Exercise is sure to be on your to-do list if you have diabetes. Get started with these go-to tips:
1. Make a list of fun activities. You have lots of options, and you don’t have to go to a gym. What sounds good? Think about something you’ve always wanted to try or something you enjoyed in the past. Sports, dancing, yoga, walking, and swimming are a few ideas. Anything that raises your heart rate counts.
2. Get your doctor’s OK. Let them know what you want to do. They can make sure you’re ready for it. They’ll also check to see if you need to change your meals, insulin, or diabetes medicines. Your doctor can also let you know if the time of day you exercise matters.
3. Check your blood sugar. Ask your doctor if you should check it before exercise. If you plan to work out for more than an hour, check your blood sugar levels regularly during your workout, so you’ll know if you need a snack. Check your blood sugar after every workout, so that you can adjust if needed.
4. Carry carbs. Always keep a small carbohydrate snack, like fruit or a fruit drink, on hand in case your blood sugar gets low.
5. Ease into it. If you’re not active now, start with 10 minutes of exercise at a time. Gradually work up to 30 minutes a day.
6. Strength train at least twice a week. It can improve blood sugar control. You can lift weights or work with resistance bands. Or you can do moves like push-ups, lunges, and squats, which use your own body weight.
7. Make it a habit. Exercise, eat, and take your medicines at the same time each day to prevent low blood sugar, also called hypoglycemia.
8. Go public. Work out with someone who knows you have diabetes and knows what to do if your blood sugar gets too low. It’s more fun, too. Also wear a medical identification tag, or carry a card that says you have diabetes, just in case.
- Exercise and Type 2 Diabetes
- How Much Exercise Is Enough if You Have Type 2 Diabetes?
- Exercising safely with diabetes
- The Importance of Exercise in Treating Diabetes
- Diabetes and exercise
- Benefits of exercising for diabetes
- Best type of exercise for diabetes
- Exercise if you have diabetes complications
- How does exercise affect blood sugars?
- Where to get support with exercise
- Healthdirect 24hr 7 days a week hotline
- Can type 2 diabetes be prevented?
- Complications of type 2 diabetes
- Common questions
- Resources and support
- Blood sugar lowering activities that will do the trick immediately
- Blood sugar lowering activities that will improve long-term insulin sensitivity
- Don’t do resistance training to get a high blood sugar down
- The step-by-step approach to better blood sugars: walking
Exercise and Type 2 Diabetes
The incidence of type 2 diabetes is on the rise, which experts largely attribute to the rise in obesity. Type 2 diabetes, which is responsible for 90 to 95% of all diabetes cases, is more common in adults, but as rates of childhood obesity increase, more young children are being diagnosed with the disease. The good news is that simple lifestyle changes can prevent and, in some cases, counter the course of this disease.
Type 2 Diabetes Explained
Following digestion, a hormone called insulin is released into the blood from the pancreas. Among insulin’s primary roles is its ability to allow carbohydrates (absorbed in the form of glucose) and proteins to enter muscle cells, where they are stored or used for energy. With type 2 diabetes, some insulin is produced, but the body does not effectively use it. This condition is known as “insulin resistance” and prohibits glucose from entering the cells. In turn, blood glucose rises to abnormal levels in the blood. If unchecked for extended periods, elevated glucose levels lead to heart disease, kidney failure, blindness and nerve dysfunction.
Type 2 diabetes is strongly linked to lifestyle factors, especially diet and exercise. People at highest risk of developing type 2 diabetes have a family history, as well as other cardiovascular risk factors, such as high blood pressure, high cholesterol, obesity and a sedentary lifestyle.
However, the same techniques that are used for prevention of this disease—a healthy diet and regular exercise—can be used to control and possibly reverse its progression.
Exercise Can Help
The latest research has put exercise at the forefront in the prevention, control and treatment of diabetes because it decreases insulin resistance. Following regular exercise training, cells can better respond to insulin and effectively take glucose out of the blood and into the cell. Exercise also helps to decrease the risk of cardiovascular disease by decreasing blood pressure, cholesterol levels and body fat.
If you have type 2 diabetes, you should adhere to the following exercise guidelines:
- Always consult with your physician before starting any exercise program to determine the potential risks associated with exercise.
- Cardiovascular exercise—Strive to accumulate a minimum of 1,000 kcal expended through physical activity each week. Pending current conditioning levels, this may require three to seven days per week of low-to-moderate intensity exercise for 20 to 60 minutes (walking and other non-weightbearing activities such as water aerobics and cycling are good choices). Daily exercise is highly recommended.
- Resistance training—Perform resistance-training activities at least two days per week, targeting the major muscle groups. Complete a minimum of one set of 10 to 15 repetitions of each exercise at a low-to-moderate intensity.
- Flexibility—Perform stretching exercises at least two to three days per week, stretching major muscle groups to the point of tension (not pain) for 15 to 30 seconds. Complete two to four repetitions of each stretch.
- The ultimate goal is to expend a minimum of 1,000 calories per week via physical activity for health benefits, or 2,000 calories per week for weight loss. Keep in mind that these are goals that you should work up to gradually over time.
What are the precautions?
If you have type 2 diabetes, you must monitor your glucose before and after exercise to understand how you respond to certain types of activities. Also, exercising with a partner and wearing an ID bracelet indicating one’s diabetic condition are very important.
Finally, don’t forget to check with your physician prior to beginning a physical-activity program and return regularly to assess the diabetic complications. If complications of the eyes, kidney or heart are present, your physician should provide you with clear boundaries regarding the intensity of any physical activity.
