Exercise and diabetes: how much activity and how to stay safe
Physical activity is a core part of diabetes care. This guide covers suggested weekly amounts, types of activity and safety points around glucose checks, medicine and feet.
Scientist and Chief Medical OfficerDr. Ambed Mishra, PharmD, PhDEducational information only, not medical advice. Always ask a qualified doctor about your own health. In an emergency call 112 (India) or 911 (US). Read the full disclaimer.
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Being active is one of the most useful things a person with diabetes can do, and it does not have to mean a gym. This article sets out what the NIDDK and NHS say about how much to do and how to stay safe. Always check with your own doctor before starting something new, especially if you take insulin.
Why activity matters
The NIDDK lists physical activity as one of the main parts of managing diabetes, alongside a meal plan, healthy weight, sleep and medicines taken as prescribed. It says losing 5% to 7% of current body weight may help manage blood glucose, cholesterol and blood pressure. Activity supports that goal. For type 2 diabetes, the NHS says lifestyle changes can sometimes bring blood glucose to a normal level.
How much activity?
The NIDDK describes these general amounts for adults:
- Aerobic activity: at least 150 minutes of moderate-intensity activity per week, such as about 30 minutes on most days. The time can be split into shorter sessions.
- Strength or resistance activity: about two times a week.
- Balance and stretching: two or three times a week.
The NIDDK says any activity is better than none, and suggests starting slowly with things you enjoy. The NHS suggests at least 2.5 hours across the week of walking or another activity that makes you breathless. The NIDDK notes that some balance activities may be unsafe if you have diabetes-related nerve damage or vision problems, so ask your care team first.
Checking glucose
The NIDDK says to check blood glucose before, during and right after activity, as your care team advises, because low levels can last for hours or even days afterwards. Extra physical activity can lower glucose for up to 24 hours. This is one of the causes of low blood sugar listed by the NIDDK.
Adjusting food or medicine
If you use insulin, the NIDDK says to ask your health care professional whether to take less insulin or have carbohydrates before, during or after activity. It also warns that taking less insulin can raise the risk of high glucose and ketones, and suggests asking your team what ketone level is dangerous for you. Do not change medicine without medical advice.
Hydration
The NIDDK advises drinking fluids. It says sports drinks are often high in sugar and calories and are not needed for most moderate activity.
Protect your feet
The NIDDK recommends comfortable, supportive shoes and checking your feet before, during and after activity. Reduced feeling or poor circulation can hide injuries. See the NIDDK's foot care guidance for daily checks.
Planning your week
- Start with short walks and add a little each week.
- Choose activities you enjoy so it is easier to continue.
- Break activity into shorter sessions if that is easier.
- Carry fast-acting carbohydrate if you use medicines that can cause lows, as your care team advises.
- Tell a friend or family member how to help if your glucose drops.
When to see a doctor
Speak with your doctor before starting a new exercise routine if you have heart disease, eye problems, nerve damage or foot problems. Tell your care team if exercise often leads to low blood sugar or if you have chest discomfort or unusual breathlessness.
Stop and seek help for chest pain or pressure, severe shortness of breath, fainting, or signs of severe low blood sugar. In an emergency, call your local emergency number (112 in India, 911 in the United States).
This article is for education only and does not replace advice from your own doctor.
Common questions
How much exercise is suggested for adults with diabetes?
The NIDDK suggests at least 150 minutes of moderate aerobic activity per week, strength activity about two times a week, and balance or stretching two or three times a week.
Can exercise cause low blood sugar?
Yes. The NIDDK says extra physical activity can lower glucose for up to 24 hours, so checking before, during and after activity is advised.
Do I need sports drinks when I exercise?
The NIDDK says sports drinks are often high in sugar and calories and are not needed for most moderate activity.
Should I change my insulin on exercise days?
The NIDDK says to ask your health care professional whether to adjust insulin or carbohydrates. Do not change insulin without advice.
Important: please read
- Educational information only. This article is general health education. It is not medical advice, diagnosis or treatment. Reading it does not create a doctor–patient relationship with MyDoctor or with anyone else.
- Ask a qualified doctor. Always talk to a qualified, registered doctor about your own health. In India, that means a doctor registered with the National Medical Commission (NMC) or a State Medical Council. In the United States, a licensed physician. Elsewhere, a doctor licensed where you live.
- Never ignore or delay professional advice because of something you read here. Do not start, stop or change any medicine or treatment without your doctor.
- Emergencies: call 112 in India, 911 in the United States, or your local emergency number. Do not wait for an online answer.
- No product is endorsed. MyDoctor does not recommend any brand, product or supplement in this article.
- About the sources. This article summarises, in our own words, information from the public health bodies named under Sources. Health knowledge changes, and this summary may not reflect the latest research or your personal situation.
- Liability. To the extent permitted by law, MyDoctor (MODERNUS HEALTH TECHNOLOGIES PRIVATE LIMITED) accepts no liability for any decision made on the basis of this content.
Sources
- NIDDK (NIH). Diabetes Diet, Eating, & Physical Activity www.niddk.nih.gov
- NHS. Type 2 diabetes: food and keeping active www.nhs.uk
- NIDDK (NIH). Managing Diabetes www.niddk.nih.gov
Dr. Ambed Mishra, PharmD, PhD
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Dr. Ambed Mishra is a clinical (patient care) scientist, author and former professor. He is Group CEO and Chief Medical Officer of MODERN US HEALTH (MODERN US GROUP), Austin, Texas, the group behind MyDoctor, and a senior consultant who teaches and trains MD/DO physicians, PharmD and PhD professionals, nurses and other healthcare professionals in patient care in the United States and India.
More about Dr. Ambed Mishra
- More than ten years of full-time leadership in United States healthcare, building patient care services that improve medication adherence and bring doctors, pharmacists and nurses together around each patient.
- Leads the MD and engineering teams behind MyDoctor: clinic and hospital management software, electronic health records and telehealth for hospitals and physician groups in the United States and India.
- Former Assistant Professor and Clinical Preceptor at Rajiv Gandhi University of Health Sciences, Bangalore, and senior researcher with hospitals, universities and patient care groups in India and the United States.
- More than 30 published research and review articles and case reports, and more than 15 international conference presentations in India, Australia, Canada, the United States, Spain and other countries.
- Chief Medical Officer and Global Program Head of a nonprofit mission that helps cover hospital and doctor visit bills for patients in need in India, Nepal, the United States and other countries.
The author's office answers questions about articles, research, speaking and collaboration. It cannot give personal medical advice.