Why is exercise important if I have diabetes?

Exercise is an important part of diabetes treatment. Getting regular physical activity can help:

• Keep your blood sugar in the right range

• Lower blood pressure and cholesterol

• With weight loss or keeping a healthy body weight

Exercise has lots of other health benefits, too.

What kinds of exercise should I do?

There are lots of different ways to move your body and get exercise. Talk to your doctor or nurse before you start a new activity or routine. They can help you choose activities that are safe and enjoyable for you. They can also help you gradually increase your activity level over time.

Types of exercise include:

• Aerobic exercise – This raises your heart rate. Examples include walking, running, dancing, riding a bike, and swimming.

• Muscle strengthening – This helps make your muscles stronger. You can do it using weights, exercise bands, or weight machines. You can also use your own body weight, like with push-ups, or by lifting items in your home, like jugs of water.

For most people, a good goal is to get at least 30 minutes of physical activity a day, most days of the week. Even gentle exercise, like walking, is good for your health. Finding types of exercise you enjoy will make you more likely to stay active.

If you are having trouble finding ways to get physical activity, talk to your doctor or nurse. They can help.

How does exercise affect my insulin dose?

If you take insulin to manage your blood sugar, you might need to adjust your dose based on how much exercise you plan to do. Your doctor or nurse can talk to you about this. They will explain how much insulin you need in different situations and how to make sure you get the right amount.

You should also do the following:

• If possible, try to exercise at about the same time each day relative to when you eat and take insulin.

• Check your blood sugar before, during, and after exercise. This can help you learn how your body reacts to exercise. If you plan to be active for an hour or longer, check your blood sugar at least every 30 minutes.

  • If your blood sugar is high, and you do not feel well, avoid heavy exercise until it is back in your normal range.

  • If your blood sugar is low before or during exercise, eat a snack with 15 to 30 grams of carbohydrates (table 1).

• If you take insulin and have type 1 diabetes or frequent episodes of low blood sugar, or if you are exercising for more than 30 minutes, eat a snack after exercising. The snack should include carbohydrates that are absorbed slowly. Examples include dried fruit, a granola bar, or trail mix. This can help prevent your blood sugar from dropping.

Exercise can make your body more sensitive to insulin for up to 24 hours afterward. After exercising, some people need to take less insulin with meals later in the day. Some people who take long-acting insulin at bedtime also have to lower the dose to help prevent low blood sugar.

Everyone responds to exercise differently. This is why it's important to monitor your blood sugar and talk with your doctor or nurse about how best to manage your insulin dosing.

How does exercise affect other diabetes medicines?

Exercise can also affect how certain other diabetes medicines work. These include:

• "Sulfonylureas," such as glimepiride or glipizide

• "Meglitinides," such as repaglinide or nateglinide

If you take any of these and start a new exercise routine, you need to check your blood sugar before, during, and after exercise. If your blood sugar is in the goal range the first few times you exercise, then you can start checking it less often. If you change how often or how heavily you exercise, go back to checking your blood sugar before, during, and after exercise. This will help you keep your blood sugar in the goal range.

If you take other diabetes medicines besides insulin, sulfonylureas, or meglitinides, the dose is not affected by exercise. But it's still a good idea to check your blood sugar often if you start a new routine or activity. This can help you learn how exercise affects your blood sugar levels.

What else can I do to stay safe when I exercise?

Talk to your doctor or nurse about what types of activities are safe for you. They might do tests, for example, to check your heart health.

Once you have an exercise plan, it's important to:

• Hydrate – Drink plenty of fluids before, during, and after exercise. This can help lower your risk of high blood sugar. Be extra careful if you are exercising in hot weather.

• Wear proper footwear – If you have problems with the nerves in your feet, you might not be able to feel pain from an injury. Wear shoes that fit well and support your feet. After exercising, check your feet for problems like cuts, blisters, redness, or swelling.

• Follow your doctor's instructions – Depending on your health, you might need to avoid certain types of exercise. For example, if you have high blood pressure or eye problems related to diabetes, your doctor might tell you to avoid straining or holding your breath.

What problems should I watch for?

If you have any of the following during exercise, stop right away:

• Chest pain

• Nausea

• Trouble breathing

• Signs of a stroke, such as sudden headache, vision problems, or weakness

Talk to your doctor or nurse before you try exercising again.

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