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Exercising with Type 2 Diabetes

Manage Glucose, Lose Weight, and Reduce Complications

If your doctor has diagnosed you with Type 2 diabetes, then she has probably already told you about the importance of adding exercise to your treatment plan. Physical activity can help you improve your blood sugar control, lose weight, and reduce your risk of heart disease, peripheral artery disease and nerve problems that are often associated with diabetes. In many cases, the right combination of diet and exercise can even help eliminate the need for medication for people with Type 2 diabetes.

But before you get started, you need to understand how exercise influences blood glucose regulation, and how to avoid potential problems, minimize risks, and recognize when you may need to get additional information or support from your health care provider. *The general information in this article is not a substitute for talking to your health care provider before you begin an exercise program, or if you experience any problems in connection with your exercise.

How Exercise Benefits People with Type 2 Diabetes

In addition to boosting your energy levels, mood, and capacity to burn calories for weight loss, regular exercise can lead to the following benefits:
  • Improved blood sugar control by enhancing insulin sensitivity. Exercising on a regular basis makes muscles use insulin better. When muscles are able to use insulin better, they are able to pull more glucose from the bloodstream to use for energy. The more vigorously you exercise, the more glucose you’ll use, and the longer the positive effects on your blood glucose levels will last.
  • Increased insulin sensitivity. Type-2 diabetics who exercise regularly need less insulin to move glucose from the bloodstream and into the cells that need it.
  • Reduced need for medication. Combined with a healthy eating plan, regular exercise can reduce—or even eliminate—the need for glucose-lowering medication in some people.
  • Reduced cardiovascular risks. Diabetes has negative effects on heart health, increasing the risk of heart attack, stroke, and other cardiovascular diseases. Exercise reduces these risks by increasing HDL (good) cholesterol, lowering LDL (bad) cholesterol, and reducing triglycerides in the blood stream. Physical activity also improves blood flow, increases your heart’s pumping power, and reduces blood pressure.
The Best Exercises for People with Type 2 Diabetes

Always discuss your exercise plan with your doctor before starting, especially if you’re taking medication or experiencing diabetes-related medical complications (discussed above and below).

Experts generally recommend that people with diabetes engage in moderate aerobic (cardio) exercise that lasts at least 30 minutes, on four or more days of the week.
  • Always warm up for at least five minutes before you exercise, and cool down for at least five minutes afterwards before you stop moving.
  • If it’s been a while since you’ve done much physical activity, and 30 minutes at a time is too much right off the bat, you can start with 10 minutes (or even less) and gradually increase your workout duration as you become more fit.
  • Moderately-intense cardio should elevate your heart rate to a level that is challenging, but not so difficult that you can’t do it for 30 minutes.
  • Examples of moderate intensity exercise include brisk walking, bicycling, dancing, swimming, climbing stairs, cross-country hiking, aerobics classes, cardio machines such as the elliptical, skating, tennis, and other sports.
  • If you pick activities that you enjoy, you'll be more likely to stick with your exercise plan.
  • Being active every day is better for you than doing more exercise on fewer days of the week, and scheduling your exercise at the same time of day can help with blood glucose control.
In addition, moderate strength training (except as noted below) and flexibility exercises are also highly beneficial. These exercises will help you better use your muscles without soreness and decrease your risk of injury.

The Risks of Exercise and How to Avoid Them

Many people with diabetes have special needs that should be addressed  when planning an exercise program. Here are four of the most common problems that will affect your exercise plan:

1. Hypoglycemia (Low Blood Sugar): Exercise can cause your blood glucose levels to drop too much, especially if you take insulin or some other glucose-lowering medications. Symptoms of hypoglycemia, or "low blood sugar," include feeling shaky, lightheaded, weak, confused, anxious, fatigued, irritable, or hungry; headache; breaking out into a clammy sweat; or even fainting.