American Diabetes Association
Centers for Disease Control
How Much Exercise Is Enough if You Have Type 2 Diabetes?
If you have type 2 diabetes, you should aim for about 30 minutes of exercise at least five days a week, according to the American Diabetes Association. However, if you’re like many newly diagnosed type 2 diabetics, you may not have exercised in a long time—if ever.
If that’s the case, it’s fine to start slow and work up. In fact, until you get a feel for how exercise affects your blood sugar (and until you get your doctor’s clearance), it might be a good idea for most newly diagnosed patients to take it slow.
Aerobics or strength training?
The best type of exercise is one that you will do. However, a 2007 study suggested that a combination of aerobic exercise and resistance training was better than either alone.
The study included just over 250 adults with type 2 diabetes. All participants except for those in the control group worked out three times a week for six months. The group that did resistance training improved, as did the aerobic exercise group (both had a drop of roughly half a percentage point in hemoglobin A1C).
But the best results “went to participants who did both strength training and aerobic exercise,” says Ron Sigal, MD, associate professor of medicine at the University of Calgary in Alberta, Canada, and the lead author of the study. That group had about a 1% drop in hemoglobin A1C compared to their sedentary peers.
“That’s often the result we hope for with medication,” says George Griffing, MD, professor of medicine at Saint Louis University School of Medicine in St. Louis.
Some approaches work better than others
People who shoot for a specific goal (10,000 steps per day on a pedometer is a common one) tend to lose more weight than those who do not—even if they don’t necessarily reach that goal.
But buying a pedometer alone may not be enough to get you working out.
“It’s not about gadgets, it’s about relationships,” says Joseph LeMaster, MD, an assistant professor of family and community medicine at the University of Missouri-Columbia School of Medicine in Columbia, Mo.
Other research has shown that people who work out in a group or a class are more likely to succeed than those who do not. But like all aspects of type 2 diabetes, you’ll need to find out what works best for you.
Exercise doesn’t mean you have to walk on a treadmill at a gym, says Gerald Bernstein, MD, director of the diabetes management program at the Gerald J. Friedman Diabetes Institute at Beth Israel Medical Center in New York City. “If you work up a sweat raking leaves, or vacuuming the carpets, that’s beneficial exercise,” he says.
Just don’t overestimate the workout you’ll get from daily chores alone. (Use this interactive tool to see how many calories you burn with daily activity.)
Walking 10,000 steps per day is equal to five miles; most people whose jobs have them largely sitting at desks only take about 4,000 to 5,000 steps each day. So reaching that goal may require fitting in some long walks nearly every day.
Exercising safely with diabetes
Regular and safe physical activity is especially important for people with diabetes.
Blood sugar and exercise
The most common concern people have about exercise and diabetes is how to keep their blood sugar levels from getting too high or too low. Here are some general guidelines to follow:
- Exercise at the same time every day, if possible. This will help you find out how exercise affects your blood sugar.
- Check your blood sugar before exercising. If your blood sugar is less than 100 before you start to exercise, eat a carbohydrate snack. If your blood sugar is 250 or higher, don’t start exercising until your blood sugar level is under 250.
- Exercise with a friend who knows that you have diabetes and knows how to help if your blood sugar gets too low.
- Make sure you have ID with you that lets people know you have diabetes.
- If you’re sick or have an infection, don’t exercise until you’re feeling better. Being sick affects your blood sugar.
Taking insulin or diabetes pills to lower blood sugar
Blood sugar can go too low (hypoglycemia) during exercise if you take too much insulin, the insulin is absorbed too quickly, or the insulin peaks during exercise. It can also happen if you take insulin or pills and don’t eat enough carbohydrate. Here are some things you can do:
- If your blood sugar is less than 100 before you exercise, eat at least 30 grams of carbohydrate before you begin. This will help keep your blood sugar level from dropping too low during exercise.
- Bring a carbohydrate snack with you whenever you exercise in case your blood sugar level drops too low during or right after you exercise.
- If your exercise will last for more than an hour, check your blood sugar after each hour of exercise. If your blood sugar is 100 or less, you should eat a carbohydrate snack.
- Check your blood sugar after you stop exercising and again over the next couple of hours. Your muscles will continue to use sugar from your bloodstream for several hours after you stop exercising. This can cause a delayed drop in your blood sugar level.
- If you take insulin, don’t take your shot in a part of your body that you’ll be using heavily during exercise. For example, don’t take your shot in your thigh if you plan to run. This can lead to the insulin being absorbed too quickly and cause your blood sugar to drop suddenly.
- Keep records to learn how your body reacts to exercise. This way you’ll be able to plan the timing and amount of your meals, medicine, and exercise to keep blood sugar levels stable.
Blood sugar can go too high (hyperglycemia) during or right after exercising. This happens if there isn’t enough insulin in your body when you start to exercise. Talk with a member of your health care team if this is happening. Your health care provider can help you learn to balance your medicines with your exercise.
Other health concerns
Some diabetes-related problems might need special planning before you begin exercising.
If you have any damage to your retina, don’t do any exercises that increase the pressure in your eyes. Don’t do exercises that make you strain, such as lifting heavy weights. Don’t exercise to the point that your heart is pounding and you’re out of breath.
Peripheral neuropathy means you have pain or numbness in your hands or feet. If you don’t have feeling in your feet, make sure your activity doesn’t put too much stress on them. It’s also very important to make sure you’re wearing the right shoes for your activity.
