A Guide to Exercise and Type 2 Diabetes

Swimming is a good cardio workout.
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If you have prediabetes or type 2 diabetes, a great way to help control your blood sugar is by incorporating more exercise into your routine. Alongside standard medical treatment and following a balanced diet, regular exercise has been shown to help improve insulin sensitivity and blood sugar levels, and it may also help with weight loss and keep blood pressure in check. Exercise may also prevent prediabetes from progressing. Learn more about how exercise helps with glucose regulation and tips for working out safely.

Benefits of Exercise

All types of exercise can be especially beneficial for people with diabetes. Specifically, high-intensity interval training (HIIT) can help burn extra glucose in the body and also decrease resistance to insulin, two effects that are good for diabetes control.

Cardio, HIIT, and strength-training exercise routines have many other positive health effects, 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 to the liver to release more glycogen for energy, which is how muscle activity can reduce glucose levels. However, if you don't have adequate insulin sensitivity, your body may not be able to get this new flood of glucose into the cells, so it'll stay circulating in your bloodstream. This could actually result in raised blood sugar levels.

How to Stay Safe

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; 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 doctor 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 to a higher than normal rate for a sustained period of time. HIIT raises the heart rate for short bursts of activity. Strength training, on the other hand, helps build muscle and supports healthy bones. Flexibility increases muscle tone and strength. All four types can be highly beneficial for managing diabetes.

Cardio

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

The maximum benefits of cardio exercise are realized when you can work out regularly. This is because the effects of the exercise aren’t permanent—although they are cumulative. For instance, research suggests that when the exercise is done regularly (every day or every other day) for the long term, then it can significantly help the body process blood sugar levels, 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 combines weight-lifting, resistance work, and cardio. A recent research study found that HIIT improves insulin sensitivity by boosting pancreatic beta-cell function, the cells responsible for creating and regulating insulin production.

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.

The Amount of 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 very important to talk with a doctor or healthcare provider before beginning a cardio training regimen, and if you're over age 35, you may need a stress test.

The American Heart Association recommends adults get a total of 150 minutes of moderate-intensity exercise weekly, which works out to five 30-minute cardio sessions per week. If you're practicing higher-intensity exercise, you may only need 75 minutes 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 doctor 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 to your own to help you both stay accountable
  • Sign up for a class. Check out your 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 got in 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 long hours at the gym. Fit in squats and lunges while you vacuum the house, walk the dog for longer stretches, take up gardening. Squeeze in mini-sessions of more movement whenever you can.

A Word From Verywell

If you're just starting to incorporate exercise, you might 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.

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