11 Tips for Exercising Safely With Type 2 Diabetes

Staying physically active can help you to maintain your health and well-being. Exercise is especially important if you have Type 2 diabetes. And there are potential added benefits to exercise when you have diabetes, like lower blood glucose (blood sugar). But there are also key safety issues to consider before you get started.

There are steps you can take before you start a new routine and when you’re exercising to avoid injury and other health problems. Below, you’ll learn 11 tips for exercising safely with Type 2 diabetes and getting the most out of your workouts. 

1. Talk to a healthcare professional before getting started

Talk with your healthcare team before you begin a new exercise program. This is an important first step for people with Type 2 diabetes. That’s because hyperglycemia (high blood glucose) can cause damage to different body systems over time. 

The American Diabetes Association (ADA) recommends that people with diabetes get a complete evaluation before increasing activity. During an evaluation, a healthcare professional will check for diabetes symptoms that can affect your heart, eyes, feet, or nervous system. What your fitness regimen ultimately looks like may depend on these test results and your medical history. 

2. Check your blood glucose before, during, and after exercise if you take insulin

Insulin is a hormone that helps your body store and use the glucose that you get from food for energy. When you have Type 2 diabetes, your body isn’t able to use insulin properly. As a result, your blood sugar levels rise over time and lead to health complications. 

Generally speaking, exercise can lower your blood glucose and help you manage your diabetes over time. But exercise can also make your blood glucose too low (hypoglycemia). So, it’s important to know how your body responds to physical activity. 

Typically, exercise-induced low blood glucose is a bigger concern for people with Type 1 diabetes. But people with Type 2 diabetes who take insulin or oral diabetes medications, including sulfonylureas, are also at risk of low blood glucose. 

If you take any of these treatments, you’ll want to check your blood glucose before, during, and after exercise. In some cases, your healthcare team may ask you to check your blood sugar even if you take non-insulin medications for diabetes. 

Experts recommend that everyone with Type 2 diabetes check their blood sugar during exercise, if their workouts are over an hour. Exercise can lower your blood glucose for 24 hours or more after a session. So, you may want to check your levels more frequently when starting a new fitness regimen. 

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3. Know your numbers

Talk with your healthcare team about your own target blood glucose range. This target may differ depending on your age and other factors. Knowing these numbers can help you stay in a safe range while exercising.

Here are some general guidelines to keep in mind before a workout:

• Check your glucose: Start by checking your blood glucose with a glucometer. If you’re using a continuous glucose monitor (CGM), check your glucose trends.

• If your blood glucose is 100 mg/dL or lower: You may need to eat a light snack of 15 g to 30 g of carbohydrates to boost your blood sugar before exercising. These are considered “free” carbs, meaning you don’t need to take any insulin for them. 

• If your blood glucose is 300 mg/dL or higher: While people with Type 1 diabetes shouldn’t exercise with high blood glucose, those with Type 2 are probably fine to do so. The ADA and the American College of Sports Medicine (ACSM) don’t have recommended activity restrictions for people with Type 2 diabetes and a blood glucose over 300 mg/dL, as long as they feel well. 

Although you don’t necessarily need to avoid activity if you have Type 2 diabetes and your blood glucose is high, be extra careful when exercising. Stay well hydrated and avoid exercising if you have concerning symptoms.

4. Fuel yourself for workouts and replenish afterward

A dietitian can help you create a diet plan that helps you manage your diabetes. And a nutritious diet can also help keep your blood glucose in a safe range during exercise. The best way to fuel your body depends on several factors, including your treatment plan, fitness goals, and the type of exercise you’re doing.

When planning your pre- and post-workout nutrition, consider the following tips:

• If your general goal is to be more active: Before you exercise, try to have a small meal or snack that contains carbs and protein, like yogurt or an apple with 1 tbsp of peanut butter. Again, these are “free” carbohydrates to raise your blood glucose for exercise.

• If you do a long or high-intensity workout: Eat a balanced meal within an hour after you do intense or prolonged exercise to help your body recover.

• If you take insulin or medications that lower your blood glucose: Keep snacks on hand that have 5 g to 30 g of carbs, like a small box of raisins, an energy bar, or a banana and a packet of peanut butter. This can help you prevent low blood glucose during or after exercise. If you plan to work out right after a meal, you may need to reduce how much insulin you take beforehand. A healthcare professional can help you figure out how to manage insulin with your exercise program.

5. Stay hydrated

Staying properly hydrated is key to safe and effective workouts. Water is the best option for daily hydration and when doing low- to moderate-intensity activity. When you don’t get enough fluids, it can lead to fatigue and poor exercise performance. 