Check your feet before and after you exercise. If you have sores or blisters, follow your doctor’s instructions for special care. Make sure to follow your daily plan for foot care.
Don’t try to do too much too soon: Increase the amount of time or distance of your activity by about 10 percent each week. It won’t seem like much at first, but it adds up quickly.
Warm up and cool down: Start out slowly and give your heart and muscles a chance to get going. When you’re finished with your activity, take a few moments to slow down before stopping completely.
Don’t work too hard: If the activity feels too hard, it probably isn’t good for you. Slow down until you feel comfortable. You should be able to carry on a conversation while you’re exercising.
While everyone can benefit from regular physical activity, some people may need to take extra precautions. If you have special health concerns, ask your doctor to help you find an exercise plan that’s right for you.
If you feel any of the following while you’re exercising, slow down gradually and then stop:
- Faint or dizzy
- Chest tightness or pain
- Extremely short of breath
- Loss of muscle control
If you still feel these symptoms several minutes after you’ve stopped exercising, call your health care provider’s office. If you think you’re having a medical emergency, call 911.
Clinical review by Avantika Waring, MD
The Importance of Exercise in Treating Diabetes
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Exercise benefits people with diabetes and those at risk for diabetes by helping manage weight, by improving blood sugar levels, and by improving heart health. For a person with diabetes, exercise is just as important as diet and medication. In fact, the American Diabetes Association recommends at least 30 minutes of physical activity that increases the heart rate five days per week.
“Healthy diet and exercise are likely as strong as any medication I will ever prescribe for diabetes, and should be continued forever,” says Michael Heile, MD, a family medicine doctor at TriHealth’s Family Medical Group.
It is important to design a lifelong exercise routine that is both attainable and enjoyable. Walking is one of the easiest and most convenient options, but you may want to explore new options, too! You should exercise at a comfortable pace and do not overexert yourself. If you adhere to a steady, regular program, you can expect these outcomes:
- Increased insulin sensitivity (insulin works better)
- Lower blood sugar levels
- Increased energy and endurance throughout the day
- Weight loss with increased muscle tone
- A healthier heart and lower blood pressure
- Better sleep at night
- Stronger bones and a lower risk of osteoporosis
- Better resistance to illness
- Improved cholesterol, heart rate, and blood pressure levels
- Lower stress, anxiety, boredom, frustration and depression
The American Diabetes Association recommends two different types of exercise for managing diabetes: aerobic and strength training.
This exercise is done by using your arms and/or legs in a continuous, rhythmic movement in order to increase your heart rate. Examples include running, dancing, biking, swimming and walking. Be sure to pick an aerobic exercise that you enjoy and set realistic goals.
Strength training (also called resistance training) makes your body more sensitive to insulin and can lower blood sugar.
In addition to aerobic activity, the American Diabetes Association recommends doing strength training exercises at least two times per week, but not two days in a row. Examples of strength training include using weight machines, free weights and resistance bands, and doing body weight exercises such as push-ups, lunges and sit-ups. Lifting items around the house such as canned goods or water bottles works, too.
Precautions for Exercising with Diabetes
- Always consult with your doctor before beginning any exercise program to be sure it is medically safe to exercise and review principles noted below.
- Exercise can lower blood sugar suddenly, but in the case of strength training, it can increase blood sugar levels. Be sure to monitor blood sugar levels before and after all exercise routines to better understand how your body responds to exercise and to prevent any severe deviations.
- Those with Type 1 diabetes should also test for ketones in their urine (if blood sugar is severely or unexplainably high) before exercising and should avoid vigorous activity/exercise when ketones are elevated. You can likely exercise when your blood sugar is high as long as there are no ketones in your urine and blood sugar is not severely high.
- For those taking insulin and/or medications such as glipizide or glyburide (insulin secretagogues), exercise can cause low blood sugar if medication dose or carbohydrate intake is not adjusted appropriately. Extra carbohydrates should likely be consumed if pre-exercise blood sugar levels are under 100 to 120 mg/dL.
- Low blood sugar is less common in diabetic patients who are not treated with insulin or insulin secretagogues, and no preventive measures for low blood sugar are usually needed in these cases.
- Stop exercising and call 911 immediately if you have any of these symptoms during, or even several hours after, exercise:
- Lightheadedness or dizziness
- Rapid heart beat
- Chest discomfort
- Jaw, arm, or upper back discomfort
- Unusual shortness of breath
- Sudden weakness
- Severe or unusual fatigue or sleepiness
- Severe discomfort of any kind
Tags Diabetes , Exercise and Fitness , Wellness and Fitness
Last Updated: August 17, 2017
Diabetes and exercise
We know that the way your diabetes affects you is unpredictable. You don’t always know how you’ll feel or what you can and can’t do. Which makes the small victories important, even when it comes to being active. Because it doesn’t matter whether it’s something small and new, or just that little bit more of something you already do.
Here we’ll take you through the benefits of being active for diabetes and show you what type of activities are good to try. We’ll help you start small and build up, in a way that suits you. And if you’re already doing exercise, we’ve got more detailed information to help you manage Type 1 diabetes or Type 2 diabetes.
“You don’t have to do traditional exercise, simply moving more is good for your health and your diabetes. That might be walking to the shops, using the stairs or even standing more. It’s amazing how quickly small changes can add up and lead to a physically active life.”
