- The best exercises for diabetes include any type of moderate physical activity, such as walking, gardening or playing tennis.
- If you have diabetes or may be at risk, it is important to do about 150 minutes of moderate exercise each week, as this can help lower blood sugar levels.
- Be sure to talk to your doctor to learn how to exercise safely with diabetes, especially if you have type 1, which may have more health risks.
- This article was reviewed by Jason R. McKnight, MD, family physician and clinical assistant at Texas A&M Medical College.
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Exercise and physical activity are extremely beneficial for overall health. And if you have type 1 or type 2 diabetes or you may be at risk, the benefits are quite useful.
“Regular exercise is especially important for those who live with diabetes,” says Dr. Alex Lee, an internal medicine specialist in Los Angeles.
But exercise can also lead to some complications for people with diabetes. Here’s how to create a safe, effective workout routine if you have diabetes.
Why exercise is important for people with diabetes
The American College of Sports Medicine and the American Diabetes Association agree that exercise is “critical to optimal health” in people with diabetes.
When you exercise, your body burns glucose or blood sugar for fuel. This helps lower your blood sugar levels. As you exercise more, this effect intensifies over time, leading to a decrease in insulin resistance. It is important to reduce insulin resistance, as it is the cause of type 2 diabetes.
Regular exercise can also help you build muscle and reduce fat, both of which increase your body’s ability to use insulin. In general, people with type 1 and type 2 diabetes benefit from becoming more sensitive to insulin.
“It can lower blood sugar in the short term, and it can improve insulin sensitivity in the long term,” said Dr. Emory Hsu, an endocrinologist at Santa Clara Medical Center in San Jose, California.
A 2019 scientific review published in the Annals of Physical and Rehabilitation Medicine found evidence that structured exercise – such as inclusion in an eight-week exercise class – could reduce insulin resistance in people with type 2 diabetes. The average participant noticed that blood sugar has fallen by 5.12 points after intervention.
In addition, a 2017 study published in the Journal of Jiroft University of Medical Sciences followed 28 women with type 2 diabetes for eight weeks. Fourteen participants did not train, while the other 14 did aerobic exercise (cardio) three times a week and resistance training twice a week. After eight weeks, the training group had lower blood sugar and less insulin resistance than the control group.
How many exercises do you need
People with diabetes, just like all other American adults, should strive to get 150 minutes of moderate exercise a week, according to the ADA’s 2016 position statement.
“If you’re not training anymore, don’t let this number scare you,” says Hsu. “Every exercise is better than none, and you can start slower and increase.”
The ADA recommends that people with type 2 diabetes or who are at risk of the condition exercise daily and never miss more than two days without physical activity. Most types of physical activity can be counted for exercise, even gardening or walking.
“If you walk, it means you have to walk hard enough to start sweating or you start to feel like you have to breathe faster,” Hsu said.
Other types of moderate exercise include:
- Lawn mowing
- I am playing tennis
- Daily cycling
All of these types of exercises can be helpful. A 2019 scientific study, published in The International Journal of Exercise Science, followed 905 people with type 2 diabetes who were previously inactive. They did aerobic exercise, resistance training, or a combination of the two for 49 minutes three times a week.
The study found that all three types of exercise reduced A1C levels, which measure average blood glucose over time. The biggest impact was the combined training, followed by aerobic exercise and then resistance training.
In general, making exercise a sustainable part of your daily routine and week is important. Try taking a walk during your lunch break or using after-work tape. Whatever allows you to hit the target 150 minutes of exercise is the right plan for you, Lee says.
How to play sports safely with diabetes
Exercise is recommended for all people with diabetes, although some may need to take extra precautions. For example, people with type 1 diabetes need to be especially careful.
“For type 1 diabetics, exercise can lower blood sugar more drastically,” says Hsu. Dangerously low blood sugar or hypoglycaemia can cause health complications, including seizures and coma in severe cases.
People with type 1 diabetes should carefully plan their exercise around food intake and insulin dose, according to the ADA. It is also important to measure your blood sugar levels before, during and after a workout – or to check your blood sugar with a continuous glucose monitor.
In general, it is best to work with your doctor to develop a routine if you have type 1 diabetes.
If you have diabetes and are starting to exercise, you need to take the following steps:
- Talk to your doctor. Let them know if you have had any other health complications with diabetes, such as eye problems, heart disease or stroke.
- Start slowly. Learn about how exercise affects your blood sugar by measuring your blood sugar before and after a workout and monitoring any major changes. Your blood sugar should stay within the healthy limits that you and your doctor have established.
- Watch your feet for ulcers or wounds. Many diabetics have reduced the sensation in their legs, Lee says, so you may not notice pain from wounds. Visual observation can help you spot them and prevent infection.
Working up to at least 150 minutes of exercise a week can help you manage your diabetes and lower your blood sugar. Exercising with diabetes – especially type 1 diabetes – may require additional planning, but the health benefits are worth it, Lee says.
For more information, read how to lower your blood sugar with further lifestyle changes.