Importance of Exercise

In general, exercise is a wise thing to do: having diabetes or not. But for people with diabetes, exercise (or being physically active) is even more important. Just like nutrition, exercise helps to regulate blood glucose. Even to that extent that people who do not use diabetes medication yet, can prevent starting  diabetes medication by exercising regularly (in combination with healthy eating). For people who (already) use diabetes medication, exercising  helps to make the body more sensitive to insulin. That is why many people who use diabetes medication and perform exercise, experience that they need less medication when they are more active. This advantage does not only occur DURING exercise, but even several hours after. Depending on the type and duration of your exercise, you might benefit from increased insulin sensitivity even a day after your exercise. That means that people with diabetes who exercise regularly (at least 3 times a week) can even lower their general need for diabetes medication. And increased insulin sensitivity and less diabetes medication often also means: better circumstances to lose weight. Low insulin sensitivity makes it more difficult to lose weight.
And of course: all general advantages of being physically active still hold: feeling more energetic and positive, increased resilience to stress, and significantly lower risks of cardiovascular

Successful diabetic athletes

The Olympic athlete is an icon of superior physical, mental, spiritual fitness, and discipline. Kris Freeman, 2010 U.S. Olympic cross-country skier, best exemplifies this type of athletic persona. Exercise and type 1 diabetes is a balancing act for the Olympic and non-Olympic athlete that can never be perfected. The feat is challenging for any athlete, let alone an individual with type 1 diabetes.

Long endurance sports such as cross-country skiing, distance cycling, and marathon running can deplete the muscle stores of glucose that may take up to 18-24 hours for the body to replace. If the muscles lose the glucose stores the energy is gone and the race is over (also called hitting the wall). Kris Freeman has trained intensely through trial and error using multiple variables to best determine any situation he may confront and how to balance his diabetes management to pursue the best outcome.

What should I do if I experience hypoglycemia?

Everyone with diabetes should be prepared to treat hypoglycemia, but people with type 1 are at the highest risk for hypoglycemia. People with type 2 are less likely to have issues with hypoglycemia during or after exercise, unless they are on insulin or an insulin secretagogue.

If you experience hypoglycemia during or after exercise, treat it immediately. Use the same process as you would any other time of the day:

  1. Have at least 15-20 grams of fast-acting carbohydrate (sports drinks, regular soda, or glucose tabs are all good ideas).
  2. Wait 15-20 minutes and check your blood glucose again.
  3. If it is still low and your symptoms of hypoglycemia don’t go away, repeat the treatment.
  4. After you feel better, be sure to eat regular meals and snacks as planned to keep your blood glucose level up.


If you want to continue your workout, you will usually need to take a break to treat your low blood glucose, depending on what activity you are doing and how much insulin you have circulating in your bloodstream. If you do stop exercising, check to make sure your blood glucose has come back up above 100 mg/dl before starting to exercise again.

Keep in mind that low blood glucose can occur during or long after physical activity. It is more likely to occur if you:

  • Take insulin or an insulin secretagogue
  • Skip a meal or don’t eat something within 30 minutes to two hours after stopping
  • Exercise for a long time
  • Exercise strenuously

If hypoglycemia regularly interferes with your exercise routine, talk to your doctor about adjusting your treatment plan. Your provider may suggest eating a small snack before you exercise or they may make an adjustment to your medication(s).

How can I overcome my barriers to exercise?

If you’re not active, it’s likely that you have at least one barrier or reason why. Perhaps you’ve never been very active. Maybe you’re afraid that your blood glucose level will drop.

Think about what is keeping you from being active and then check out some of our solutions to the most common barriers to physical activity. Is there a solution for you?

I don’t have time to exercise for 30 minutes a day.

  • Think about your day – do you have available time slots? Take advantage of any extra time that you may have and pencil in a workout. If you find yourself waiting for the kids to finish practice or watching their game from the sidelines, use that time to take a walk or pace while you watch.
  • Do as much as you can. Every step counts. If you’re just starting out, start with 10 minutes a day and add more, little by little. Work up to at least 10-minute sessions, three times a day. You can also try for 15-minute sessions twice a day.
  • Make physical activity part of your daily routine. For example, walk or bike to work or to the store, exercise while you watch TV, take the stairs instead of the elevator, or do something active with your family to spend time together.

I’ve never been active.