– Neil Gibson, Physical Activity Insight Advisor at Diabetes UK
You’re not alone in this, we can help you get active. That’s why we’ve teamed up with Sport England and other charity partners to help promote moving more across the UK in new campaign We Are Undefeatable.
Benefits of exercising for diabetes
Some people worry that being physically active will be too tiring or make their diabetes harder to manage.
And if you’re someone who gets hypos, you’re probably worried about getting more. But activity doesn’t always make your blood sugar levels go down – it can make them go up too. We’ve made a guide to blood sugar levels and exercise to help you.
That’s a lot of worries and they’re all understandable. But we’re here to bust these myths and make sure you know all the important benefits of exercising when you have diabetes.
Benefits of being active with diabetes include:
- helps the body use insulin better
- helps you look after your blood pressure, because high blood pressure means you’re more at risk of diabetes complications
- helps to improve cholesterol (blood fats) to help protect against problems like heart disease
- helps you lose weight if you need to, and keep the weight off after you’ve lost it – there are so many more benefits to losing extra weight
- gives you energy and helps you sleep
- helps your joints and flexibility
- benefits your mind as well as your body – exercise releases endorphins, which you could think of as happy hormones. Being active is proven to reduce stress levels and improve low mood.
- and for people with Type 2 diabetes, being active helps improve your HbA1c.
Being active is even more beneficial if you do things like make healthier food choices, don’t smoke and get enough sleep.
“The thought of being more active might be overwhelming, but once you start people have told me how great it makes them feel. You won’t just see the benefits now. It’s about building a healthier future too – we know being active helps protect your body against diabetes complications and can help you lead a happier and healthier life.”
– Emma Elvin, Senior Clinical Advisor at Diabetes UK
Best type of exercise for diabetes
There isn’t one type of activity that’s best for everyone with diabetes. It’s about finding what works for you and depends on lots of things, like what you enjoy, where you are and how much time you have. Think about how activity can fit in with your life, not the other way around. And work towards adding in some more traditional exercise too.
It’s best to do a mixture of different types of activity, because different types have different benefits. And doing the same thing can get boring after a while.
For example, swimming can make you breathe harder and raise your heart rate. This is good for your heart health because your heart has to work harder to pump blood around the body. And with diabetes, keeping your heart healthy and fit is even more important because you’re more at risk of heart disease and other complications.
Whereas doing something like digging in the garden helps with strength and can help the body use insulin better.
“I love music and I started dancing at home. By changing my diet and how active I was, I stabilised my HbA1c. There was a lot to learn but talk to people, talk to your GP. Diabetes doesn’t have to control you, you can control diabetes.”
– Zahoor decided to make changes to his lifestyle
Get active at home
When you have diabetes, there are loads of things you can do at home to get active.
- Carrying shopping bags
- Stand during a TV ad break
Get active when travelling
When you’re out and about, it’s surprising how a slight change of routine will increase how active you are and help you feel better when you’re living with diabetes.
- Getting off the bus one stop earlier
Get active at work
Keeping active at work when you have diabetes is important, especially if you have to sit down in front of a computer for a long time.
- Walking up stairs
- Walking meetings
- Standing when you’re on the phone
- Chair-exercises like sitting and lifting your arms up
Get active as a hobby
Start up an active hobby – it’ll help you manage your diabetes and feel good.
- Yoga or pilates YouTube video
- Swimming or dance class
- Throwing or kicking a ball around in the park
- Walking catch-ups with friends
Why not take a look at our fundraising events – there’s a big range to choose from, involving walking, swimming, cycling and lots more. We organise these to help you get active and to raise more money so we can keep working towards a world where diabetes can do no harm.
If you’re worried about starting any of these types of activities, talk to your GP. They will be able to give you advice on how you can adjust things to suit you.
Exercise if you have diabetes complications
If you have diabetes complications, like problems with your eyes and feet, you’ll need to think a bit more about the activity you choose. For example, if you have foot ulcers you might need to avoid certain types of weight-bearing activity like jogging. Chair-based exercises might be better for you, like raising your legs one after the other or lifting baked bean cans while you’re sitting down.
Remember that a little bit of activity has so many benefits, so do as much as you can and reward yourself for any small changes you make.
It’s really important you take care of your body, as well as be active. So speak to your healthcare team for more advice on what’s best for you before starting anything new. They can help you decide what’s safe for you and consider any complications you have.
How does exercise affect blood sugars?
Being physically active can affect blood sugar levels in different ways, depending on the type of activity you’re doing.
We know a lot of people don’t want to exercise because it can lower their blood sugars. You might be constantly worried about hypos, and that’s understandable. But did you know that not all types of exercise make your blood sugars go down? Some make them go up too.
Understanding more about what happens before, during and after you’re active could help ease some of this worry and also manage how your levels fluctuate. If you check your blood sugars yourself, whether that’s using some diabetes technology or test strips, try doing this more often around the time you’re getting active. Trial and error can really help you spot patterns, but remember to stay safe – check out our tips on managing blood sugars.
But it’s not an exact science. Some days you’ll do exactly the same type of activity and eat the same foods, but your blood sugar levels may act differently to what you’d expect. This can be really frustrating, but it’s completely normal. Anything from hormones to the weather can affect your diabetes.
Managing blood sugars when being active
There’s no single way to manage your blood sugars, because everyone manages their diabetes differently. We’ve put together some tips to help, but talk to your diabetes healthcare team for more advice.
