Physical Activity

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We all know exercise is good for our overall health, but there are benefits from exercise that are important for keeping type 2 diabetes under control. Regular exercise can help lower blood sugar levels in the short and long term. Many health organizations recommend 150 minutes of moderate intensity exercise each week.

This page summarizes general information and recommendations from reliable sources and provides useful links about exercising for type 2 diabetes management.

It is important to remember that exercise is different for everyone. Not all the information below will apply to every person. Check with your healthcare provider before starting or changing your exercise plan and report any unusual experiences while exercising.

How Does Exercise Help with Type 2 Diabetes Management?

As with diet and medications, regular exercise is important for diabetes management. Exercise’s impact on blood sugar varies, depending on how long you are active, the activity you are doing, and other factors.

These are some of the benefits of exercise:

helping control blood sugar in the short term and long term
helping insulin work better
improving blood pressure and cholesterol
reducing the chances of heart disease
relieving stress
improving sleep and mood
improving energy
strengthening your heart, muscles, and bones
improving circulation and toning muscles
keeping your body and joints flexible
improving balance
improving general wellbeing

What Counts as Exercise?

There are many ways to stay active. Going to the gym is a great option, but it doesn’t work for every lifestyle. Finding simple ways to stay active throughout the day can be just as effective.

For tips on how to stay active while at work, check out these resources:

And the New York City Department of Health and Hygiene has information on how to be active in New York.

As the table below shows, different kinds of exercise have different benefits.

Type of exercise	How it helps	Examples
Cardiovascular/Aerobic exercise	Raises your heart rate	Walking, biking, swimming, light yard work, vacuuming, low-impact or armchair aerobics
Strength training	Increases bone and muscle mass	Lifting, pulling, or pushing weights or bodyweight exercises like sit-ups or push-ups
Stretching/balance	Increases flexibility	Yoga, Pilates, working with an exercise ball

For more information about the importance of exercise for diabetes:

Patient Education Library (American Diabetes Association)
Patient Education Materials (Johns Hopkins Medicine)

How Much Exercise Is Needed?

Any exercise is better than none, but 150 minutes of moderate intensity exercise each week is recommended.

Depending on your schedule and preference, exercise can be spread out in several different ways during the week:

50 minutes of exercise three times a week
30 minutes five times a week
25 minutes six times a week

Each breakdown has a slightly different impact on blood sugar. For the best help for diabetes management, try to go no more than 48 hours between exercise sessions.

Meeting Exercise Goals

Shorten your sessions: instead of 30 to 60 minute sessions, try three 10-minute sessions throughout the day
- Example: 10-minute jump rope session before work, a 10-minute walk at lunchtime and 10 minutes on an exercise bike after dinner
- Set SMART goals: set goals that are Specific, Measurable, Attainable, Realistic, and Time-bound. When you don’t have time for a full workout, replace some of that time with something as simple as 10 minutes of vacuuming to get your heart rate up
Pick a routine that matches your fitness level: if you’re new to exercise, pick a routine that can helps you gradually build towards 150 minutes of exercise
- Example: If you sit at a desk all day, set a goal to get up twice every hour and walk around the office
Make time for fitness: a successful exercise routine works into the demands of your day
- Find a time that fits into your schedule or when you’re most energized.
- Keep in mind:
  - Your medication routine can affect your workout timing
  - Increasing your amount of exercise can affect your medications
Track your progress: monitoring your progress and preparing for difficulties can help you stay motivated
Have fun: you’re more likely to stick with an exercise if it’s fun for you! Find something you enjoy and make that your workout
Excuse-proof your plan: prepare alternative workout options for days when things don’t go as planned or the weather isn’t great
- Example: Inside of cycling outside, you can walk laps indoors, use an elliptical at the gym or do 10 minutes of stair-climbing at home

For more information about how much to exercise and meeting exercise goals, visit the American Diabetes Association page on weekly exercise targets.

Exercising Safely

Before starting an exercise program, talk to your doctor to be sure the exercise you choose is safe and appropriate for you and your overall health. Remember to start slowly, especially if you have not been physically active for a while.