Hypoglycemia can happen during exercise, right after exercise, or even up to 24 hours after you finish exercising. Symptoms of hypoglycemia can be mild and gradual; but it is more common for symptoms to occur quickly with diabetes-related hypoglycemia. It is also important to note, that in rare cases, individuals may not experience any symptoms at all. By paying close attention to how you’re feeling, and by knowing how to treat low blood sugar symptoms correctly, you can prevent problems before they put you at risk of injury. To prevent exercise-related hypoglycemia:
  • If you take insulin, do not inject insulin near the primary muscles that will be used during exercise (typically the thighs or back of the arms), because it will be absorbed too quickly.
  • Check your blood glucose level before you exercise. SparkPeople's Carbohydrate Adjustments for Exercising Diabetics Chart will tell you what adjustments to make before exercise, based on your glucose reading.
  • Do not skip planned meals prior to exercise, or go too long without eating.
  • Carry an easy-to-consume glucose source (such as juice, hard candy, or glucose tablets) when you exercise
  • Drink plenty of water before and during exercise—dehydration can affect glucose levels.
2. Poor Blood Sugar Control: In some cases, exercise can also cause blood sugar levels to rise (known as hyperglycemia). If you take insulin, or if your glucose levels aren’t well-controlled, you must discuss your exercise plan with your doctor before starting. To prevent exercise-related blood sugar problems:
  • Do NOT exercise if your blood glucose is above 300 mg/dL, or your fasting blood glucose is above 250 mg/dL and you have ketones in your urine.
  • Check your glucose level before and after exercise, to see how your exercise has affected it. Share this information with your doctor (especially if you take any oral medications for diabetes or insulin) to help you determine the best times of day for you to exercise, and how to adjust the timing or amount of your dosage before exercising.
3. Diabetic Retinopathy: If you have this condition (damaged blood vessels in the retina of the eye), exercise could damage your eyesight. Strenuous activities could lead to bleeding or retinal detachment, so you may need to avoid certain activities, such as weight lifting or jogging. Ask your doctor to recommend appropriate exercise activities for you.

4. Reduced Sensation or Pain in Extremities: Because diabetes can cause nerve damage as well as interfere with blood circulation, many people with diabetes can lose all or part of the sensation in their feet. To prevent exercise-related foot problems:
  • Check your feet for cuts, blisters, or signs of infection on a regular basis.
  • Wear good, properly-fitting shoes with ample cushioning and support
  • Wear synthetic or cotton-blend socks that minimize moisture problems.
If you experience pain in your legs (or other extremities) at anytime during or after your exercise routine, contact your doctor right away. Exercise-induced pain can be a symptom of one or more diabetes-related complications that require medical attention. If numbness or pain becomes constant or severe, talk to your doctor about alternate forms of exercise that may be appropriate.

Exercise Checklist for People with Type 2 Diabetes

There’s no doubt about it—consistent, moderate exercise is one of the most important and effective weapons you can use to help manage your diabetes and your weight. To keep yourself safe, follow this checklist:
  • Talk to your doctor about the right exercises for you.
  • Always check your blood sugar level before and after exercising.
  • Always wear diabetes identification. Everyone with diabetes should wear a comfortable necklace or bracelet that states they have diabetes.
  • Check your feet for blisters or sores before and after exercising.
  • Wear proper shoes and socks.
  • Warm up before each exercise session, and cool down and stretch afterwards.
  • Drink plenty of fluids before, during, and after exercising.
  • Bring a fast-acting carbohydrate snack in case you experience symptoms of hypoglycemia.
  • Report any recurring, exercise-related pain in your legs or extremities to your doctor right away.
Sources of information contained in this article included:
For more specific information or help, talk to your health care provider. The American Diabetes Association's National Call Center also offers live advice from 8:30 a.m. to 8 p.m. EST, Monday through Friday at 1-800-DIABETES or 1-800-342-2383.
This article has been reviewed by Registered Dietitian, Becky Hand, and Amy Poetker, Registered Dietitian and Certified Diabetes Educator.