Here are some things that might help:
- If you normally check blood sugars, keep a record of what happens when you’re being active and show this to your diabetes nurse or doctor.
- If you’re at risk of hypos, keep hypo treatments handy. And a snack with some carbs in.
- Wear diabetes ID so people around you can help if they need to.
- If you use insulin to treat your diabetes, you might need to make changes to the dose you give around exercise.
Where to get support with exercise
Now you know all the facts about diabetes and exercise, here’s how to get started.
Talk to your healthcare team
Ask at your GP surgery about local services to help you get active. They should be able to point you in the right direction, and give you advice on what type of activity might benefit you the most.
Find out what’s happening in your local area
Getting active with others can often give you that extra bit of motivation you need. Whether that’s friends and family, or a local walking group.
We run local diabetes support groups to bring people with diabetes together. Sharing tips and stories with like-minded people could help you learn and figure out what’s best for you. Use our postcode finder to find out if you’ve got one in your area and check out what activities they run. Some hold badminton games and do walking days.
And why not sign up to one of our fundraising events like the London Bridges walk or the One Million Step Challenge. You’ll be part of our team and we’ll support you every step of the way. Signing up to a challenge like this can give you a realistic goal to plan ahead for.
Use tools to set exercise goals and plan ahead
Setting goals can help you break down what you need to do and how to do it. It can also give you the chance to think ahead about any barriers you might come across. If one of your aims is to lose weight, we’ve made a weight loss planner (PDF, 534KB) you can download. You can stick it to your fridge to help you keep track each day.
Use our Learning Zone to learn more about how effective a little bit of activity can be for your diabetes. And hear from other people with diabetes on what they do to get active and how they do it.
If you’re short on time and prefer to plan while you’re on the go, try apps like the Couth to 5K and Active 10. Apps can be really motivating and give your planning some structure.
“It can be difficult finding what works for you, with days of frustration and tiredness. Just remember that this happens to most people, especially if you’re new to activity. Try and think about your overall goals and visualise what you want to achieve – this is proven to work for some people.”
– Neil Gibson, Physical Activity Insight Advisor at Diabetes UK
Healthdirect 24hr 7 days a week hotline
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Can type 2 diabetes be prevented?
Unlike type 1 diabetes, type 2 diabetes can be prevented or delayed by:
- maintaining a healthy weight
- regular physical activity
- eating healthily
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Complications of type 2 diabetes
Treating type 2 diabetes is important to prevent long-term complications, such as:
- heart disease
- kidney disease
- eye complications
- foot problems
- nerve problems
Watch this video to learn how to take care of your feet if you have diabetes. The video is available in multiple languages.
Video provided by Diabetes Victoria.
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What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes is an auto-immune disease where the body’s immune system attacks the insulin-producing cells of the pancreas. Type 2 diabetes is associated with hereditary factors and lifestyle risk factors such as poor diet, insufficient physical activity and being overweight or obese.
What are the first signs of type 2 diabetes?
Many people with type 2 diabetes do not experience any symptoms at first. If they do have symptoms, these may include being very thirsty, passing more urine than usual, feeling tired, feeling hungry or having cuts that heal slowly.
Can type 2 diabetes be cured?
Type 2 diabetes cannot be cured, but people with the condition may be able to manage their type 2 diabetes through lifestyle changes and, if needed, diabetes medications to control blood sugar levels.
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Resources and support
For more information and support, try these resources:
- Diabetes Australia’s website has information about type 2 diabetes and advice on living with diabetes in general.
- The National Diabetes Services Scheme (NDSS) can give you access to a range of subsidised products to help you manage your diabetes. Call the NDSS Helpline on 1300 136 588.
Aboriginal and Torres Strait Islanders
This information has been developed for indigenous communities:
- Diabetes Australia: Diabetes in Aboriginal and Torres Strait Islander communities (including video)
- Healthy Living NT: Diabetes: Keep your feet healthy
- Healthy Living NT: Nutrition for diabetes in pregnancy
Do you prefer other languages than English? These websites offer translated information about diabetes:
- NDSS Multicultural Portal
- Multicultural Health Communication Service NSW
- Health Translations Victoria
Apps and tools
You might find these apps and tools helpful:
- healthdirect’s Risk Checker (diabetes, heart disease and kidney disease)
- Diabetes Australia’s risk calculator
- Diabetes Australia’s mobile app
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With a diabetes diagnosis also comes the daily task of self-management, and if you have lived with diabetes for any amount of time, you know that that’s no easy task.
Not only do you have to become an expert in how your body reacts to different kinds of foods, but you also need to understand how to manage your blood sugars with medication and exercise.
If you don’t take any diabetes medication or takes medication like Metformin that doesn’t lower blood sugars instantly, exercise is the easiest way to lower your blood sugar.
The first thing to ask yourself is what you are trying to achieve. Is the goal to get a high blood sugar down to your preferred range or are you looking to lower your average daily numbers by improving your insulin sensitivity permanently?
Depending on your goal, different exercise strategies should be considered.
Blood sugar lowering activities that will do the trick immediately
If you’re experiencing a post-meal high (or another sticky high), I recommend a brisk walk or living room dance-off, accompanied by plenty of fluid.
(Here I have to note that if you have ketones in your urine or have several very high blood sugar readings, you should contact a medical professional).
What you want to achieve is an increased heart rate that stays up for a period of time. This type of activity is called steady-state cardio and will typically lower blood sugars pretty quickly. Most people I have worked with see an impact already after 15-20 minutes, but it really depends on you, your blood sugar level, and your insulin sensitivity.
