Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.
Melissa Nieves, LND, RD, is a registered dietitian and licensed nutritionist who works as a bilingual telehealth dietitian. She founded the Fad Free Nutrition Blog and Nutricion al Grano websites and is based in Texas.
Type 2 diabetes can result from lifestyle factors like lack of exercise and poor diet. Regular exercise can significantly reduce complications of type 2 diabetes. Exercise can decrease body fat, lower blood pressure, and prevent high blood sugar.
This article will review important points to take into consideration when beginning an exercise plan with type 2 diabetes and how to create an exercise routine that will work for you.
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Always make sure to consult with your healthcare provider before beginning any new exercise program to make sure you are healthy enough to support an increase in physical activity. Certain medications that treat diabetes can also cause low blood sugar with exercise, so it is important to consult with your healthcare provider to determine if there are any specific precautions you need to take before beginning exercise.
Committing to a specific time to exercise can help fit it into your day. Allotting time before or after work or on the weekends can help you stick to a consistent routine.  When it comes to exercise, consistency is key. It is recommended that those with type 2 diabetes exercise for at least 30 minutes per day for three to seven days per week.
If you take insulin or certain medications to manage insulin levels and you don’t properly adjust them for your activity levels, you may be at risk of experiencing low blood sugar (hypoglycemia) during exercise. Symptoms of hypoglycemia while exercising include:
Low blood sugar while exercising is more likely to occur if you take insulin or medications that affect your insulin levels, exercise strenuously or for a long period of time, or skip meals. To reduce your risk of having low blood sugar when exercising, check your blood sugar immediately before you begin your workout.
If your blood sugar level is 100 mg/dL or lower before you start, you should first eat 15–20 grams of carbohydrates to raise your blood sugar. Quick sources of 15–20 grams of carbohydrates include:
You should then check your blood sugar again after 15 minutes. If it is still below 100 mg/dL, you should consume another serving of 15 grams of carbohydrates and continue to recheck your blood sugar. When your blood sugar level is above 100 mg/dL, you can safely begin exercising.
Keeping carbohydrates on hand is important in case you experience symptoms of low blood sugar during your workout. You may need them while you exercise if you start to experience symptoms of hypoglycemia.
Exercising too much or too intensely can take a toll on your body. For people with diabetes, exercising for too long or too intensely can also increase your risk of hypoglycemia.
When starting any new exercise program or routine, start off slowly to allow time for your body to adjust. Sedentary individuals should always start off slowly and gradually increase exercise intensity, duration, and frequency over time. 
Recent evidence suggests that a combination of both aerobic exercise and strength training is most effective for managing type 2 diabetes. Aerobic exercise helps the body absorb insulin, while strength training can improve how quickly the blood absorbs sugar (also known as blood sugar uptake).
It is important to have supportive, properly fitting sneakers for exercising to prevent skin breakdown and foot ulcers, a common complication of diabetes.
Aerobic exercise is any activity that increases your heart rate more than when you are at rest. This causes more oxygenated blood to circulate throughout your body and works muscles. Over time, regular aerobic exercise strengthens your heart and lungs, making them work more efficiently. Aerobic exercises include:
Aerobic exercise is recommended for at least 150 minutes per week spread out over three to seven days with no more than two consecutive days of rest in between.
Strength training is exercising to increase muscle strength through resistance training. Resistance can be in the form of weights, resistance bands, or through your own body weight with movements like:
Strength training is recommended for two to three days per week with at least one day of rest in between. Strength training sessions should consist of eight to 10 different exercises, each completed for one to three sets of 10–15 repetitions.
Drinking water while exercising is important to keep you adequately hydrated. Dehydration during exercise can cause symptoms similar to hypoglycemia, including fatigue, weakness, dizziness, lightheadedness, and difficulty concentrating.
Having a structure for your exercise sessions can help keep you on track and make exercising a consistent habit. Aim to have alternating days between strength training and aerobic exercise or perform strength training and aerobic exercise on the same days with rest days in between.
Regular exercise is incredibly important for managing type 2 diabetes to lower your blood sugar and decrease insulin resistance. When starting a new exercise program, make sure to consult your healthcare provider to receive clearance that you are healthy enough to increase your activity levels. Start off slowly, make sure to monitor your blood sugar before exercising, and keep carbs on hand to increase your blood sugar before or during exercise if needed. For the most benefits, combine aerobic exercise and strength training throughout the week for a minimum of 150 minutes of exercise per week.
If you’re new to exercising, you may feel scared when starting a workout plan. Starting exercising may be intimidating at first, but the more you exercise and incorporate physical activity as a regular part of your life, the healthier you will be, and with better control over your diabetes.
People with diabetes should avoid exercise that is too intense or for too long a period of time, gradually building up strength and endurance over time to avoid a low blood sugar crisis.
The best time to exercise is whatever time is best for you depending on your schedule and energy. If you exercise in the morning, make sure you eat breakfast before exercising to prevent hypoglycemia.
Centers for Disease Control and Prevention. Diabetes fast facts.
Kirwan JP, Sacks J, Nieuwoudt S. The essential role of exercise in the management of type 2 diabetes. Cleve Clin J Med. 2017 Jul;84(7 Suppl 1):S15-S21. doi: 10.3949/ccjm.84.s1.03.
American Diabetes Association. Blood sugar and exercise.
Sampath Kumar A, Maiya AG, Shastry BA, et al. Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Ann Phys Rehabil Med. 2019 Mar;62(2):98-103. doi: 10.1016/
By Kristen Gasnick, PT, DPT
Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.

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