U.S. Department 

of Health and 

Human Services 

What I need to know about
 

Physical Activity Physical Activity and Diabetes and Diabetes

NATIONAL INSTITUTES OF HEALTH 

National Diabetes Information Clearinghouse 

What I need to know about 

Physical Activity and 

Diabetes 

NATIONAL INSTITUTES OF HEALTH 

National Diabetes Information Clearinghouse 

Contents
 

How can I take care of my diabetes? ............................... 1
 

What can a physically active lifestyle do 

for me? ................................................................................ 1
 

What kinds of physical activity can help me? .................. 3
 

Can I exercise any time I want? ........................................ 8
 

Are there any types of physical activity 

I shouldn’t do?.................................................................... 9
 

Can physical activity cause low blood glucose?............. 10
 

What should I do before I start a
 

physical activity program? ............................................... 13
 

What can I do to make sure I stay active? ..................... 14
 

For More Information ..................................................... 15
 

How can I take care of my diabetes? 

Diabetes means your blood glucose, also called blood 

sugar, is too high. Your body uses glucose for energy. 

But having too much glucose in your blood can hurt you. 

When you take care of your diabetes, you’ll feel better. 

You’ll reduce your risk for problems with your kidneys, 

eyes, nerves, feet and legs, and teeth. You’ll also lower 

your risk for a heart attack or a stroke. You can take 

care of your diabetes by 

l being physically active 

l following a healthy meal plan 

l taking medicines, if prescribed by your doctor 

lower your blood glucose and your blood pressure 

l lower your bad cholesterol and raise your 

good cholesterol
 

l improve your body’s ability to use insulin
 

l lower your risk for heart disease and stroke
 

l keep your heart and bones strong
 

l keep your joints flexible 


What can a physically active lifestyle do 

for me? 

Research has shown that physical activity can 

l


 
l lower your risk of falling 

l help you lose weight 

l reduce your body fat 

l give you more energy 

l reduce your stress levels 

Physical activity also plays an important part in 

preventing type 2 diabetes. A major Government study, 

the Diabetes Prevention Program (DPP), showed that 

modest weight loss of 5 to 7 percent—for example, 

10 to 15 pounds for a 200-pound person—can delay and 

possibly prevent type 2 diabetes. People in the study 

used diet and exercise to lose weight. 

For more information about the study, read the DPP 

fact sheet online. Go to www.diabetes.niddk.nih.gov/intro 

and click on Diabetes Prevention Program under 

“Pre-diabetes.” Or call the National Diabetes 

Information Clearinghouse at 1–800–860–8747 to 

request a printed copy. 


 
What kinds of physical activity can help 

me? 

Four kinds of activity can help. You can
 

l be extra active every day
 

l do aerobic exercise
 

l do strength training
 

l stretch 

Be Extra Active Every Day 

Being extra active can increase the number of 

calories you burn. Try these ways to be extra active, 

or think of other things you can do. 

l Walk around while you talk on the phone.
 

l Play with the kids.
 

l Take the dog for a walk.
 

l Get up to change the TV channel instead of 


using the remote control.
 

l Work in the garden or rake leaves.
 

l Clean the house.
 

l Wash the car.
 

l Stretch out your chores. For example, make 


two trips to take the laundry downstairs instead 

of one.


 
____________________________________________ 

l	 Park at the far end of the 


shopping center parking lot and 


walk to the store.
 

l	 At the grocery store, walk down 


every aisle.
 

l	 At work, walk over to see a
 

co-worker instead of calling
 

or emailing.
 

l	 Take the stairs instead of the 


elevator.
 

l	 Stretch or walk around instead 


of taking a coffee break and eating. 


l	 During your lunch break, walk to the post office or 

do other errands. 

l	 Other things I can do: ________________________ 

Do Aerobic Exercise 

Aerobic exercise is activity that requires the use of large 

muscles and makes your heart beat faster. You will also 

breathe harder during aerobic exercise. Doing aerobic 

exercise for 30 minutes a day at least 5 days a week 

provides many benefits. You can even split up those 

30 minutes into several parts. For example, you can take 

three brisk 10-minute walks, one after each meal. 


 
____________________________________________ 

If you haven’t exercised lately, see your doctor first to 

make sure it’s OK for you to increase your level of 

physical activity. Talk with your doctor about how to 

warm up and stretch before you exercise and how to cool 

down after you exercise. Then start slowly with 5 to 10 

minutes a day. Add a little more time each week, aiming 

for at least 150 minutes per week. Try 

l	 walking briskly 

l	 hiking 

l	 climbing stairs 

l	 swimming or taking a wateraerobics class 

l	 dancing 

l	 riding a bicycle outdoors or a 

stationary bicycle indoors 

l	 taking an aerobics class 

l	 playing basketball, volleyball, 

or other sports 

l	 in-line skating, ice skating, or skate boarding 

l	 playing tennis 

l	 cross-country skiing 

l	 other things I can do: _________________________ 


 
The National Institute on Aging offers a free 

booklet, Exercise: A Guide From the National 

Institute on Aging. To read it online, go to 

www.nia.nih.gov/HealthInformation/Publications, 

click on “Healthy Aging,” and then choose “Exercise 

Guide (only).” Or call 1–800–222–2225 to request a 

printed copy. 