I usually recommend a brisk walk, but it can be whatever activity works for you, as long as it raises your heart rate. If its’ pouring rain or snowing outside, you can walk or dance around the house instead (or put on an exercise video).
If you have limited mobility, it might be something as simple as standing up and sitting down several times in a row or simply fluttering your legs while seated. Work with what you got!
I think you get my point by now, just move, and get your heart rate up!
I also mentioned hydration, which is a critical component. Most people forget to get enough water throughout the day, and being dehydrated does not help when it comes to lowering blood sugars. So make sure to drink enough, even if you live in a cold climate.
Blood sugar lowering activities that will improve long-term insulin sensitivity
Being on the defense when it comes to blood sugar management isn’t always optimal, but let’s face it, it happens. But that doesn’t mean that you can’t be proactive when it comes to improving your insulin sensitivity, and thereby daily blood sugar levels.
The key to improving your insulin sensitivity is to add resistance training to your exercise routine. And before you stop reading, I’m not necessarily talking about hitting the gym and lifting massive weights.
You can, of course, do that, but if resistance training is new to you, I suggest you ease into it with bodyweight exercises in the comfort of your home. Start out with pushups against a wall and air squats until you build up enough strength to advance to more demanding exercises.
If you decide to exercise at home, check out my home resistance training videos for inspiration.
The beauty of resistance training is that it will improve your insulin sensitivity up to 48-hours after you’re done! Increasing your overall muscle mass will further serve to permanently improve your insulin sensitivity.
Don’t do resistance training to get a high blood sugar down
While resistance training is great for improving your insulin sensitivity, it’s not the appropriate type of exercise if you’re looking to get a high blood sugar down quickly since it can make your blood sugar increase during your workout (you can read why in this post).
The spike in blood sugars that many people see during resistance training (or other types of anaerobic training) is only temporary, but not what you want if you are trying to lower your blood sugar.
I hope that this post has given you a good idea of how you can use exercise to lower your blood sugars, even if you’re not on any medications, as well as given you an overview of which types of exercise if optimal for different goals. Now go have fun with it!
Suggested next posts:
- Is Type 2 Diabetes Reversible?
- Metformin Side Effects: What You Need to Know
If you found this guide to lowering your blood sugar with exercise useful, please sign up for our newsletter (and get a free chapter from the Fit With Diabetes eBook) using the form below. We send out a weekly newsletter with the latest posts and recipes from Diabetes Strong.
The step-by-step approach to better blood sugars: walking
by Adam Brown
If you’re like me, you might have a health-focused New Year’s resolution posted on your wall: “lose weight,” “exercise more, “be less stressed.”
Unfortunately, making resolutions is easy, but sticking to them is hard. A 15,000-person survey found that four out of five people who make New Year’s resolutions eventually break them. And it gets worse: a sizeable percentage of people (11%) in one survey actually broke their resolution one week in!
As I pondered this depressing data, I thought about scientifically testing the simplest, most fundamental exercise possible: walking. It can be done anywhere, does not cost anything, and requires no equipment. And because the barriers to doing it are so low, it also helps address that very basic New Year’s Resolution conundrum outlined above. What follows is my personal diabetes experience testing the blood sugar benefits of walking, a brief review of studies on diabetes and walking, and five tips to incorporate walking into your daily routine.
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Walking with diabetes – my own experience
As a fitness fiend my whole life, I tend to think of “exercise” with a very intense, all-or-nothing frame of reference: cycling, strength training, and playing basketball. So when I approached the question of how much walking could really drop my blood sugars, I was skeptical. In an effort to test it objectively, I performed a dozen periods of walking, and measured my blood glucose immediately before and immediately after finishing. I timed each walk with a stopwatch, always made sure I had less than one unit of insulin-on-board, and tried to go at a normal speed.
On average, walking dropped my blood sugar by approximately one mg/dl per minute. The largest drop I saw was 46 mg/dl in 20 minutes, more than two mg/dl per minute. Walking was also surprisingly effective: my blood sugar dropped in 83% of my tests. There were only two times where I did not see a drop in blood sugar; in these instances, I suspect it was either blood glucose meter inaccuracy or a delayed blood glucose rise from meals (e.g., fiber, fat) that contributed to the increase. Those interested can see the complete table of my walking endeavors at the end of this article.
Some might argue that one mg/dl per minute is not very impressive, but the key for me is reducing my insulin intake. One unit of insulin tends to drop my blood glucose by 25 mg/dl (morning) and 35 mg/dl (afternoon and evening). My rapid-acting insulin (Novolog) takes about 60-90 minutes to peak and three hours to completely finish working, meaning any drop in blood glucose takes a while. With a blood sugar of 170 mg/dl, I could either take two units of insulin and wait well over an hour for my blood glucose to really drop, or I could walk for a little more than 30-40 minutes. I found it liberating that something as simple and easy as walking could be a replacement for (or augment to) taking insulin.
I originally had hoped to test the effects of walking after meals but found it hard to do a thoroughly scientific job of it. What I can say, however, is that walking after meals definitely lowered my insulin requirements. Generally, planning a post-meal walk of around 20 minutes meant I needed about half as much insulin as normal, and in some cases no insulin at all. The caveat is that I do tend to eat pretty low carbohydrate meals, so those eating higher carb meals may find their needs differ. The best way to see how walking affects your blood sugar it to try it for yourself.
What does the research say about walking with diabetes?