Below are other safety tips:

Check your blood sugar before and after exercise until you are aware of how your body responds to exercise. Make sure your blood sugar is less than 250 mg/dl before exercising.
- Do a five-minute warm-up before and a five minute cooldown after exercising. Warm-ups and cooldowns should be less intense than the rest of your time exercising. This helps get your blood flowing and warms up your joints.
Drink plenty of water before, during and after exercise to prevent dehydration.
Be prepared for any episodes of low blood sugar. Take with you something that can bring sugar levels up, such as hard candy, glucose tablets or 4 ounces of juice.
Wear proper shoes and clean socks that fit well to protect your feet. Remember to check inside your shoes before wearing them.
Carefully inspect your feet before and after activity for blisters, redness, or other signs of irritation. Talk to your doctor if you have a foot injury or a non-healing blister, cut, or sore.
If exercising for an extended period (more than an hour or two), you may want to have a sports drink that provides carbohydrates.
- Be careful to check the nutrition facts; you may need to water down the drink so that you don’t have too much, which can cause your blood sugar to spike.
- Activities should be energizing but not overly difficult. Use the “talk test” to make sure you are not pushing yourself too hard. If you become short of breath and you can’t talk, then slow down. This is most important when you are just starting to increase the activity in your routine. As you become fit, you’ll be able to exercise at a higher intensity and chat with others while you do it.
Wear a medical alert ID band. If an emergency occurs, EMS will know how to treat you properly.
Always carry a cell phone.
Avoid exercising in extremely hot or cold temperatures.

As with any exercise, always listen to your body. If you become short of breath, dizzy, lightheaded, or feel any pain, stop exercising. Report any unusual problems you experience to your doctor.

For more information on safety tips, visit Injury-Free Exercise – 11 Quick Safety Tips | American Diabetes Association

How does exercise affect blood sugar?

Low blood sugar can occur during or after exercise. It is more likely to occur if you do one or more of the following:

Take insulin or oral diabetes pills that cause your pancreas to make more insulin (such as glimepiride/Amaryl, glipizide/Glucotrol, or repaglinide/Gluconorm).
Skip meals.
Exercise for a long time.
Exercise strenuously.

Talk to your healthcare provider about the best treatment plan for you. Your provider may suggest eating a small snack before you exercise or they may make an adjustment to your medication.

If you feel symptoms of low blood sugar during or after exercise, follow these steps for treatment:

Check your blood sugar. If your reading is 100 mg/dL or lower, consume 15 to 20 grams of carbohydrate to raise your blood glucose. Four glucose tablets (4 grams per tablet), one glucose gel tube (15 grams per gel tube), four ounces (1/2 cup) of juice or regular soda (not diet), or one tablespoon of sugar or honey all provide enough carbohydrate.
Check your blood glucose again after 15 minutes. If it is still below 100 mg/dL, have another serving of 15 grams of carbohydrate.
Repeat these steps every 15 minutes until your blood glucose is at least 100 mg/dL.

For more information on how exercise lowers blood sugar, visit the American Diabetes Association page Understanding Blood Glucose and Exercise.

You may experience a rise in blood sugar after workouts. Workouts such as heavy weightlifting, sprints, and competitive sports cause you to produce stress hormones (such as adrenaline), and this raises blood sugar levels. The food you eat before or during a workout can also cause blood sugar to rise. If you eat too many carbs before exercising, your workout might not be enough to keep your blood sugar within your goal range.

Below are some strategies to avoid a rise in blood sugar during or after exercising:

Choose moderate-intensity aerobic workouts or circuit weight training with light weights and high repetitions.
Practice relaxation techniques such as paced breathing, visualization, or meditation before and during your workout to minimize the adrenaline effect.
Consider moving your workout to later in the day if you usually exercise in the early mornings. There is a natural rise in blood sugar that happens between about 4:00 and 8:00AM, and this can lead to higher blood sugar levels during morning exercise. The same workout done later in the day is less likely to result in a rise.
Talk with your provider about adjusting your diabetes medications before doing a workout that usually leads to a blood sugar rise.
Avoid eating excessive amounts of carbohydrates before and during your workouts. Instead, try yogurt with nuts or peanut butter.

For more information about how exercise can raise blood sugar, visit the American Diabetes Association’s page Blood Glucose and Exercise: Managing Post-Exercise Hyperglycemia & Glucose Spikes.

Exercise Examples for Older Adults or Limited Mobility

For older adults or individuals with limited mobility, low-impact exercises are great modifications that still provide all the benefits of exercise. Examples include seated cardio, chair exercises, resistance bands, and bodyweight exercises.

Consult with your provider before starting a new routine or if you have any concerns. Learn more about exercises to try from the American Diabetes Association (ADA).

Below are more videos with some low-impact workouts you can try:

More Information

American Diabetes Association: Get Active! | Exercise & Diabetes | ADA

NIH, National Institute on Aging: Exercise and physical activity | National Institute on Aging

Diabetes Teaching Center: Activity & Exercise | Diabetes Teaching Center

NYC Health: Physical Activity for Older Adults - NYC Health

Physical Activity | NYU Langone Health