  • Don’t discount your everyday activities. You may be more active than you think. Housekeeping or mowing the lawn counts as activity. Being active is more than just planned exercise.
  • If you have never been active or have not been active for a while, it is important to start slowly. If you feel unsure about your health, check with your health care provider before making big changes in your exercise plan.
  • Starting slowly is important and so is choosing activities that you enjoy. Over time, the activities you do will get easier. You will even find that you can increase the duration and/or intensity.

I’m too tired after work.

  • Find a time when your energy is highest. You could plan to do something active before work or during the day. For example, you could try walking for 30 minutes during your lunch break a few days each week or hitting the gym early in the morning.
  • Remember that increasing the amount of physical activity you do will actually increase your energy.

I don’t have the right clothes.

  • Wear anything that’s comfortable as long as you have shoes that fit well and socks that don’t irritate your skin.

I’m too shy to exercise in a group.

  • Choose an activity you can do on your own, such as following along with an aerobics program on TV or going for a walk.
  • Remember that the everyday activities you do on your own like gardening and household chores get you moving and help burn calories.

I don’t want to have sore muscles.

  • Exercise shouldn’t hurt if you go slowly at first. Choose something you can do without getting sore.
  • Make sure you warm up and cool down.

I’m afraid my blood glucose level will drop too low.

  • The people who need to be most careful about lows are people with type 1 diabetes and those who are on insulin or insulin secretagogues. If you’re taking a medication that could cause low blood glucose, talk to your health care provider about ways to exercise safely.
  • Always be prepared. Make sure you’ve got some regular Gatorade, glucose tabs, or another fast-acting carbohydrate to treat a low if one should occur. Wearing a diabetes ID is another important safety precaution. (See our “12 Quick Safety Tips“)

Walking hurts my knees.

  • Try chair exercises, swimming, biking, or an elliptical machine. These and other low-impact exercises may be less painful.

It’s too hot outside.

  • If it’s too hot, too cold, or too humid, walk inside a school or a shopping center.
  • Think of some other activities that are always available regardless of the weather like using a stationary bike, indoor aerobics classes, yoga videos at home, indoor swimming, stair climbing, calisthenics, or dancing.

I’m afraid I’ll make my condition worse.

  • Remember that getting enough physical activity is important for everyone’s general health – whether you have diabetes or not.
  • Remember that exercise helps lower A1C and has many other health benefits. (See our list of the benefits of physical activity.)
  • If you have certain complications from diabetes and are unsure about your health, talk to your doctor before making any big changes to your fitness routine.

I can’t afford to join a fitness center or buy equipment.

  • Do something that doesn’t require fancy equipment, such as walking, jogging, calisthenics, or using water bottles for weights.
  • Jumping rope and resistance band exercises are other activities that only require one piece of inexpensive equipment.
  • Look for inexpensive resources in your community like community education programs, park and recreation programs, walking trails, school running tracks, or worksite wellness programs. Your employer is another place to check for discounts on gym membership or reimbursement for fitness-related activities

 Exercise is boring.

  • Find something you enjoy doing.
  • Mix it up. Try different activities on different days, and make sure you pick an activity that you enjoy!
  • Exercise with someone else to keep you company.
  • If you can, try exercising while listening to music or watching television.

I don’t really know how to exercise.

  • Select activities that require few skills, like climbing stairs, walking, or jogging.
  • Take a class and develop new skills.

I don’t have the motivation to exercise.

  • Invite a family member or friend to exercise with you on a regular basis. You can also join an exercise group or class in your community.
  • Remember all of the benefits that come with being physically active.
  • Make a plan so you decide when you will do each type of activity. Be sure to set realistic goals and make a plan so you know what you are working toward.


What if I don’t feel like exercising today?

Here are a number of things you can do which will already increase your daily exercise.

  • Walk around while you talk on the phone.
  • Play with the kids.
  • Get up to change the TV channel instead of using the remote control.
  • Clean the house.
  • Work in the garden or rake leaves.
  • Take the dog for a walk.
  • Stretch out your chores. For example, make two trips to take the laundry downstairs instead of one.
  • Park at the far end of the shopping center parking lot and walk to the store.
  • At the grocery store, walk down every aisle.
  • At work, walk over to see a co-worker instead of calling or emailing.
  • Take the stairs instead of the elevator.
  • Stretch or walk around instead of taking a coffee break and eating.
  • During your lunch break, walk to the post office or do other errands.