I found many published studies on walking with diabetes, and most showed a benefit. I’ve categorized them below into type 1 diabetes, type 2 diabetes, and prediabetes/overweight/obese. The list below is not exhaustive by any stretch, but I hope it gives a broad sense of some of the scientific research supporting the benefits of walking.
Type 2 Diabetes: A 2012 study of 201 people with type 2 diabetes found that every additional 2,600 steps of walking each day was associated with a 0.2% lower A1c. For reference, 2,600 steps is a little over a mile (about 20 minutes walking at a normal pace). In an interesting 2005 study of 179 patients with type 2 diabetes, medication costs, insulin usage, and physical activity were tracked over a two-year period. Over that time, taking a three-mile daily walk (about an hour per day) was estimated to reduce drug costs by $550 and other medical costs by $700. The number of patients on insulin therapy also fell by a compelling 25%. And a small 2012 study examined the emotional effects of walking in individuals with type 2 diabetes – in the 16 patients that participated in the study, 20 minute walks were associated with significant positive influences on psychological well-being.
Type 1 Diabetes: Though few studies have tested walking in people with type 1 diabetes, the results do seem positive, particularly after meals. A 2012 study examined 12 patients with type 1 diabetes over 88 hours. Those who walked after meals had approximately one half the glucose excursion compared to those who did not walk after meals. Interestingly, the same study found a similar glycemic benefit in those without diabetes. The researchers concluded, “Walking significantly impacts postprandial glucose excursions in healthy populations and in those with type 1 diabetes.”
Prediabetes/Overweight/Obese: A 2007 analysis, which included five studies examining walking and the risk of type 2 diabetes (data from a staggering 301,221 people), found that those who walked regularly (about 20 minutes per day) had a 30% lower risk of developing type 2 diabetes compared to those who did almost no walking at all. A 1999 analysis of the Nurses Health Studyalso examined the risk of developing type 2 diabetes, this time in over 70,000 female nurses over an eight-year period. Walking was strongly associated with a lower risk of type 2 diabetes, and the speed was important – compared to those who walked at an “easy pace” (longer than 30 minutes to walk one mile), those who walked at a “normal” pace (20-30 minutes per mile) had a 14% lower risk of developing type 2 diabetes. Walking at a brisk pace (faster than 20 minutes per mile) was linked with a 41% lower risk of type 2 diabetes.
How can I incorporate walking and other types of exercise into my daily routine?
1. Take it one step at a time: A good way to start something new is to take it slow, set achievable goals, and then make them more ambitious over time. If you don’t walk at all right now, make a goal to walk one minute per day. Next week, walk two minutes per day. Starting small and building up over time makes starting a new goal less daunting. Plus, the gains you make will give you a sense of satisfaction and encourage you to keep going.
2. Make a schedule: One easy way to remind yourself to walk or exercise is to schedule it on your calendar – this can serve as a daily reminder, as well as a way to protect that time and avoid overscheduling yourself. And if your goal is 100 minutes of walking per week, a calendar can make it seem manageable: just 15 minutes per day.
3. Involve friends and family: Having someone join you in an exercise program can help keep you accountable (i.e., you may be less likely to skip out on a session if you know you’d be letting your partner down), make the time pass more quickly, and even help foster some healthy competition.
4. Make it fun: To pass the time while walking, I’ve become a huge fan of listening to audiobooks, music, or calling family members. There are also a variety of smartphone apps that are designed to make walking more fun, trackable over time, and even more competitive. I’m a big fan of activity trackers like Fitbit, which can be very motivating for increasing daily steps.
5. Sneak it in: If you’re not into planning exercise, there are still cool and easy ways to get more walking in. You can park farther away when you go to the store, take the stairs instead of the elevator or escalator, and take walking breaks with colleagues at work – the latter is a diaTribe staff favorite to enjoy the beautiful Lower Haight neighborhood here in San Francisco.
By Serena Gordon
THURSDAY, Dec. 15 (HealthDay News) — Lack of time is a common reason cited for not exercising, but new research suggests that several short intensive workouts a week may help lower blood sugar levels similarly to longer, more regular exercise regimens.
The small, new study found that 30 minutes of high-intensity exercise a week — a total exercise time of 75 minutes a week with warm-up and cool-down included — could lower blood sugar levels for 24 hours after exercise, and help prevent post-meal blood sugar spikes in people with type 2 diabetes.
“If people are pressed for time — and a lot of people say they don’t have enough time to exercise — our study shows that they can get away with a lower volume of exercise that includes short, intense bursts of activity,” said the study’s senior author, Martin Gibala, professor and chair of the department of kinesiology at McMaster University in Hamilton, Ontario, in Canada.
Results of the study are published in the December issue of the Journal of Applied Physiology.
Experts already know that exercise can lower blood sugar levels, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Muscles use glucose as fuel, so any type of activity can bring blood sugar levels down. Exercise also helps the body use insulin more efficiently, which in turn, helps the body use more glucose.
Current recommendations from the American Diabetes Association suggest that people with diabetes should try to get at least 150 minutes of moderate to vigorous exercise each week. That’s about 30 minutes a day, most days of the week.
But, not everyone has time to do that much exercise, Gibala noted. So he and his colleagues wanted to see if high-intensity exercise, done for a shorter time, could also have an impact on blood sugar levels.
The study included eight people with type 2 diabetes. Their average age was 63, and their body mass index (BMI) was 32, a level considered obese. BMI is a measurement of body fat that takes into account height and weight.