Hydration is particularly important for people with Type 2 diabetes because dehydration can negatively affect blood glucose levels and heart function. The ADA recommends drinking 17 oz of fluid about 2 hours before you work out. And remember to stay hydrated during and after exercise, too, to replenish the fluid you lose through sweat. 

6. Switch up your workouts

Your fitness routine should include different types of exercises that help manage diabetes, including: 

• Aerobics: Adults should try to get 150 minutes of moderate aerobic activity every week to help manage Type 2 diabetes. You can meet this goal with heart-healthy activities, like walking, running, and swimming. 

• Strength training: Strength training can help you maintain muscle mass and strength. Experts recommend that adults aim for two to three weekly sessions of muscle-strengthening workouts that target major muscle groups. 

• Balance and flexibility training: Balance and flexibility training is particularly important for adults 65 and older. Activities like heel-toe walking and tai chi may lower your risk of falls and help you stay mobile. Try to do balance and flexibility training 3 days per week. 

Switching up your workouts can help you find out what activities you enjoy, boost your motivation, and reduce the risk of exercise-related injuries. 

7. Find the right time

In general, the best time to exercise for better blood sugar management is about 30 minutes after you eat a meal. Blood sugar usually spikes around 90 minutes after you eat. So, physical activity around this time can help bring down your blood sugar.

But working out after a meal isn’t always practical. The best time for you to exercise will depend on various factors, including your treatment regimen and personal schedule. Aim to find a time that works for you, so you can make movement a consistent part of your life.

There’s also some research suggesting that morning workouts can be a good option for people who experience early-morning glucose spikes. If you're struggling to establish a routine that feels right, reach out to a healthcare professional. They can help you figure out your blood sugar trends and how your body responds to physical activity throughout the day.

8. Check your feet

Diabetes can lead to neuropathy (nerve damage) in your feet. And this can make it harder to feel pain. So, remember to check your feet — for cuts, blisters, or other changes — after every workout.

When you exercise, wear supportive shoes to avoid injury. And, if you have foot pain, consider activities that are easier on your feet, such as water aerobics, cycling, or chair yoga. Check in with a healthcare professional for regular foot exams and other tips to keep your feet healthy. 

9. Listen to your body

A new exercise regimen may cause slight discomfort at first. But it shouldn’t hurt. Stop your workout immediately if you notice new or concerning symptoms, such as:

• Pain

• Shortness of breath

• Dizziness

• Light-headedness 

These reactions could signal a serious problem. Be sure to talk to your healthcare team if you experience any new or unusual symptoms when exercising.

10. Have a hypoglycemia treatment plan

Make sure you have emergency treatment for hypoglycemia with you while exercising. This will help you avoid emergency situations.

The “15-15” rule is an easy way to remember how to quickly treat low blood glucose that’s between 55 to 69 mg/dL:

• Take 15 g of fast-acting carbohydrates.

• Wait 15 minutes.

• Check your glucose level again. If it’s still below 70 mg/dL, repeat the cycle.

Here are some examples of 15 g of fast-acting carbohydrates:

• 4 glucose tablets

• 1 tube of glucose gel

• ½ cup of fruit juice or regular soda

• 6 large jelly beans

• 1 tbsp of sugar or honey

If you have very low blood glucose, you may need more help. Teach others to call 911 if you:

• Don’t respond to fast-acting sugars

• Can’t eat or drink

• Have confusion or trouble talking or walking

• Pass out or have a seizure

11. Carry ID and your phone

If you have diabetes, consider wearing a medical ID, such as a medical alert bracelet or necklace. The ID contains information about your condition, which lets people know how to help you in an emergency. This safety precaution may be especially helpful if you use insulin to help manage your Type 2 diabetes.

What are the benefits of exercising if you have diabetes?

If you have or are at risk for diabetes, regular exercise may:

• Increase insulin sensitivity, potentially for up to 48 hours after a session 

• Help manage your blood glucose levels, since your muscles use blood glucose for energy

• Lower high blood pressure, which can go hand in hand with Type 2 diabetes

• Help you manage your weight and prevent obesity, which is also a risk factor for Type 2 diabetes

• Prevent Type 2 diabetes 

• Reduce depression symptoms and improve mood

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Written by:

Jennifer Clements, MD, MSEd, NBHWC

Jennifer Clements, MD, MSEd, NBHWC, is a board-certified physician and health coach who believes in achieving optimal health through healthy lifestyles. She’s a diplomate of the American Board of Obesity Medicine.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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