Do Strength Training 

Doing exercises with hand weights, elastic bands, or 

weight machines three times a week builds muscle. 

When you have more muscle and less fat, you’ll burn 

more calories because muscle burns more calories 


 
than fat, even between exercise sessions. Strength 

training can help make daily chores easier, improving 

your balance and coordination, as well as your bones’ 

health. You can do strength training at home, at a 

fitness center, or in a class. Your health care team can 

tell you more about strength training and what kind is 

best for you. 

Stretch 

Stretching increases your flexibility, lowers stress, and 

helps prevent muscle soreness after other types of 

exercise. Your health care team can tell you what kind 

of stretching is best for you. 

The Weight-control Information Network, a service 

of the National Institute of Diabetes and Digestive 

and Kidney Diseases, has information about exercise. 

Call 1–877–946–4627, toll-free, to request free copies 

of the following publications, or read them online. 

l	 Active at Any Size 

www.win.niddk.nih.gov/publications/active.htm 

l	 Walking: A Step in the Right Direction 

www.win.niddk.nih.gov/publications/walking.htm 

l	 Physical Activity and Weight Control 

www.win.niddk.nih.gov/publications/physical.htm 


 
Can I exercise any time I want? 

Your health care team can help you decide the best time 

of day for you to exercise. Together, you and your team 

will consider your daily schedule, your meal plan, and 

your diabetes medicines. 

If you have type 1 diabetes, avoid strenuous exercise 

when you have ketones in your blood or urine. Ketones 

are chemicals your body might make when your blood 

glucose level is too high and your insulin level is too low. 

Too many ketones can make you sick. If you exercise 

when you have ketones in your blood or urine, your 

blood glucose level may go even higher. 

If you have type 2 diabetes and your blood glucose is high 

but you don’t have ketones, light or moderate exercise 

will probably lower your blood glucose. Ask your health 

care team whether you should exercise when your blood 

glucose is high. 


 


Are there any types of physical activity 

I shouldn’t do?

If you have diabetes complications, some kinds of 

exercise can make your problems worse. For example, 

activities that increase the pressure in the blood vessels 

of your eyes, such as lifting heavy weights, can make 

diabetic eye problems worse. If nerve damage from 

diabetes has made your feet numb, your doctor may 

suggest that you try swimming instead of walking for 

aerobic exercise.

When you have numb feet, you might not feel pain in your 

feet. Sores or blisters might get worse because you don’t 

notice them. Without proper care, minor foot problems 

can turn into serious conditions, sometimes leading to 

amputation. Make sure you exercise in 

cotton socks and comfortable, well-fitting 

shoes designed for the activity you are 

doing. After you exercise, check your 

feet for cuts, sores, bumps, or 

redness. Call your doctor if any 

foot problems develop.
Can physical activity cause 


low blood glucose?
 

Physical activity can cause low blood glucose, also called 

hypoglycemia, in people who take insulin or certain types 

of diabetes medicines. Ask your health care team 

whether your diabetes medicines can cause low blood 

glucose. 

Low blood glucose can happen while you exercise, 

right afterward, or even up to a day later. It can make you 

feel shaky, weak, confused, grumpy, hungry, or tired. You 

may sweat a lot or get a headache. If your blood glucose 

drops too low, you could pass out or have a seizure. 

However, you should still be physically active. These 

steps can help you be prepared for low blood glucose: 

Before Exercise 

l	 Ask your health care team whether you should check 

your blood glucose level before exercising. 

l	 If you take diabetes medicines that can cause low 

blood glucose, ask your health care team whether you 

should 

• change the amount you take before you exercise 

• have a snack if your blood glucose level is 


below 100
 

0
 
During Exercise 

l	 Wear your medical identification (ID) bracelet or 

necklace or carry your ID in your pocket. 

l	 Always carry food or glucose tablets so you’ll be 

ready to treat low blood glucose. 

l	 If you’ll be exercising for more than an hour, check 

your blood glucose at regular intervals. You may 

need snacks before you finish. 

After Exercise 

l	 Check to see how exercise affected your blood 


glucose level. 



 
Treating Low Blood Glucose 

If your blood glucose is below 70, have one of the 

following right away: 

l 3 or 4 glucose tablets 

l 1 serving of glucose gel—the amount equal to 

15 grams of carbohydrate 

l 1/2 cup (4 ounces) of any fruit juice 

l 1/2 cup (4 ounces) of a regular—not diet—soft 

drink 

l 1 cup (8 ounces) of milk 

l 5 or 6 pieces of hard candy 

l 1 tablespoon of sugar or honey 

After 15 minutes, check your blood glucose again. 

