Exercising Caution When You Have Diabetes
Exercise can help keep blood sugar under control. It can also lower the risk of other health problems like heart disease. But there are some safety steps to keep in mind.
The Importance of Balance
A balance of eating, exercise, and insulin can help keep type 1 diabetes in balance.
But, your body does not produce insulin if you have type 1 diabetes. You must take over as the regulator of blood sugar. This is an important job, as both high and low blood sugar levels can have serious health consequences.
In type 2 diabetes, your body produces insulin, but your body either cannot use it properly or does not make enough. People who manage type 2 diabetes with meal planning and exercise usually do not have problems with hypoglycemia. But if you use insulin injections or take some types of oral medications, you may be at risk for exercise-induced hypoglycemia.
Exercise can lower glucose levels in the blood. This will work for those with type 1 and type 2 diabetes on. It stimulates the body to use glucose, even without insulin. It is a great tool to help manage blood glucose but there is a need for planning.
Exercise can lead to a very low blood glucose level called hypoglycemia. Blood glucose levels below 70 mg/dL [3.9 mmol/L] are considered too low. It can lead to shakiness, sweating, headache, pale skin, irritability, clumsy movements, and confusion. Very low levels can lead to more serious illness. Hypoglycemia is a risk for everyone with type 1 diabetes due to use of insulin. It can also happen in people with type 2 diabetes who use insulin or other medicine that lowers glucose. However, the benefits of exercise are much greater than the risk of hypoglycemia. A few simple steps can also help you safely exercise:
- Talk to the medical team about your diabetes care plan . It will show the best times for you to exercise. The doctor will also give you safe blood glucose targets. These are a little different from person to person.
- Test your blood glucose before you exercise . Your doctor will give you a range that is safe for you. If the glucose is in the right range you are ready to start. Extra steps may be needed if:
- Glucose levels are low normal or low. Eat a snack before exercise. Look at your care plan to know how much to eat. A snack of 15 to 30 grams of carbs is common. Choose things that bring up glucose fast like fruit or fruit juice.
- Glucose levels are too high. Exercise can actually make glucose level shoot up even higher if you start with higher than normal levels. You may need to test for ketones in your urine. If ketones are present, take steps to lower your blood glucose. Follow the plan made with your doctor for high blood glucose. Wait until the test shows no ketones before you exercise.
- Be on the lookout for signs of low blood glucose during workout . Stop exercise and check your blood glucose if you feel symptoms.
- Check your glucose if you are doing a new activity . You may not know quite how your body will react to new or more intense exercise. Testing for the first 1 or 2 times will give you a better idea of how to plan.
- Test glucose right after exercise and in hours after . Blood glucose will drop faster than normal while your body recovers from exercise. Glucose levels will help guide your treatment steps.
Always have blood testing tool, insulin, and snacks with you. Good snacks include juice, glucose tablets or gel, or hard candy. Talk to your care team if you have a lot of very low or very high blood glucose with exercise. Your care plan may need to be changed.
Check Your Feet!
Diabetes can cause a change in small blood vessels and nerves. This may mean even minor cuts or injuries like blisters will have a hard time healing. Pain may also be dulled by problems of the nerves. The feet are one of the first areas to be affected.
Take good care of your feet. Check for blisters or other changes after every workout. Buy footwear that is suited for your sport and that fits you well. Wear clean, smooth-fitting socks. Choose synthetic fibers over cotton.
Careful planning can help to manage diabetes. Exercise is the same. Find an activity you enjoy and get moving!
American Diabetes Association
Joslin Diabetes Center
Canadian Diabetes Association
Blood glucose and exercise. American Diabetes Association website. Available at: http://www.diabetes.org/food-and-fitness/fitness/get-started-safely/blood-glucose-control-and-exercise.html. Accessed June 10, 2020.
Diabetes diet, eating, & physical activity. National Diabetes Information Clearinghouse website. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activity. Updated December 2016. Accessed June 10, 2020.
Low blood glucose (hyypoglycemia). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia. Updated August 2016. Accessed June 10, 2020.
Physical activity for type 2 diabetes. EBSCO DynaMed website. Available at:https://www.dynamed.com/management/physical-activity-for-type-2-diabetes/. Updated February 7, 2020. Accessed June 10, 2020.
Last reviewed June 2020 by EBSCO Medical Review Board Last Updated: 6/10/2020