and after your exercise routine, so determine how you will carry your glucose meter and treatment for low glucose.

Exercise plan and blood glucose in diabetes

Remember, your glucose response during and after exercise will depend on:

  • Your glucose prior to exercise
  • The active insulin or other diabetes medications in your body
  • The type and amount of foods you ate before and during your exercise
  • The intensity and duration of your activity

Based on your exercise plan and glucose, a carbohydrate snack may be recommended.

The following table shows general guidelines for grams of carbohydrates needed to maintain glucose during exercise.

  15 minutesLess than 100100-150150-200Greater than
Low0-5 gNoneNoneNone
Moderate5-10 g0-10 g0-5 gNone
High0-15 g0-15 g0-10 g0-5 g
  30 minutesLow5-10 g0-10 gNoneNone
Moderate10-25 g10-20 g5-15 g0-10 g
High15-35 g15-30 g10-25 g5-20 g
  45 minutesLow5-15 g5-10 g0-5 gNone
Moderate15-35 g10-30 g5-20 g0-10 g
High20-40 g20-35 g15-30 g10-25 g
  60 minutesLow10-15 g10-15 g5-10 g0-5 g
Moderate20-50 g15-40 g10-30 g5-15 g
High30-45 g25-40 g20-35 g15-30 g

This table is adapted from the Diabetic Athlete’s Handbook by Sheri Colberg, PhD.

For glucose greater than 250 or if ketones are present, do not exercise. You may require additional insulin and should get advice from your provider.

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About the Author MyEndoConsult

The MyEndoconsult Team. A group of physicians dedicated to endocrinology and internal medicine education.

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