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Exercise and diabetes: Mayo Clinic
How a little activity can help you manage your condition
Exercise is a useful tool to help manage your diabetes. Through physical activity, you can more effectively control your blood sugar, weight and cardiovascular health.
Besides improving your overall level of fitness, long-term regular exercise — 30 minutes most days of the week — can help manage your blood sugar (glucose) and weight, and improve your cardiovascular health.
Along with a healthy-eating plan, regular exercise can reduce your need for glucose-lowering medication. In fact, some people with type 2 diabetes manage their diabetes through diet and exercise alone.
Thinking about adding exercise to your diabetes treatment regimen? Deepen your understanding of how exercise affects your diabetes. Assess possible limitations, and keep your blood sugar on track as you increase your activity level.
What exercise can do for your health
Besides boosting your mood and energy levels, exercise provides an abundance of helpful health benefits for people with diabetes.
Improves blood sugar control
If you have type 2 diabetes, exercise can improve your blood sugar control. As your muscles contract and relax during exercise, they use sugar for energy. To meet this energy need, your body taps into sugar supplies in your blood during and for a period after exercise, reducing your blood sugar level. The duration and intensity of activity determines how much your blood glucose is reduced.
Exercise can also increase your insulin sensitivity if you have type 2 diabetes. That means your body requires less insulin to escort sugar into your cells, which also reduces your blood sugar level.
Improves cardiovascular health
Cardiovascular disease is the leading cause of death among those with diabetes. In addition to improving your overall fitness and conditioning, exercise can help counteract the risk of developing cardiovascular disease by improving the flow of blood through small blood vessels and increasing your heart's pumping efficiency.
Some studies show that exercise can also reduce levels of low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol that causes formation of plaques in your blood vessels. At the same time, exercise might increase levels of high-density lipoprotein (HDL) cholesterol, the "good" type that helps keep your arteries clean. This also can improve your cardiovascular health.
In addition, exercise can help control or reduce elevated blood pressure. And high blood pressure can cause a variety of cardiovascular problems, including heart attack and stroke.
Helps manage your weight
Exercise helps you lose weight, if necessary, and is critically important in maintaining a healthy weight. Regular exercise takes off pounds by burning calories and increasing your metabolism.
Exercise might also be the key to shedding intra-abdominal fat — the fat that lies deep within your belly, around your abdominal organs. This type of fat has been linked to type 2 diabetes and insulin resistance, a condition in which your body doesn't respond as well to insulin. Reducing intra-abdominal fat will help restore better insulin response.
Before you start: Assess your limits
Be sure to talk to your doctor first if you've been inactive and plan to start a program of regular exercise to manage your diabetes. He or she can tell you about any precautions you need to take and likely conduct a pre-exercise physical that focuses on your:
Heart and blood vessels
Eyes
Kidneys
Blood supply to your legs and feet
Nervous system
Blood pressure
Diabetes-related conditions that can make a difference in the types and intensity of exercise you include:
Eye conditions. For example, if you have active proliferative diabetic retinopathy — abnormal growth of blood vessels on your retina — strenuous activity could lead to bleeding or retinal detachment. Depending on the severity of your retinopathy, you may need to avoid such activities as weightlifting, boxing, heavy competitive sports, jogging and racket sports.
Foot conditions. If you have reduced sensation in your feet because of peripheral neuropathy, for instance, you have less ability to feel pain. And that means you might continue exercising even when it's causing skin ulcerations or small fractures of your feet. You might need to avoid such activities as treadmills, jogging, step exercises and prolonged walking. On the other hand, swimming, rowing, biking and other non-weight-bearing exercises are generally safe.
Impaired circulation. If you have impaired circulation to your legs, you may experience pain or cramping when you walk. Although uncomfortable, it's still safe to walk. Walking tends to improve the circulation in the legs. Walk until you experience some discomfort, rest and resume walking again. With time, as the circulation improves, you'll notice you can walk for longer distances without stopping. You just have to walk slower and gradually increase your speed.
Age-related conditions. Because diabetes can contribute to the degeneration of muscles, ligaments, bones and joints caused by aging and disuse, older adults might have to restrict their activities. Your doctor can advise you of any restrictions based on your pre-activity physical exam.
Ready to exercise? What to watch out for
Does the thought of improved blood sugar control and better health motivate you to exercise? If so, that's great. Exercise good judgment when you're active or working out to avoid injury. Keep in mind:
Your blood sugar
Exercise can affect your blood sugar. You'll need to closely monitor your blood sugar before, during and after exercise. Have glucose tablets or hard candy with you in case you experience signs and symptoms of low blood sugar (hypoglycemia).
