A Guide to Exercise and Type 2 Diabetes

For people with type 2 diabetes, regular exercise is a highly effective addition to eating a healthy diet and standard medical treatment for improving insulin sensitivity and blood sugar levels. As a bonus, physical activity also helps with weight loss and blood pressure control. Exercise may also help prevent prediabetes from progressing.

Benefits

Virtually any type of exercise—from walking to vigorous cardio to strength training—can be beneficial for someone with diabetes. Specifically, one form of cardio known as high-intensity interval training (HIIT) can help burn extra glucose in the body and also decrease resistance to insulin, both of which can help support diabetes control.

Exercise has many positive health effects for people with or without diabetes, such as:

• Improving control of blood sugar levels
• Improving muscle strength
• Reducing body fat
• Increasing energy levels
• Lowering blood pressure
• Increasing the level of good cholesterol
• Decreasing the risk of coronary artery disease
• Strengthening the heart
• Boosting circulation

Exercising utilizes the glucose stored in your muscles, liver, and bloodstream. When glucose is stored in your liver and muscles, it's known as glycogen. Once glycogen and readily available glucose stores have been used up, the body signals the liver to release more glycogen for energy. Then, after exercise, your muscles and liver replenish their stores by taking in glucose from the blood. This improves your blood sugar.

Exercise can also help you burn calories and, in turn, lose weight. Losing a small amount of weight—just 5% to 7% of your total body weight if you are overweight—can help reduce your risk of type 2 diabetes, improve insulin resistance, and help you better manage blood glucose.

Safety

As exercise can lower or raise your blood sugar levels, it's important that you take some precautions before working out. Eat a small snack consisting of protein, fat, and some carbs (think: bread with nut butter or cheese and crackers) before starting any activity, and test your glucose levels before, during, and after exercise, as well.

Be sure to pack a carb-based snack such as juice or fruit for after your workout in case your levels drop too low. You may also want to wear a medical ID bracelet that states you have type 2 diabetes, just in case of a hypoglycemic or hyperglycemic emergency.

Drink plenty of water before, during, and after exercise to prevent dehydration.

People with diabetes need to pay particular attention to their feet during exercise, as diabetic neuropathy could affect your ability to notice injuries to extremities, like your feet. The American Diabetes Association suggests using silica gel or air midsoles in your shoes as well as polyester or cotton-polyester socks to prevent blisters and keep the feet dry.

As always, people with diabetes should keep their healthcare providers well informed of anything that can affect their health. Exercise, especially, falls into this category. Talk to your healthcare provider about what kind of exercise is best for you, and be sure to discuss any questions or concerns that arise as your exercise program progresses.

Types of Exercise

Cardio training, or aerobic exercise, raises a person’s heart rate for a sustained period of time. HIIT raises the heart rate for short bursts of activity, followed by lower-intensity periods for recovery. Strength training, on the other hand, helps build muscle and supports healthy bones. Balance and flexibility training can also increase muscle tone and strength. All four types of exercise can be highly beneficial for managing diabetes.

Cardio

Aerobic exercise increases breathing capacity and improves overall health. Cardio work gets the heart beating faster, is rhythmic, and involves the large muscle groups, such as those in the legs.

You'll get the maximum benefits of cardio exercise by working out regularly. This is because the effects of aerobic activity aren’t permanent (although they are cumulative). For instance, research suggests that when cardio exercise is done regularly (every day or every other day), over the long term it can significantly help the body process blood sugar, but if the exercise is only done once, then the effects only last for approximately two days.

Many types of physical activity can be categorized as cardio exercise, including:

• Jogging or running
• Walking or hiking
• Bicycling
• Using a stair step or elliptical machine
• Cross-country skiing
• Rowing
• Dancing
• Swimming

High-Intensity Interval Training (HIIT)

HIIT is an aerobic activity centered on short bursts of intense physical activity followed by short rest periods and can involve weight-lifting, resistance work, and cardio. One study found that HIIT improves insulin sensitivity by boosting pancreatic beta-cell function, the cells responsible for producing insulin and regulating insulin levels.

Strength Training

Anaerobic exercise such as strength training may still have major benefits for people with diabetes, including improved glucose control and insulin sensitivity. Examples of strength training exercise include:

• Free weights
• Weight machines
• Resistance bands
• Bodyweight exercises

Flexibility and Balance

These types of anaerobic activities help improve flexibility around joints and improve steadiness while preventing falls. Flexibility exercises may include stretching, yoga, and resistance work, while balance activities include yoga and tai chi, among others. Both flexibility and balance work may have some glycemic benefit: specifically, studies centered around yoga and tai chi have shown improved glycemic control in subjects.

How Much Exercise to Aim For

The amount of exercise you'll want to plan for will depend on your personal fitness goals. If you're just starting out, aim for just one or two 10-minute exercise sessions per week, then build up to five or more 30-minute sessions weekly. Because people with diabetes often have complicated health concerns, it’s important to talk with a medical professional or healthcare provider before beginning a cardio training regimen. If you're over 35, you may need a stress test.

The American Heart Association recommends adults get at least 150 minutes of moderate-intensity exercise each week, which works out to five 30-minute cardio sessions per week.

Achieving and maintaining a higher-than-normal heart rate is the basic goal of a cardiovascular workout, and can be a good metric to reference for intensity level. Different people have different target heart rates and will want to maintain those rates for different lengths of time. Heart-rate monitors can help determine these metrics. A practitioner or healthcare provider also can help with these determinations.

Staying Motivated

It can be tough to fit a workout routine into your already-busy schedule. Here are a few tips to help you keep your new healthy habit:

• Find a workout buddy. Look around for jogging or walking groups in your area, or rope in a friend who has similar workout goals as your own to help you both stay accountable.
• Sign up for a class. Check out local gyms to see if there's a weekly class that fits with your schedule, then add it to your calendar and plan other events around it, not the other way around.
• Break it up. Exercise still counts even when broken up into 10-minute segments. Maybe you walk for 10 minutes before breakfast, at lunch, and after dinner—and by the end of the day, you've gotten your 30 minutes of movement.
• Try an app. Download a fitness app like FitOn or ClassPass Go, which offer free online classes in a range of skill levels and durations that you can do from anywhere.
• Work in daily movement. Increasing your exercise doesn't have to mean spending long hours at the gym. Fit in squats and lunges while you vacuum the house, walk the dog for longer stretches, or take up gardening. Squeeze in mini-sessions of more movement whenever you can.

A Word From Verywell

If you're just starting to exercise, consider working with a personal trainer or physical therapist at first. Just a few sessions with a professional can help you learn the basic principles of your chosen activity, determine and monitor your target heart rate, and develop an overall plan that you can carry out on your own, safely.

Another great way to get more information about exercising with diabetes is by talking to your healthcare team. Ask them what kind of exercise and at what intensity would be best for your individual needs.