Over two weeks, the study participants completed six sessions of high-intensity training. For one minute, the study participants would exercise intensely, followed by a minute of rest. This was then repeated until they’d completed 10 minutes of intense exercise. The exercise sessions also included a warm-up and cool-down period for a total of 25 minutes of exercise.
The intense exercise was done at a level to get the heart rate to about 90 percent of their maximal heart rate. Gibala said this means you’re exercising really hard for that minute. “You’re not at an all-out pace, like you’re trying to save your child, but you’ll definitely be out of breath and have trouble talking after a minute,” he said.
The best thing about this type of exercise is that “these intervals can be scaled to your level of fitness so that it’s safe and effective for you,” he noted.
In addition to testing blood sugar levels throughout the study, the researchers also biopsied thigh muscles from each participant at the start of the study, and after the last bout of exercise.
The investigators found that blood sugar levels dropped from 137 milligrams per deciliter (mg/dL) to 119 mg/dL. In addition, blood sugar levels after meals were also reduced long after training sessions were complete.
The biopsies from the thigh muscles showed increased skeletal mitochondrial capacity, an indicator of improved metabolic health.
Gibala said there are more glucose-transport proteins in the blood after exercise, and these transporters move glucose into the muscles. That’s why there’s less glucose in the blood.
Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, agreed that short bouts of exercise can help the body better use glucose, but that more exercise is better.
“If you can only do five to 10 minutes of exercise, that’s better than nothing, but you really start to see the effects of exercise if you can regularly exercise 20 to 30 minutes at least a few times a week,” he said. “Constant training leads to a steady demand for glucose.”
Copyright © 2011 HealthDay. All rights reserved.
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People with Type 2 diabetes can reverse their condition with diet and exercise, although remission is not very common, according to a new study from the Centers for Disease Control and Prevention.
After one year of regular counseling sessions to encourage weight loss and physical activity, 11.5 percent of obese adults with Type 2 diabetes saw their condition at least partially reverse — meaning their blood sugar levels decreased to those of a prediabetic, without the need for medication. Just 2 percent of those who did not receive intensive counseling partially reversed their diabetes. After four years, the rate of partial diabetes remission in the counseling group declined slightly, to 7 percent.
Full remission — achieving normal blood sugar levels — was rarer, with just 1.3 percent of people in the counseling group and 0.1 percent in the non-counseling group meeting this goal after one year.
Type 2 diabetes has traditionally been seen as a progressive disease that is managed rather than cured. Recent studies have suggested it can be reversed with weight loss surgery, or by following an extreme diet that mimics surgery.
However, until this study, little was known about the rate of long-term diabetes reversal without surgery or extreme dieting. About 26 million Americans have diabetes, according to the Centers for Disease Control and Prevention.
The study confirms that complete Type 2 diabetes remission is rare, but that partial remission is an obtainable goal for some patients, the researchers said.
Experts said that, because the definitions of complete or partial diabetes remission are arbitrary, researchers should not focus on these measures. What’s more important is that patients improve their weight and blood sugar levels, as people in this study did, said Dr. Pieter Cohen, an assistant professor of medicine at Harvard Medical School and a general internist at Cambridge Health Alliance.
“If the great majority of people are losing weight and their sugars are going down, whether or not we call that a remission…it’s great news,” said Cohen, who was not involved in the study. Although most patients in the study didn’t meet the strict criteria for remission, they are moving in the right direction, he said.
The study involved about 4,500 obese adults with Type diabetes ages 45 to 76, who were followed for four years.
Half of the participants were randomly assigned to complete an intensive lifestyle- change program, which included weekly counseling sessions for six months, and at least twice-monthly sessions for the remainder of the study period. People in this group were given specific weight loss and physical activity goals. The rest of the participants were offered just three sessions on diet and physical activity per year, and did not have any goals to meet.
People in the counseling group lost 8.6 percent of their weight after one year, compared with just 0.7 percent in the non-counseling group. After four years, the counseling group lost 4.7 percent of their weight, compared with 0.8 percent in the non-counseling group.
Rates of remission were about 15 to 20 percent higher among those who lost substantial weight, improved fitness, had lower blood glucose levels at the study start, or had been diagnosed with diabetes more recently, compared to those who did not meet these criteria.
Diabetes and disease
It’s important to note that people in the study had been living with Type 2 diabetes for an average of five years before it began. If diabetes is detected early, and interventions started soon thereafter, Cohen said he would expect that more people could be “cured” with lifestyle changes.
In addition, people who received counseling were provided with meal replacement drinks to help them meet their weight-loss goals. The results might have been better if real fruits and vegetables had been provided, Cohen said.
So far, improving blood sugar levels through diet and exercise has not been shown to reduce the risk of heart attack and stroke in people with diabetes. Future studies will examine whether or not lowering blood sugar with lifestyle changes reduces rates of kidney and eye disease, Cohen said.
In an editorial accompanying the study, Dr. David Arterburn, of the Group Health Research Institute in Seattle, and Dr. Patrick O’Connor, of the HealthPartners Institute for Education and Research in Minneapolis, said the results underscore the need to prevent, rather than treat, diabetes.
“Prevention of diabetes and obesity should be a rallying cry for all clinicians who care about the health of the nation,” they wrote.
The study and editorial were published in the Dec. 19 issue of the Journal of the American Medical Association.
Pass it on:It’s possible to reverse diabetes with weight loss and exercise changes.
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