Diabetes and Exercise

Why is exercise important for people with diabetes? 

Physical activity can help control blood glucose (sugar) and improve overall health. When you exercise, your muscles use glucose for energy. This reduces the amount of glucose in your blood. Exercise also makes your body more sensitive to insulin, which means that insulin can do a better job of moving glucose from your blood into your cells. It also helps improve other health problems that are common in people with diabetes, such as high blood pressure and high cholesterol and triglycerides, and decreases the risk of heart disease. Physical activity also helps  and could make you feel better about yourself. 

What type of exercise is best for diabetes and how much? 

Aerobic exercise (walking, running, biking, swimming), high-intensity interval training (HIIT) and resistance exercise (weight training, resistance bands) can all help. Aerobic exercise improves body sensitivity to insulin and can help decrease blood glucose  and overall diabetes control, decreases blood pressure and lipids and decreases risk of heart disease. Resistance exercise helps increase muscle mass and strength helping insulin work better. Other types of exercise such as yoga, tai chi help with improving flexibility and balance. 

It is recommended that you have 150 minutes of aerobic exercise per week and add resistance exercise  2-3 times a week.

How do you get started with an exercise routine?

Before you begin an exercise routine, your health care team will check your heart, eyes, kidneys, feet, and nervous system to make sure you are healthy enough for physical activity. Some types of activities may not be right for you. For example, if you have problems with the nerves in your feet, your doctor might recommend a type of exercise that does not put pressure on your feet. Choose a type of exercise that you enjoy so that you are more likely to stick with it. Ask your doctor whether your choice of exercise is a good one for you.

As you begin to exercise, start slowly so that your body can get used to it. Start with a five to ten minute walk outdoors or on a treadmill several days a week, and then gradually add a few more minutes of walking each week. Experts recommend building up to at least 150 minutes (2 ½ hours) a week of aerobic exercise, such as brisk walking, swimming, cycling, or dancing. You should spread this activity out over at least three days throughout the week. Try not to let more than 2 days pass without exercising. 

Try adding resistance training to your exercise routine two or three times a week. Using weights, machines, or resistance bands builds muscle, burns more calories, and helps control blood glucose.

When it comes to exercise, something is better than nothing. Even avoiding sitting for a long period of time by getting up and having some light activity for 3 minutes every 30 minutes can help your blood glucose. 

Blood Glucose Levels and Exercise

The blood glucose response to exercise is different from person to person and also with different types of exercise. Generally aerobic exercise decreases blood glucose especially after meals, but very intense exercise might increase blood glucose. Blood glucose levels tend to be lower for hours after exercise. Checking your blood glucose before, during and after exercise will help you understand how your body responds. If you are taking insulin, particularly if you have type 1 diabetes, you might need to decrease your insulin dose before and during exercise. Your doctor will help you make these adjustments. Eating a snack before or during exercise will also help prevent low blood sugars. If your blood glucose is less than 90 mg/dL (50 mmol/L) before exercising, you should eat a snack to keep you blood glucose from going too low.

What should you know about diabetes medications and exercising?

Because exercise can lower blood glucose, your insulin dose and some diabetes medication doses may need to be adjusted when you exercise and sometimes for several hours after exercising. 

Benefits of exercise for people with diabetes

  • Lowers blood glucose, blood pressure, and cholesterol
  • Reduces the need for insulin and oral medications
  • Prevents weight gain and promotes weight loss
  • Strengthens the heart, and helps decrease the risk of heart disease 
  • Improves muscle strength, flexibility, and endurance
  • Strengthen bones 
  • Promotes overall health and well-being

Questions to ask your doctor

  • What kind of exercise are best for me? What exercise should I avoid? 
  • How frequently and how much should I exercise? 
  • What time of day is best for exercise? 
  • Do I need to adjust my insulin dose or diabetes medicines when I exercise? Should I eat a snack before or after exercise? 
  • When should I avoid exercise?
  • Should I see an endocrinologist for my diabetes care?
  • Should I see a diabetes educator and/or dietitian? 
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