How to best manage diabetes and lower blood sugar with exercise

• People with diabetes should aim to get 150 minutes of moderate exercise per week.
• It's important to do both cardio, like walking, and strength training, like weight lifting.
• Other exercises that can help manage blood sugar levels include swimming, biking, and tennis.

Exercise and physical activity are extremely beneficial for overall health. And if you have type 1 or type 2 diabetes, or may be at risk, the benefits are quite useful.

"Regular exercise is especially important for those living with diabetes," says Alex Li, MD, deputy chief medical office for L.A. Care Health Plan.

But exercise can also present some complications for people with diabetes. Here's how to create a safe, effective workout routine if you have diabetes.

Why exercise is important for people with diabetes

When you exercise, your body burns glucose, or blood sugar, for fuel, which helps lower blood sugar levels. As you exercise more, this effect is amplified over time, which is important for people who experience chronically high blood sugar levels, like those with diabetes or who are at risk of developing it.

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A 2019 scientific review found evidence that structured exercises - like engaging in an eight-week exercise class - reduced insulin resistance for people with type 2 diabetes. The average participant saw their blood sugars drop by 5.12 points after intervention.

Regular exercise can also help you build muscle and decrease fat, both of which boost your body's ability to use insulin - the hormone that helps your body convert blood sugar into fuel. In general, people with both type 1 and type 2 diabetes benefit from becoming more sensitive to insulin because it's the key component to helping regulate blood sugar.

A small 2017 study followed 28 women with type 2 diabetes for eight weeks. Fourteen participants did not exercise as part of the control group, while the other 14 did aerobic exercise (cardio) three times a week and resistance training twice a week. After eight weeks, the exercise group had lower blood sugar and less insulin resistance than the control group.

"In the short term, it can lower blood sugar, and in the long term, it can improve insulin sensitivity," says Emory Hsu, MD, an endocrinologist with Santa Clara Valley Medical Center.

How much exercise you need

The ADA recommends that people with type 2 diabetes or who are at risk for the condition exercise daily and never let more than two days lapse without physical activity. Most types of physical activity can count as exercise, even gardening or walking.

"If you are walking, this means you should walk briskly enough to start breaking a sweat or start to feel like you need to breathe more rapidly," Hsu says.

Note: The American Diabetes Association recommends American adults get 150 minutes of moderate exercise per week. "Don't let this number intimidate you," Hsu says. "Any exercise is better than none, and you can start more slowly and ramp up." Try going for a walk on your lunch break, or using resistance bands after work.

Other types of moderate exercise include:

• Mowing the lawn
• Swimming
• Playing tennis
• Casual bike riding

All of these types of exercise can be beneficial. A 2019 scientific study published in The International Journal of Exercise Science followed 905 people with type 2 diabetes who were previously inactive. They did aerobic exercises, resistance training, or a combination of the two for 49 minutes three times per week.

The study found that all three types of training reduced A1C levels, which measure average blood glucose over time. Combination training had the biggest impact, followed by aerobic exercise and then resistance training.

How to exercise safely with diabetes

Exercise is recommended for all people with diabetes, though some may have to take extra precautions. For example, people with type 1 diabetes should be particularly careful.

"For type 1 diabetics, exercise can lower blood sugar more dramatically," Hsu says. Dangerously low blood sugar, or hypoglycemia, can cause health complications including seizures and coma in severe cases.

People with type 1 diabetes should carefully plan their exercises around food intake and insulin dosage, according to the ADA. It's also important to measure your blood sugar levels before, during, and after exercise - or check your blood sugar with a continuous glucose monitor.

If you have diabetes and are starting an exercise routine, you should take the following steps:

• Speak with your doctor. Let them know if you've had any other health complications with diabetes, like eye problems, heart disease, or stroke.
• Start slow. Familiarize yourself with how exercise affects your blood sugar by measuring your blood sugar before and after exercise, and monitoring any major changes. Your blood sugar should stay within the healthy range that you and your doctor have established.
• Monitor your feet for ulcers or sores. Many diabetics have decreased sensation in their feet, Li says, so you might not notice pain from sores. Visual monitoring can help you spot them and prevent infection.

Insider's takeaway

Working your way up to at least 150 minutes of exercise per week can help you manage your diabetes and lower blood sugar. Exercising with diabetes - particularly type 1 diabetes - can take some extra planning, but the health benefits are well worth it, Li says.

For more information, read about how to lower your blood sugar with further lifestyle changes.

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