Exercise & Diabetes

Regular exercise helps in the prevention and management of type 2 diabetes mellitus as it improves blood glucose control.

Special Considerations

Hypoglycemia (low blood sugar) can occur in people with diabetes when they exercise as rapid drop in blood glucose might happen during exercise. Blood glucose level less than 3.9mmol/L should be cautious. Some common symptoms of hypoglycemia include shakiness, abnormal perspiring, anxiety and tingling sensation. Monitor blood sugar before, during, and after exercise.
Consider these general guidelines relative to your blood sugar level.

  • Before exercise:

Lower than 5.6 mmol/L :

Blood sugar may be too low to exercise safely. Consume a small carbohydrate content snack, such as fruit or crackers, before exercising.

5.6 to 13.9 mmol/L :

Safe pre-exercise blood sugar range.

13.9 mmol/L or higher :

This is a caution zone. Test your urine for ketones (substances made when your body breaks down fat for energy) before you begin exercise. Excess ketones indicate that the body does not have enough insulin to control the blood sugar. Exercise with a high level of ketones might lead to Ketoacidosis, a serious complication of diabetes that needs immediate treatment. Do not exercise until your urine test indicates absence or a low level of ketones.

16.7 mmol/L or higher :

Blood sugar may be too high to exercise safely, as these high glucose levels may increase your risk of dehydration and ketoacidosis. Postpone exercise until blood sugar drops to a safe pre-exercise range.

  • When exercising, be cautious:

Cease activity if there are signs of hypoglycemia, e.g. dizziness, blurred vision and abnormal perspiring. Blood glucose should be monitored and consume carbohydrate snacks such as sweets and chocolate. The blood glucose level should be re-checked 15 minutes after consumption to ensure it has increased.

Recommended Exercises

 

1. Aerobic Exercise

Frequency Intensity Time Type
3 – 5 days per week Moderate intensity at 50-70% Heart rate maximum * Work towards 150 minutes per week of moderate intensity exercises Jogging, swimming, brisk walking, cycling

* A simple measure of exercise intensity: During moderate intensity exercise, you should be able to talk but not sing.

2. Resistance Training

Frequency Intensity Time Type
2 – 3 days per week Moderate (50% of 1-RM) to vigorous (75 – 80% 1-RM) 5 – 10 exercises per session, target major muscle group (e.g. biceps, abdominal, quadriceps) 1 set of 8 – 12 repetitions (may progress to more than 1 set) Resistance machines and free weights (e.g. dumbbells and barbells); Bodyweight exercise (e.g. squats and push up)

* 1 repetition maximum (1-RM): the maximum weight an individual can lift with one repetition.

3. Flexibility / Balance Training

Frequency Intensity Time Type
2 – 3 days per week Stretch to range of motion tightness 8 – 10 stretches involving both upper and lower body Hold for 15 – 30 seconds per stretch; 2 – 4 repetitions per stretch Sit & reach, triceps stretch Tai Chi, stand on one foot with support

* 1-RM: the maximum weight an individual can lift with one repetition.