Your feet
With diabetes, the skin of your feet is predisposed to ulcers and other problems because of reduced blood flow. If you aren't careful, exercise can add to the trauma. Consider using silica gel or air midsoles in your shoes plus polyester or polyester-blend socks to prevent blisters and keep your feet dry. Be sure there are no creases in your socks over the bottom of the feet. Proper footwear is especially important if you have peripheral neuropathy. Closely monitor your feet before and after exercise for any signs of potential damage, such as blisters, which can lead to ulcers if left untreated.
Hydration
Be sure to drink enough fluids while you exercise, especially when it's hot. Dehydration can affect blood sugar levels and heart function. Try to drink about two glasses of fluid in the two hours before exercise. If you sweat during your exercise, drink enough fluids to compensate. If you exercise for more than an hour, drink carbohydrate-containing beverages rather than plain water.
Limitations
Exercise safely and pay attention to your limitations. For example, lifting weights — also called resistance or strength training — is useful for maintaining or building upper and lower body strength. But if you're an older adult or have long-standing diabetes, use only moderate weights. Heavy lifting may pose a health threat because it can dramatically increase your blood pressure.
Warning signs
Don't ignore symptoms that may signal a problem, such as dizziness, faintness, nausea, tightness in your chest, severe shortness of breath, chest pains, pain in an arm or your jaw, or heart palpitations. Get medical help if you have any of these symptoms.
Identification
Wear a diabetes identification bracelet or shoe tag while exercising, in case of an emergency.
Set your goal, stick with it
Over time, work up to a goal of 30 minutes of moderate-intensity exercise on at least five days of the week. If you prefer, you can divide the 30 minutes into three separate 10-minute sessions — you still receive the health benefits.
If you've been inactive, start slowly with perhaps five to 10 minutes of moderate-intensity activity each day. Examples of such activities include:
Walking
Dancing
Swimming
Water aerobics
Riding a bicycle
Try not to get discouraged if exercise causes significant changes in your blood sugar and upsets your normal management routine. Continue to test your blood sugar until you begin to notice a pattern and can adjust your meals and medications accordingly.
As you develop a routine, you'll have a good idea of how your blood sugar responds and you may not need to check it as often. Your health care team can help you fine-tune your exercise, eating and medication routine to make sure it's safe and effective.
How a little activity can help you manage your condition
Exercise is a useful tool to help manage your diabetes. Through physical activity, you can more effectively control your blood sugar, weight and cardiovascular health.
Besides improving your overall level of fitness, long-term regular exercise — 30 minutes most days of the week — can help manage your blood sugar (glucose) and weight, and improve your cardiovascular health.
Along with a healthy-eating plan, regular exercise can reduce your need for glucose-lowering medication. In fact, some people with type 2 diabetes manage their diabetes through diet and exercise alone.
Thinking about adding exercise to your diabetes treatment regimen? Deepen your understanding of how exercise affects your diabetes. Assess possible limitations, and keep your blood sugar on track as you increase your activity level.
What exercise can do for your health
Besides boosting your mood and energy levels, exercise provides an abundance of helpful health benefits for people with diabetes.
Improves blood sugar control
If you have type 2 diabetes, exercise can improve your blood sugar control. As your muscles contract and relax during exercise, they use sugar for energy. To meet this energy need, your body taps into sugar supplies in your blood during and for a period after exercise, reducing your blood sugar level. The duration and intensity of activity determines how much your blood glucose is reduced.
Exercise can also increase your insulin sensitivity if you have type 2 diabetes. That means your body requires less insulin to escort sugar into your cells, which also reduces your blood sugar level.
Improves cardiovascular health
Cardiovascular disease is the leading cause of death among those with diabetes. In addition to improving your overall fitness and conditioning, exercise can help counteract the risk of developing cardiovascular disease by improving the flow of blood through small blood vessels and increasing your heart's pumping efficiency.
Some studies show that exercise can also reduce levels of low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol that causes formation of plaques in your blood vessels. At the same time, exercise might increase levels of high-density lipoprotein (HDL) cholesterol, the "good" type that helps keep your arteries clean. This also can improve your cardiovascular health.
In addition, exercise can help control or reduce elevated blood pressure. And high blood pressure can cause a variety of cardiovascular problems, including heart attack and stroke.
Helps manage your weight
Exercise helps you lose weight, if necessary, and is critically important in maintaining a healthy weight. Regular exercise takes off pounds by burning calories and increasing your metabolism.
