How To Exercise With Diabetes

As New Year resolutions take hold, local gyms suddenly burst at the seams and a steady stream of walkers and runners travel down every trail. Kicking off the year by starting the healthy habit of exercise is great and one that hopefully takes hold long-term, but for those with diabetes starting an exercise program can seem even more challenging. Just how to exercise with diabetes is a legitimate question, but one that we’ll show has a pretty easy answer. 

The benefits of exercise for diabetics are not markedly different than for non-diabetics. Exercise can:

• Strengthen muscles and bones
• Burn body fat
• Reduce the risk of heart disease and stroke
• Lower blood pressure
• Lower your heart rate
• Improve cholesterol levels
• Boost energy
• Reduce Stress

But for those with diabetes, healthier living can also impact blood sugar levels and, in some cases, dramatically reduce the risks that come with diabetes. In general, it is recommended that adults spend 150 minutes each week engaged in an aerobic exercise like swimming, cycling, or fast walking. For children, the recommendation is 60 minutes each day, even if they have Type 1 diabetes. 

Test Blood Sugar Before, During, and After Exercise

The key to exercising with diabetes is to carefully monitor blood sugar. This is extra important if you take any medicine like insulin for diabetes. When you exercise, the cells of your muscles are better able to use glucose for energy, and your blood sugar levels may be lower for a day or more after a workout. This can also make your body more sensitive to insulin so for those who take insulin, there’s a risk for hypoglycemia if insulin doses or carbohydrate intake isn’t adjusted for exercise. Talk to your doctor before you start an exercise program so together you can map out the best plan to ensure your blood sugar levels are managed. 

Before Exercise: Generally, blood sugar levels of 100 to 250 mg/dL mean all systems are go for a good workout. Levels lower than 100 mg/dL may mean blood sugar levels are too low and eating a small snack with 15 to 20 grams of carbs before you put on your running shoes is good practice. Readings above 250 mg/dL may mean blood sugar levels are too high. To further explore this, urine should be tested for the presence of ketones. If ketones are found it's a sign your body does not have enough insulin to control blood sugar so exercise should be put on hold until blood sugar level moderates and urine comes back free of ketones. 

During Exercise: Once you hit the gym, start down the trail, or dive into the pool, monitoring blood sugar doesn’t end. If you’re planning to exercise for a long time, check your blood sugar levels every 30 minutes. This may seem excessive, but especially for someone starting off a new exercise routine, seeing how the activity impacts glucose is important. If blood sugar levels drop below 70 mg/dL or you begin to feel shaky or confused, stop what you’re doing and grab a fast-acting carb like fruit juice, hard candy, or a glucose tablet or gel that has 15-20 grams of carbohydrates. Wait 15 minutes and retest. If blood sugar levels are still low eat another snack and repeat this process until sugar levels return to a normal range then you can continue with your workout. 

After Exercise: After you logged several miles, got your heart rate up, and broke a sweat, don’t head right for the showers. The muscles you just used have been fueled by stored sugar and as that storage is depleted your body pulls in replacement sugar from your blood lowering your blood sugar levels. After a particularly long or hard workout, it may take your body several hours to fully recover so if levels are low, eat a slow-release carb snack like a granola bar or fruit juice to help get you back to normal.

A key to testing is to have a reliable, transportable method of testing. Our Genteel Plus Lancing Device fits the bill with the bonus that it doesn’t hurt fingers, so gripping those weights or racquets is painless. The Genteel Travel and Organizer Pouch has all you need for testing in one convenient bag. 

Diabetic Health Risks

There are specific health risks related to diabetes that can factor into exercising. Exercise can raise your blood sugar in some cases. When you exercise your body fuels its muscles with glucose. If you do short intense workouts like sprinting, the body can release an exaggerated amount of glucose in a short amount of time. It’s supposed to do that to fuel you, but for diabetics, particularly those with insulin-treated Type 1 diabetes, the sugar spike can be dangerous if not properly managed. Working out too soon after waking up or not taking the proper amount of insulin to cover a meal before you workout can be complicating factors. Through blood testing, you can experiment to find your ideal starting glucose level to target before your workout and learn how much glucose or insulin dosing you may need during exercise to keep blood glucose levels under control. Talk to your doctor to find out what can work to stop the spikes while allowing you to do any exercise you want. 

If you have diabetes-related nerve damage, either peripheral or autonomic neuropathy you can lose feeling in your feet and toes affecting your balance, and become light-headed if you move around too fast. For these diabetics, it’s best to do exercises that don’t impact your joints. For instance, replace running and tennis with swimming and cycling. 

Eye problems can also stem from diabetes in the form of proliferative retinopathy. New blood vessels actually grow in your eyes but they are weak and often leak and bleed if you make sudden jarring movements like jumping or lifting heavy weights. If you have this condition, talk to your eye doctor about what exercise is best for you. 

Best Exercise for Diabetics

Aerobic exercise is one of the best exercises for those with diabetes because it is most effective at promoting weight loss, lowering blood pressure, and moderating heart rate. But  strength training and balance should be part of a workout routine as well. Weight lifting, resistance bands, or plain old pushups and squats can build muscle tone and strength. The slow, controlled movement of tai chi and yoga are also beneficial for building strength and balance, and both have been shown to not only help with diabetes but also prevent nerve damage to the feet. 

We mentioned that doctors, whether you have diabetes or not, recommend 150 minutes of moderate exercise each week. That does not necessarily mean intense exercise but rather something that leaves you able to talk but uses too much breath for singing. If 150 minutes seems daunting, approach it in segments. During the workweek, you could sneak in 10 minutes of exercise, like a quick walk or jump rope session, three times a day. At the end of the workweek, you will have met your quota. Or maybe you only have three days to work out. A 50-minute session on three different days will still have the needed health and cardiovascular benefits. 

The best exercise for those with diabetes is really any exercise you enjoy and will stick with. And remember to turn to healthy eating as well. Exercise and healthy food can go a long way towards diabetes management and even reduce the risk of prediabetes turning into Type 1 or Type 2. So get moving and get your diabetes under control! 

For some inspiration, see below for an exercise tip from diabetes and health advocate, Basma Adams, on Instagram! 

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