Diabetes and Exercise

Main energy source of our body is a simple sugar, glucose. Our muscles use most of the blood sugar (glucose).  Muscles of patients with Type 2 diabetes are resistant to insulin which allows glucose entrance into the muscle cell.  Therefore, exercise is very important.  Muscle cells use glucose as energy source due to increase on energy need by exercise.

Exercise is as important as diet and drug therapy in Type 2 Diabetes treatment.  Regular exercise has a great importance on lowering blood sugar.

Effects of Regular Exercise on Type 2 Diabetes

  • Normalizes blood sugar (glucose).
  • Reduces insulin requirement of patients with Type 2 Diabetes who use insulin.
  • Provides weight loss and reduces obesity (fatness requiring treatment).
  • Supports and strengthens bones and muscles.
  • Increases blood circulation of the heart muscle and strengthens heart muscle.
  • Reduces bad cholesterol and blood lipid levels in the blood.
  • Creates happiness and increases treatment compliance.
  • Briefly, exercise does good.

What Kind of Exercise and When?

A patient with Type 2 Diabetes under control on normal conditions may apply normal exercises like every person.  However, patients with Type 2 Diabetes who are elder and have problems on diabetic control and use insulin should consult with their diabetes specialist before start any exercise.  If you have an underlying cardiac problem or ketone bodies are detected in the urine, the exercise that you will make may adversely affect glucose metabolism.  Your ketone production may increase and you may experience a kind of diabetic coma that we call ketoacidosis.

  • If your blood sugar (glucose) is over 200-250 mg/dl and you have ketonuria (ketone excretion by urine), contact your physician before exercise.

After required controls are done, exercise programs should be evaluated with your physician.  Exercise programs may be arranged with different densities and frequencies.  Factors such as your age, occupation, whether you are active, your diabetes period, in what extent your diabetes is controlled should be considered.

Things That Should be Remembered before Exercise

  • Measure your blood sugar before and after the exercise.  If dizziness or severe exhaustion appears during exercise, just stop and control your blood glucose.  Hypoglycemia should be a possibility that you must keep iin your mind.
  • If exercise will be done in outdoor and long distances besides indoor (home or sports center), keep a glucometer and some candy with you.
  • Arrange insulin injection area according to your exercise type.  For example, if you will swim in a summer morning, do not inject insulin on your arms; or if you will ride a bike or jog, do not inject insulin on your legs since one day before.


Things That Should be Remembered before Exercise








  • If you will make exercise, do not exercise one hour before the meal and during the period after.  Especially, if you use insulin, you should decrease insulin dose either before or after the exercise or you should take more carbohydrate.
  • It is recommended for Type 2 Diabetes who exercise because of over weight problem to decrease insulin doses and restrict calorie accordingly instead of normal insulin doses and more carbohydrate intake.
  • Exercise increases sensibility of our muscles to insulin.  Even though everything is ok, you may experience hypoglycemia (reduction in blood glucose) even it is mild.  In that case, consult with your physician and adjust your insulin doses.
  • Carry a card where phone numbers of your relatives were written with you.  hanging this card with PVC coating on your neck is better for strangers to see it.  Your identity information and your condition, Type 2 Diabetes written should be read easily.
  • Your feet comfort is very important for diabetes.  Specifically chose your shoes for exercise.
  • Keep in your mind that late hypoglycemia may appear after the exercise. You may have a snack before going to bed after a night walk during summer seasons.

Risks of Exercise For Type 2 Diabetes

  • Hypoglycemia
  • Worsening of a heart disease which is known or unknown before
  • Worsening on degenerative joint disease
  • Risk of injury or trauma on joints due to neuropathy
  • Hemorrhage on fundus with severe exercise in patients with Proliferative Diabetic Retinopathy
  • Protein excretion by urine (proteinuria) in patients who have borderline kidney failure (diabetic nephropathy)