Exercise might also be the key to shedding intra-abdominal fat — the fat that lies deep within your belly, around your abdominal organs. This type of fat has been linked to type 2 diabetes and insulin resistance, a condition in which your body doesn't respond as well to insulin. Reducing intra-abdominal fat will help restore better insulin response.
Before you start: Assess your limits
Be sure to talk to your doctor first if you've been inactive and plan to start a program of regular exercise to manage your diabetes. He or she can tell you about any precautions you need to take and likely conduct a pre-exercise physical that focuses on your:
Heart and blood vessels
Eyes
Kidneys
Blood supply to your legs and feet
Nervous system
Blood pressure
Diabetes-related conditions that can make a difference in the types and intensity of exercise you include:
Eye conditions. For example, if you have active proliferative diabetic retinopathy — abnormal growth of blood vessels on your retina — strenuous activity could lead to bleeding or retinal detachment. Depending on the severity of your retinopathy, you may need to avoid such activities as weightlifting, boxing, heavy competitive sports, jogging and racket sports.
Foot conditions. If you have reduced sensation in your feet because of peripheral neuropathy, for instance, you have less ability to feel pain. And that means you might continue exercising even when it's causing skin ulcerations or small fractures of your feet. You might need to avoid such activities as treadmills, jogging, step exercises and prolonged walking. On the other hand, swimming, rowing, biking and other non-weight-bearing exercises are generally safe.
Impaired circulation. If you have impaired circulation to your legs, you may experience pain or cramping when you walk. Although uncomfortable, it's still safe to walk. Walking tends to improve the circulation in the legs. Walk until you experience some discomfort, rest and resume walking again. With time, as the circulation improves, you'll notice you can walk for longer distances without stopping. You just have to walk slower and gradually increase your speed.
Age-related conditions. Because diabetes can contribute to the degeneration of muscles, ligaments, bones and joints caused by aging and disuse, older adults might have to restrict their activities. Your doctor can advise you of any restrictions based on your pre-activity physical exam.
Ready to exercise? What to watch out for
Does the thought of improved blood sugar control and better health motivate you to exercise? If so, that's great. Exercise good judgment when you're active or working out to avoid injury. Keep in mind:
Your blood sugar
Exercise can affect your blood sugar. You'll need to closely monitor your blood sugar before, during and after exercise. Have glucose tablets or hard candy with you in case you experience signs and symptoms of low blood sugar (hypoglycemia).
Your feet
With diabetes, the skin of your feet is predisposed to ulcers and other problems because of reduced blood flow. If you aren't careful, exercise can add to the trauma. Consider using silica gel or air midsoles in your shoes plus polyester or polyester-blend socks to prevent blisters and keep your feet dry. Be sure there are no creases in your socks over the bottom of the feet. Proper footwear is especially important if you have peripheral neuropathy. Closely monitor your feet before and after exercise for any signs of potential damage, such as blisters, which can lead to ulcers if left untreated.
Hydration
Be sure to drink enough fluids while you exercise, especially when it's hot. Dehydration can affect blood sugar levels and heart function. Try to drink about two glasses of fluid in the two hours before exercise. If you sweat during your exercise, drink enough fluids to compensate. If you exercise for more than an hour, drink carbohydrate-containing beverages rather than plain water.
Limitations
Exercise safely and pay attention to your limitations. For example, lifting weights — also called resistance or strength training — is useful for maintaining or building upper and lower body strength. But if you're an older adult or have long-standing diabetes, use only moderate weights. Heavy lifting may pose a health threat because it can dramatically increase your blood pressure.
Warning signs
Don't ignore symptoms that may signal a problem, such as dizziness, faintness, nausea, tightness in your chest, severe shortness of breath, chest pains, pain in an arm or your jaw, or heart palpitations. Get medical help if you have any of these symptoms.
Identification
Wear a diabetes identification bracelet or shoe tag while exercising, in case of an emergency.
Set your goal, stick with it
Over time, work up to a goal of 30 minutes of moderate-intensity exercise on at least five days of the week. If you prefer, you can divide the 30 minutes into three separate 10-minute sessions — you still receive the health benefits.
If you've been inactive, start slowly with perhaps five to 10 minutes of moderate-intensity activity each day. Examples of such activities include:
Walking
Dancing
Swimming
Water aerobics
Riding a bicycle
Try not to get discouraged if exercise causes significant changes in your blood sugar and upsets your normal management routine. Continue to test your blood sugar until you begin to notice a pattern and can adjust your meals and medications accordingly.
As you develop a routine, you'll have a good idea of how your blood sugar responds and you may not need to check it as often. Your health care team can help you fine-tune your exercise, eating and medication routine to make sure it's safe and effective.
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