Numerous studies show that regular exercise, especially aerobic exercise, improves the ability of your body to metabolize sugar. That is true even if there is not an accompanying weight loss. There is a possibility that exercise may cause a temporary drop in blood sugar (hypoglycemia), but that doesn’t stop the millions of individuals with diabetes who enjoy the benefits of exercise. Many find that eating some carbohydrates (hard candy, for example) and/or adjusting their insulin dosage prevents blood sugar fluctuations during exercise. To be active and safe, talk with your doctor before starting a new exercise routine or making changes in your food intake or medication level.

The NIH and the American Diabetes Association both recommend regular exercise in combination with diet modifications for patients with type 2 diabetes. From all the evidence, people with type 2 diabetes who exercise regularly in addition to observing proper diets are better able to control blood sugar levels and reduce complications related to cardiovascular disease.

Weight Loss 

If you do not have diabetes, maintaining ideal body weight is one vital step in the right direction if you want to avoid one main health risk associated with diabetes. According to the NIH, approximately 80% of all people with type 2 diabetes are overweight, and though more research is needed before medical science can fully explain the relationship between diabetes and weight, there is no doubt that exercise, in combination with a carefully controlled diet, helps people to lose weight. With weight loss—benefits including, improved circulation and lower blood pressure are remarkable. Furthermore, people who are 20% or more over their normal weight have an increased risk of developing type 2 diabetes. The NIH emphasizes that exercise alone is not usually effective for weight loss unless accompanied by an appropriate eating plan.

Exercise Suggestions 

Recent studies suggest that the ideal type of exercise regimen for individuals with diabetes is one that emphasizes an all-around approach. Selecting appropriate exercises, along with setting a responsible intensity level (try monitoring your heart rate with a heart rate monitor and planning a schedule of regular frequency will yield steady fitness results. According to the American College of Sports Medicine, exercise programs that address cardiovascular conditioning, muscular strength, and flexibility yield the best total fitness for all people, including those with diabetes. In combination with a controlled meal plan, consistent appropriate exercise the best way for individuals with diabetes to achieve overall fitness, combat cardiovascular disease, and control blood sugar levels.

Types of Exercise 

Do something you enjoy so you will stick with it. Make it something you can do at least three days a week, and five would be better. Aerobic exercises are the most effective kind of activity for lowering blood sugar levels and combating cardiovascular disease. To obtain the aerobic training effect, you should be able to do an exercise for a minimum of 20-30 minutes without stopping. Exercise hard enough that you feel invigorated but not exhausted. A good way to tell that your exercise intensity is appropriate is that your breathing rate increases, but you are still able to carry on a conversation.

The simplest way to begin exercise aerobically is by walking, especially if you are just getting into exercise. Walk outdoors when the weather is fine, or otherwise pick from a number of indoor possibilities. The only thing you need to begin your aerobic walking exercise is a good pair of shoes. Be sure your shoes fit well because diabetic foot neuropathy and reduced circulation could place you at an increased risk for blisters, ulcers, and infections. Foot care is especially important for people with diabetes. People with diabetes should have two pairs of walking shoes and alternate from day to day between pairs to help keep their feet dry.

Exercise Safely 

Cardiovascular conditioning is the single most important aspect of an exercise program for a person with diabetes. Try to add  frequent mild to moderately intense aerobic exercise into your schedule, but do it safely.

Before Exercise Checklist

• Monitor your blood sugar levels before and after exercise.
• Eat a healthy portion of fibrous moderate glycemic index foods 2-3 hours before exercise.
• Don’t exercise on an empty stomach.
• Avoid drinking any alcohol at exercise time.
• Drink plenty of water 1-2 hours before exercise.
• Be sure to warm up for 5-10 minutes before exercising.
• Check your feet regularly for blisters, scratches, and open wounds.

Certain conditions associated with diabetes may prevent you from exercising. Complications of specific health disorders or diseases must be fully evaluated prior to exercise. Please note the complications listed below and, with your doctor’s consent and direction, brief suggested exercise.

