Exercise and staying safe
Follow basic safety steps: warming up and stretching before you start, increase your activity levels gradually to prevent injuries!
People are moving more!
You will be surprised how easy and quick it is to start feeling fitter. Becoming more active is great for your physical health and will make you feel good.
Simple safety steps for everyone:
- Start exercising slowly with ‘warm ups’
- Wear comfortable shoes if you are outdoors
- Make sure you have enough water to drink
- Be aware that very warm weather may lower your blood sugar levels.
- Discuss with your diabetes care team before you start your exercise programme as you may need to reduce your diabetes tablets or insulin.
- Very cold weather can raise your blood sugar, however people may have different responses so you will need to know how your body reacts.
- If you have specific health conditions, or are on medication, discuss your exercise and physical activity plan with your healthcare team before you begin to prevent low blood sugars.
Do you have?
For people with type 1 diabetes
You can exercise and do the sport you enjoy if you have type 1 diabetes. You'll just have to take some extra steps to make sure you do it safely.
Exercise and sport affects your blood sugar levels. Depending on the type of exercise or sport you do, it can cause your blood sugar levels to rise (hyperglycaemia) or drop (hypoglycaemia).
There are things you can do to avoid this.
Moderate exercise that lasts a while, like walking or cycling, can cause a slow drop in blood sugar levels.
Some exercise, like running or football, might cause your blood sugar levels to rise.
You can avoid hypos (low blood sugar) by eating the right amount of carbohydrate before, during and after exercise.
You should adjust your insulin and check your blood sugar regularly. Your diabetes team can help.
Exercise affects everyone differently and it might take a little while to find out what works for you. But try to stick with it.
Exercise is not only good for your physical and mental health, it also helps reduce sugar spikes after meals.
As a general rule:
- check your blood sugar level before and during exercise – this'll help you work out what you should eat and when to adjust your insulin
- record your blood sugar levels and what you eat when you exercise – share this with your diabetes team to help find what works for you
- check your blood sugar levels regularly after exercise (they can drop up to 12 hours after exercise) – you may need to take extra carbohydrate or a lower dose of insulin before bed
- if you exercise, it's likely you'll need extra carbohydrate to prevent hypos
- drink plenty of water while you exercise
Diabetes UK has more detailed information on sports nutrition and type 1 diabetes.
Runsweet also gives practical advice about sport, exercise and diet for people with diabetes.
Top tips for safe activity with type 2
The benefits of exercise on your general health and well-being are huge. However, if you are on certain medications, you may need to be more careful:
- If you take medication which causes your blood glucose to drop during exercise (this will differ from person to person but insulin and some tablets can cause low blood glucose), do check your blood sugar before, during and after you exercise'
- If taking one or both of these medications and blood glucose is below 5mmol/L at the start of exercise, consider having a small carbohydrate-containing snack which contains 15–30g of fast-acting carbohydrate (e.g. a banana, 150ml fruit juice or 3-4 glucose tablets)
- Remember, fast-acting carbohydrate is only required if there is a risk of your blood glucose going low (below 4 mmol/l). Do not take fast-acting carbohydrate just ‘in case’. Instead, always carry a source of glucose with you whilst exercising.
- If blood glucose is high (greater than 14 mmol/l) before exercise, there may be the risk of your blood glucose continuing to rise because you do not have enough circulating insulin. In this instance, avoid high-intensity, vigorous exercise and, instead, perform more gentle, lower-intensity exercise.
- Stay well hydrated. In most cases, water is adequate, although you can also consider having sugar-free electrolyte drinks. Increasing your fluid intake is especially important if you exercise with high blood glucose levels.
Get inspired by others and find out how they get more active.
Medication and hypos (low blood sugar)
Having a blood sugar low might be a worry if you have type 2 diabetes and take medication (you may also be injecting insulin).
Low blood glucose can happen when you start to exercise for the first time and this is because your body becomes more ‘insulin sensitive’ when you are moving more.
If you start to exercise regularly you will probably need to reduce your tablets and / or your insulin.
Being more ‘insulin sensitive’ is really good news because it means that your body is working more effectively and it is really important that you see your diabetes care team to review your medication and advise you so that you can continue to exercise safely.
Insulin and some tablets are more likely to make your blood glucose drop such as sulfonylureas (gliclazide, glimipiride)
Using insulin with type 2 diabetes
• If exercising meal-time insulin two hours before or after a meal, you may need to reduce your meal-time insulin dose to prevent low blood sugar.
• Watch the effects of exercise on your blood sugar and speak to your diabetes team for advice on appropriate insulin reduction, if this is necessary.
• Reducing your meal-time insulin when exercising will reduce the risk of low blood sugar and it can also help you to lose weight if weight loss is one of your goals.
Do you have diabetes complications?
If the answer is yes, you should consider the following
Nerve problems (neuropathy)
• Wear comfortable supportive and closed footwear (don’t go barefoot)
• Do mostly non-weight bearing activities, especially if you have any structural foot problems
• If you have any foot ulcer you should avoid weight bearing activity, especially jogging
• If you have postural hypotension (this can make you dizzy or light headed when you stand up), avoid activities with fast changes in direction
Eye problems (retinopathy)
• If you have had problems with your eyes in the past and you are being seen in a specialist ophthalmology clinic, discuss your exercise plan with your eye doctor first.
• If you have had problems with your eyes (retinopathy), you should avoid activities that raises blood pressures, such as weight lifting
• If you have had treatment for your eye problems you should avoid vigorous activity, jumping and breath holding.
Kidney problems (nephropathy)
• If you have had problems with your kidneys in the past and you are being seen in a specialist kidney clinic, discuss your exercise plan with your kidney doctor first.
• If you have small amounts of protein in your urine, most activities are safe.
• Avoid vigorous exercise the day before urine protein tests as the results will be affected
If you are on dialysis, best to avoid high-intensity and strenuous exercise