If it’s still too low, have another serving. Repeat 

until your blood glucose is 70 or higher. If it will be 

an hour or more before your next meal, have a 

snack as well.


 
What should I do before I start a physical 

activity program? 

Check with your doctor. Always talk with your doctor 

before you start a new physical activity program. Ask 

about your medicines—prescription and over-thecounter—and whether you should change the amount 

you take before you exercise. If you have heart disease, 

kidney disease, eye problems, or foot problems, ask 

which types of physical activity are safe for you. 

Decide exactly what you’ll do and set some goals. 

Choose 

l the type of physical activity you want to do 

l the clothes and items you’ll need to get ready 

l the days and times you’ll add activity 

l the length of each session 

l your plan for warming up, stretching, and cooling 

down for each session 

l a backup plan, such as where you’ll walk if the 

weather is bad 

l your measures of progress 

Find an exercise buddy. Many people find they are more 

likely to do something active if a friend joins them. If 

you and a friend plan to walk together, for example, you 

may be more likely to do it. 


 
Keep track of your physical activity. Write down when 

you exercise and for how long in your blood glucose 

record book. You’ll be able to track your progress and 

see how physical activity affects your blood glucose. 

Decide how you’ll reward yourself. Do something nice 

for yourself when you reach your activity goals. For 

example, treat yourself to a movie or buy a new plant 

for the garden. 

What can I do to make sure 


I stay active?
 

One of the keys to staying on track is finding 

some activities you like to do. If you keep finding 

excuses not to exercise, think about why. Are your 

goals realistic? Do you need a change in activity? 

Would another time be more convenient? Keep trying 

until you find a routine that works for you. Once you 

make physical activity a habit, you’ll wonder how you 

lived without it. 


 
For More Information 

To find diabetes teachers—nurses, dietitians, and other 

health professionals—near you, call the American 

Association of Diabetes Educators toll-free at 

1–800–TEAMUP4 (832–6874). Or look on the Internet 

at www.diabeteseducator.org and click on “Find a Diabetes 

Educator.” 

For additional information about diabetes, contact 

American Diabetes Association 

National Service Center
 

1701 North Beauregard Street
 

Alexandria, VA 22311
 

Phone: 1–800–DIABETES (342–2383)
 

Fax: 703–549–6995
 

Email: AskADA@diabetes.org
 

Internet: www.diabetes.org 


Juvenile Diabetes Research Foundation International 

120 Wall Street
 

New York, NY 10005–4001
 

Phone: 1–800–533–CURE (2873)
 

Fax: 212–785–9595
 

Email: info@jdrf.org
 

Internet: www.jdrf.org 


This publication may contain information about medications used to treat a 

health condition. When this publication was prepared, the NIDDK included 

the most current information available. Occasionally, new information 

about medication is released. For updates or for questions about any 

medications, please contact the U.S. Food and Drug Administration at 

1–888–INFO–FDA (463–6332), a toll-free call, or visit their website at 

www.fda.gov. Consult your doctor for more information. 


 

National Diabetes 


Information Clearinghouse
 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

Internet: www.diabetes.niddk.nih.gov 

The National Diabetes Information Clearinghouse (NDIC) is a 

service of the National Institute of Diabetes and Digestive and 

Kidney Diseases (NIDDK). The NIDDK is part of the National 

Institutes of Health of the U.S. Department of Health and Human 

Services. Established in 1978, the Clearinghouse provides 

information about diabetes to people with diabetes and to their 

families, health care professionals, and the public. The NDIC 

answers inquiries, develops and distributes publications, and works 

closely with professional and patient organizations and 

Government agencies to coordinate resources about diabetes. 

Publications produced by the Clearinghouse are carefully reviewed 

by both NIDDK scientists and outside experts. The original 

version of this booklet was reviewed by Andrea Kriska, Ph.D., 

University of Pittsburgh, Department of Epidemiology; David G. 

Marrero, Ph.D., Indiana University School of Medicine, Division 

of Endocrinology; and Susan Yanovski, M.D., NIDDK, Division 

of Digestive Diseases and Nutrition, Obesity and Eating Disorders 

Program. Field-testing was facilitated by Sally A. Stacey, R.N., 

C.D.E., Regional Diabetes Center, Home Hospital, Lafayette, IN. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this booklet to duplicate and distribute as 

many copies as desired. 

This booklet is also available at www.diabetes.niddk.nih.gov. 
U.S. DEPArTmENT OF HEALTH 

AND HUmAN SErvICES 

National Institutes of Health 

NIH Publication No. 08–5180 

March 2008