Diabetes Complications

• Heart Disease
  Moderately intense exercise including activities of daily living, multi-joint exercise within the prescribed training heart rate zone, and flexibility exercises.
• High Blood Pressure
  Again, moderate intensity, activities of daily living, progressive exercise beginning with moderate cardiovascular exercise and resistance exercise completed within the prescribed training heart rate zone.
• Nephropathy
  Refer to your doctor’s recommendations, exclude strenuous exercise, perhaps try aquatics classes that do not require weight bearing or strenuous activity.
• Peripheral Neuropathy
  Refer to your doctor’s recommendations, check your feet regularly, if no foot injury or ulcers exist to proceed with moderate physical activity including activities of daily living, walking, and weight-bearing exercise or aquatics classes.
• Autonomic Neuropathy
  Refer to your doctor’s specific recommendations.
• Retinopathy
  Avoid straining, holding your breath during exercise, and complete exercises that require you to keep your head higher than your waist, no bending over at the hip below waist level.
• Peripheral Vascular Disease
  Refer to your doctor’s recommendations. Avoid strenuous or high impact exercise. Try aquatics classes, non weight bearing exercise, or swimming.
• Osteoporosis or Arthritis
  Avoid high impact exercise. Try moderately intense exercise including activities of daily living, multi-joint exercise within the prescribed training heart rate zone, and flexibility exercises.
• Stroke
  If blood sugar, blood pressure, and cholesterol levels are within an acceptable range as directed by your doctor, try continuing activities of daily living, walking, and regular swimming or aquatics classes.
• Hyperosmolar Hyperglycemic Nonketotic Syndrome
  Do not exercise. Because ethos condition can be very serious and lead to dehydration, seizures, coma, or death, refer to your doctor’s specific recommendations. Be aware of warning signs like blood sugar over 600 mg/dl[1], dry mouth, high fever, hallucinations, asymmetric weakness on half of your body, loss of vision, or sleepiness.
• Gastroparesis
  Do not exercise. refer to your doctor immediately if you experience symptoms like heartburn, nausea, vomiting, weight loss, abdominal bloating, erratic blood sugar values, Gastroesophageal reflux, or spasms in your stomach.

Foot Complications

• Neuropathy
• Skin Changes
• Calluses
• Foot Ulcers
• Poor Circulation
• Amputation

In recent years strength training has come into its own as an essential component of overall fitness training, not just a training method for athletes and body builders. Aerobic conditioning will improve your cardiovascular system, but strength training can keep your muscles from weakening as a result of diabetes and preserve muscle mass during periods of weight loss. Weight training for people with diabetes should begin with light weights until your cardiovascular fitness increases.

The need to exercise regularly is independent of your age. Always warm up first before starting your exercises. If you are older and it is hard to get out, then begin with various small stretches, sitting down if necessary. Gradually work up to taking short walks. After a while, you will probably discover that you can do more than you thought you could do. For individuals who have both diabetes and arthritis, exercise is a special challenge, but it is possible. Always warm-up and then work on doing exercises that strengthen your muscles and make you feel better.  Even the best fitness program is not safe if complications are not diagnosed and treated, so be sure to obtain a complete medical examination before starting an exercise program.

Exercise Intensity 

Starting a more active lifestyle is not easy, and it is even more challenging to stick to it, but rest assured that millions of individuals with diabetes before you have made these important changes in their lives, and you can too. Your first step, following a thorough medical examination, should consist of setting realistic goals with a schedule you feel sure you can maintain. At first, your exercises should be fairly easy, perhaps short walks at a specific time each day. Then gradually build up your program and begin to include some cross-training by changing elements of your exercise to keep motivated. Exercising with a trainer is an especially good idea. Exercising alone can lead to discouragement and losing interest, but a good fitness trainer can provide encouragement and motivation to keep you going.

It is a good idea to meet with an exercise professional who has a great deal of experience working with people managing diabetes. Finding the right personal trainer can help you to create a program and construct an environment of support and satisfaction. You will increase exercise intensity according to your needs and how you feel. If you are producing good results from exercise, try to stay consistent rather than simply add more intense exercise to your program.  Finally, reward yourself whenever you achieve a fitness goal. The reward might be some new clothes or music, but not food!

Exercise can be extremely beneficial for people managing diabetes. It is important to know when you are taking your medication, how much medication you are taking regularly, and how you feel while being physically active. Exercising while managing medications for diabetes or associated health-related complications must be very controlled. Any preexisting conditions or complications as described above qualify as vital considerations to be discussed with your doctor and calculated with your personal trainer prior to exercise.

Best Forms of Exercise for People with Diabetes

Cardiovascular Exercise

Mild to Moderate Resistance Exercise

Aquatics or Pool Exercise Classes