Diabetes: The Basics – Being Active

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Updated by Kim Ladd, RN, BS, CPHQ, CDCES, September 2021

Being active helps to lower blood sugar levels, cholesterol levels, improve blood pressure, lower stress and anxiety, and improve your mood, but be sure to engage in appropriate physical activity and exercise while following necessary precautions.

Being Active: General Information

Regular physical activity is essential to diabetes management. It helps keep the heart and blood vessels healthy, prevents diabetes complications, and, if you have type 2 diabetes, is important for keeping blood glucose near normal. Vision loss may affect your ability to participate in the physical activities you once enjoyed, but with proper rehabilitation and attention to the modest safety measures that follow, most people can easily incorporate vigorous and rewarding physical activity into their daily routine.

Be Active, Be Safe

Vision loss need not impede an active lifestyle, whether or not diabetes is a factor. Many physical activities that sighted people enjoy can—with your doctor’s OK—be easily adapted and enjoyed by people with visual impairment. These include walking, jumping rope, dancing (especially with a partner), gardening, swimming, and tandem biking.

With diabetes, however, there are potential trouble areas that you will have to pay close attention to as you proceed with your exercise plan. Keep in mind:

Heart Safety

You should consult your doctor before beginning an exercise program; it’s especially important to do so if you’ve lived with diabetes for five or more years. Diabetes is a strong risk factor for heart disease. Your doctor can help you plan an exercise program that is safe for you and can help prevent heart disease.

Foot Safety

If you have any foot problems, discuss your physical activity plans with your doctor or podiatrist before beginning. Even if you don’t have foot problems, you need to protect your feet. Remember:

  • Always use proper footwear for the activity you are planning.
  • Inspect your feet before and after exercising.
  • Wash your feet daily.

Eye Safety

If you have active diabetic retinopathy and you have useful remaining vision, try to avoid any activity that can cause retinal bleeding. These might include racquet sports, high-impact aerobics, fencing, and jogging—activities that involve pounding throughout the body or sudden movements of the head. You should also avoid activities that increase blood pressure to the head—for example, exercises that involve leaning over with your head below the level of your heart. Lifting heavy objects or exercises that involve holding your breath and straining (as with leg lifts or sit-ups) can also lead to retinal bleeding.

Other Safety Considerations

If you have other disabilities that affect activity and mobility, such as amputation, arthritis, fibromyalgia, foot injury, paralysis, heart disease, kidney disease, multiple sclerosis, etc., you can still benefit from appropriate exercise. Again, consult your doctor before beginning, and consider meeting with a physical therapist to plan physical activities that will work for you.

Why Exercise?

Regular exercise can help control diabetes by helping to keep blood sugar levels normal. When you’re active, your cells become more sensitive to insulin so it works more effectively. It also helps your body use insulin to move sugar out of the blood and into the cells, all of which help to lower blood sugar levels.

Regular exercise can also help:

  • Control your weight
  • Lower your blood pressure
  • Keep your cholesterol close to normal
  • Keep your heart healthy
  • Increase restful, sound sleep
  • Increase your feeling of having enough energy
  • Lower stress
  • Decrease depression and anxiety

When you exercise, you move your muscles. Moving your muscles burns glucose. Glucose is also called “sugar” and is your body’s main source of energy. Just as a car needs gas, your body needs glucose to work well. Besides burning glucose while you exercise, moving your muscles can also make it easier for insulin to move glucose out of the blood and into your cells for up to 2 days after you exercise.

Guidelines for Safe Exercising with Diabetes

  1. Before you begin any exercise program, talk with your doctor about what type of exercise is best for you.
  2. If you have any diabetes complications or other medical problems, you may need to modify your exercise plan for safety.
  3. If you have type 1 diabetes, it’s very important to balance your insulin doses with the food you eat and any exercise that you do.
  4. Ask your doctor about what specific precautions you should take before and after exercise.
  5. Test your blood sugar before you start exercising.
  6. If your blood sugar is lower than 100 mg/dcl, eat a snack like fruit or half a sandwich, so your blood sugar does not go too low.   
  7. Do not exercise if your blood sugar is over 250 mg/dcl. When your blood sugar is too high, exercising can make it go higher and cause serious problems.
  8. In general, the best time to exercise is 1 to 3 hours after eating, when your blood sugar level is likely to be higher.
  9. Exercise can make your blood sugar go too low.
    1. Low blood sugar is also known as hypoglycemia. These signs may mean your blood sugar is too low:
  10. Feeling weak or tired
  11. Feeling hungry
  12. Feeling sweaty
  13. Feeling shaky
  14. Having a fast heart beat
  15. Feeling dizzy
  16. Carry some food with you.
  17. A piece of fruit, a juice box, 4 or 5 pieces of hard candy, or glucose tablets; eat the food if you feel like you are having symptoms of low blood sugar.
  18. Try to exercise every day.
  19. If you cannot exercise every day, try to exercise at least 150 minutes a week. It’s okay to start slow and work up to at least 30 minutes each day.
  20. Wear something that says you have diabetes.
  21. Wear something that says you have diabetes, like a necklace, bracelet or shoe tag. You can purchase these items at your local pharmacy or by searching on the internet for ‘medical alert identification’.
medical alert bracelet
Medical alert bracelet