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Member Comments

    This article make me think I' was diabetic as a teenager although I am diagnosed as pre-diabetic now. I got many of these symptoms when exercising including black outs after exercise. Hmm. Doctors didn't think much when i complained about my symptoms. Maybe because I was so underweight.
  • This morning my blood sugar was 85, did a two mile walking tape, WATP's, and checked my numbers again and it was at 123. Other days I am at 123 and after walking it is down in the 85-100 range. The pattern I see different in these reactions is my intake of food. It will raise when I exercise at the end of a fast over night, and lower after a small meal with protein. When you do not have enough glucose in your system, your body starts using your fat to produce glucose, to raise the blood sugars to keep you balanced and able to move and do all the body functions it needs to do, that is why the body stores it. I am no doctor, it is only the patterns that I see, I may not have the technical terms, but I know how my body responds, and that may not be the case for everyone. We are our own best advocates to health. Keep studying your body, the issues, side effects of the medicines you take, awareness is key!
  • Type 2 diabetic, I have found stress raises my numbers. I have been off meds for 5 years - 5 years since I have worked in the workplace. Now I have to stop watching newsprograms (live in USA) I can't stop the mess in govt, those in power have to do that. I have, however, called my US Senator and voiced my concern. In my own small way, I am trying to preserve what was wonderful before election day. I am determined not to ruin my health.
  • I was diagnosed with Type 2 Diabetes 10 years ago. Way back when, when I was in my early 20s I was told I had prediabetes. I was very fit, very active and ate well at the time. In my late 40s it caught up with me.

    My diabetes had progressed quickly and I was on 7 injections a day, 5 of insulin and 2 of Victoza. And I gained weight because as my endo said, insulin definitely can cause weight gain in Type 2s. I could never get my A1C below 7.

    Thanks to my doctor I'm now on only 2 injections of Victoza, have lost 30 pounds (need about 20 more to get to ideal weight) and am coming off my blood pressure meds. She expects my to be off of Victoza by October and she expects my diabetes to be completely reversed.

    I had been on every diet around, and this doc gave me the strictest I've ever been on. The fact that she took me off mealtime insulins right from the start what a huge motivator for me to stick with it. Then the 2x/daily long acting insulins were removed. And it's enough to keep me going for the rest of my life.

    Talk to your doctor about diet. They may be able to help.
  • I was diagnosed with Type 2 over a decade ago. So far, I've been on oral meds, but my A1c has slowly gone up, along with my weight. Finally getting serious about control by cutting down on fried and sugary foods and adding more fruits and veggies. Also exercising, tho I'm having to start VERY slowly due to an old injury and an underlying Mast Cell disease. In addition, I've noticed my blood sugar goes wonky when I exercise. Some days up. Some days down. I haven't figured out a pattern. Is this normal?
  • I've been diagnosed with Type 2 Diabetes in the last couple of weeks. It is overwhelming. Then, you realize how life threatening it is. And how serious it is! Although it has answered a lot of questions of signs from the past.

    The information on SparkPeople has been a real help. Online all I am getting to my questions is advertising. On Spark People I am beginning to get some real answers to some hard questions. Thanks Spark People.
  • I was diagnosed with type 2 a week ago. It can be a little overwhelming. I found this article really informative. I needed that!
  • Great article and very informative, now to impliment daily yet gradual since I haven't been active for over a year.
  • KOKO-Sky - the chart is linked to the last page of the article under: Carbohydrate Adjustments for Exercising Diabetics Chart
    I was disappointed with the article did not include the refernced chart showing glucose levels, exercise before and after hypoglycemic examples. This is why I was reading the article as the information in the article was very basic and I cant say I learned anything that I didn't already know.
    great article. I learned a lot.
  • My GP told me I should be power walking every single day for at least an hour each time. Hmm!

    Thanks for this article - very informative.
    My diabetic husband, 67, often works in the yard in the heat for hours at a time, not even stopping to eat or drink. It worries me sick, since I am at work and have no control over this craziness! I try to allow him to be responsible for his own diabetes control, but one of these days he will be in trouble and no one will be around to help. Diabetics,please think of your loved ones and seriously control your health. Life IS too short for carelessness!
  • Love the article.

About The Author

Dean Anderson Dean Anderson
Dean Anderson has master's degrees in human services (behavioral psychology/stress management) and liberal studies. His interest in healthy living began at the age of 50 when he confronted his own morbid obesity and health issues. He joined SparkPeople and lost 150 pounds and regained his health. Dean has earned a personal training certification from ACE and received training as a lifestyle and weight management consultant. See all of Dean's articles.

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