22. You can also use the Medical ID: In Case of Emergency app on your smartphone. https://play.google.com/store/apps/details?id=app.medicalid.free&hl=en_US&gl=US 

23. For Android phones download the app. For iPhones it’s part of the Health app.

24. Create a medical profile accessible from the lock screen that includes any vital information first responders might need to know to treat you in an emergency situation (e.g., allergies, blood type, medications, medical contacts), A medical profile is part of the Health app that comes standard on iPhones.

Suggestions for People Who Don’t “Exercise”

Almost everyone who has diabetes has been told by a doctor or diabetes educator to “exercise more.” Physical activity has tremendous benefits and is an important part of self-management for everyone with diabetes.

But for people who are not physically active, deciding on an activity and fitting it into an already-busy life can be a real challenge. Physical activity does not have to be “exercise” to help control your diabetes. It can be anything that you do to move your body around. If you have been inactive, the most important thing is just to start moving more than you did before.

Ideas to Increase Physical Activity

  • Any type of dance can be a good workout. Dance with other people, or dance alone.
  • Play happy, energetic music when you are doing housework. Move to the music, and exaggerate your movements. Vacuum vigorously. Shake your clean clothes out before you fold them. Dust your upper shelves with a flourish. Clean your windows until they shine.
  • Walk around your block, or in a park.
  • Many malls open early, before the stores open, for mall-walkers. Often they have groups who support each other in continuing to walk regularly.
  • Take the bus or other public transportation when you need to go somewhere, like to work or shopping. Walk to and from the bus stops on both ends of your trip.
  • If there are young children in your life, playing with them can give you a good workout. Depending on their ages, you can play on the floor, give them rides on your back, play with balls or play tag, push them on swings, swim, or throw a Frisbee, to name just a few examples.
  • Gardening and yard work can give you vigorous activity in almost any season—digging, planting, weeding, raking leaves, or shoveling snow.
  • If you have an exercise machine, such as a treadmill, skiing, or rowing machine, make a rule for yourself that during the first 10 minutes of watching television you must always use your exercise machine. Gradually increase the amount of time.
  • Use an exercise video or DVD. Many public libraries have a wide variety of these for loan—from armchair fitness or gentle yoga routines to vigorous aerobics. Find one that suits your level of fitness and your personal preferences before you buy one.
  • If you live near a pool, find out if the pool has water aerobics classes. This can be an especially good choice for people who have arthritis or other pain, since moving in water puts less stress on the joints.
  • Learn a gentle exercise and stretching routine. Take a Yoga or Tai Chi class, or an armchair aerobics class.
  • Get a dog and walk with your dog. Or volunteer to walk a friend’s dog. Research has shown that people who assume responsibility for a dog get much more exercise that they did before.
  • Get a step-counter (also called a pedometer). Many programs recommend getting at least 10,000 steps a day, which is about 5 miles total of walking. For a person who has not been getting much activity, it’s a good idea to wear your step-counter a few days and find out how many steps you actually already get. Many Americans get only 2,000 to 3,000 steps a day. Wherever you are starting from, increase by 200-500 steps each week. By the time you are getting 2,000 more steps than where you started, you will probably notice that you have more energy and better diabetes control than when you started.
  • Whatever you decide to do, it does not have to be the same thing every day. In fact, people who do several different activities throughout the week are often more successful at keeping up with regular exercise.

Finally, remember that most people do better by starting slowly and building up gradually. Any activity that moves your body more than before is worthwhile, and will help you control your diabetes. Even if you begin by doing only 5 minutes of an activity or even losing 10-15 pounds can have a significant impact on your health. It’s worthwhile. Just keep it up, and gradually increase the time, and you will see results.

Here are some fun exercise apps that you can download to your phone:

  • Charity Miles
    • For iPhone and Android phones
    • https://charitymiles.org/
    • The app lets you log all types of movement, from running and walking to dancing and biking. For every mile you move, you help earn money from our corporate sponsorship pool for the charity of your choice.
  • Zombies, Run!
    • For iPhone and Android phones
    • https://zombiesrungame.com/
    • Walk, run or jog while listening to music and your mission. When you receive a post-apocalyptic mission and the app says you’re being chased by zombies, you must speed up. The over 200 missions and storylines available makes this smartphone fitness game fun for everyone.

Free, online, exercise resources for people with vision impairments:

Diabetes and Exercise Resources

Fitness and Diabetes from the American Diabetes Association (ADA)

Exercise & Type 1 from the American Diabetes Association (ADA)

Diabetes, Exercise and Competitive Sports

The importance of exercise when you have diabetes by Harvard Health Publishing.