The content in this article should not be taken as medical advice. Please consult your healthcare provider regarding your individual health needs.
Proper nutrition and regular exercise play an important role in successfully managing diabetes. After adjusting your nutrition and eating habits, exercise can be extremely beneficial for people who live with diabetes (and those without diabetes as well!)
But how do you know what exercise is right for you, where do you start, and how can a Dexcom Continuous Glucose Monitoring (CGM) System help along the way?
We asked Dexcom Clinical Education Manager, Sarah Ehlers to answer those questions and more. A registered dietitian, personal trainer and passionate advocate, she has managed her Type 1 diabetes for 24 years with the right balance of nutrition, exercise, and technology, including the pairing of the Tandem t:slim X2 insulin pump with the Dexcom G7 CGM System. Her Dexcom G7 CGM, specifically, has really helped her to tweak and continually adjust along the way, which is important when taking a realistic approach to nutrition, exercise, and diabetes management.
“Dexcom G7 brings me so much information and peace of mind, and I don't know where I'd be without it,” she said. “But exercise has also really helped to bring me back into range at times. And at this stage of my life in my 30s, exercise has also become something that helps me with mental health.”
Learn more about the best exercises for diabetes and how they can help you better manage diabetes in our Q&A with Sarah
Q: Why is routine exercise so important for those living with diabetes?
A: Insulin acts like a key that unlocks the door to our cells, allowing glucose, our body’s primary energy source, to enter from the bloodstream and be used for energy. Exercise enhances our metabolic fitness, helping this "key" work more effectively to move glucose into cells. Exercise can help boost metabolism, aid in weight loss, and lower blood pressure by improving "good" cholesterol levels.1
Most importantly, exercise can enhance physical and mental well-being. For people living with diabetes, regular exercise helps manage blood glucose levels, reduces the risk of heart disease and stroke, and assists with overall weight management and other metabolic health issues often associated with diabetes.2
Let's think about heart health during exercise. Your heart is like a busy highway system at rush hour. Cars (oxygen and nutrients) speed along to reach their destinations (your muscles and extremities), ensuring everything keeps moving smoothly and efficiently.
High blood glucose, which means extra sugar floating around in the bloodstream because it can't get into the cells to create energy, can hinder this necessary oxygen and nutrient delivery to extremities and muscles, adding stress to the body, and potentially causing some vascular road rage! Exercise can help burn some of that excess glucose.
Q: How can I start to add exercise to my diabetes management routine?
A: Self-reflection is a great place to start. What is your current fitness activity level? How much do you move around throughout the day? Do you sit while you work, or could you stand or incorporate more walking? Do you park the car far away and walk? Do you use the stairs instead of the elevator? Those daily movements are a great place to start when considering how to increase the amount of activity, or exercise, in your day.
Next, figure out your goals. What seems realistic to you for the next step? Why are you starting? What are your motivators? What do you want to accomplish? How do you feel once you achieve success? What time of day works best for you if you’re adding in a new routine? Once you become clear on some of these areas, it’s a good idea to get in touch with your physician next. If you are on insulin or medication, you may want to ask your doctor or consider how these areas come into play as well. Timing/exercise time of day can be especially helpful to consider while on different medications and insulin, Dexcom CGM, which continuously monitors your glucose in real time can especially help to observe and notice glucose trends when testing new activities at different times of the day. A physician can also help with that but ultimately, the best exercise is the exercise that you do, when you do it!
Q: How do I figure out the type of exercise that’s best for me?
A: There are so many ways we can move our bodies, so figure out what’s the most fun for you. What type of environment are you looking for? What feels comfortable? What will you repeat until it becomes a consistent routine?
Different types of exercise have different impacts. For example, resistance training is great for our heart. If you have concerns about your joints, like your knees and ankles, flexibility and mobility are important, so yoga might be interesting or fun for you. If you respond better to motivational energy, an exercise class environment might be more your speed. Or, if you prefer solitude, walking or running with your earbuds in might be the right choice.
Notably, more intense workouts like weightlifting and high-intensity interval training (HIIT) can raise hormone levels, such as adrenaline, which can cause hyperglycemia.3 On the other hand, most aerobic or cardiovascular activities can cause hypoglycemia. Using a continuous glucose monitor (CGM) can help you track your glucose levels before, during, and after workouts to stay in a safe range or adjust as needed. A physician can also assist with this.
It all comes back to sustainability. While we can always change our exercise routines, the goal is to find one that will stick and doesn’t feel like a chore. The right exercise will make you feel like you want to do it–you’ll look forward to it. That’s the best exercise for you. Choose activities you enjoy, so you’re more likely to repeat them.
Q: Generally speaking, what are some of the best types of exercise for those who have diabetes?
A: All movement is beneficial–just get moving! Start with a small, achievable goal like 20 minutes of exercise. Small wins feel good and add up, keeping motivation high. Consistency is often more important than duration, so regular 20-minute workouts can be more beneficial than occasional two-hour sessions.
Walking: This low-intensity, aerobic exercise can be done almost anywhere, indoors or outdoors. Walking activates the body, and you can track your glucose levels before, during, and after. It's great steady-state cardio, and you can vary the pace for added benefits.
Cycling: Cycling offers a good workout with less impact on joints compared to running. Whether riding a bike outside or using an indoor cycling class, it’s excellent for cardiovascular health, muscle-building, stress relief, regulating blood pressure, and weight loss. It also helps the body use insulin more effectively.
Team sports: Sports are an easy entry into regular aerobic exercise and great for those who love the group dynamic and competition. Anything from recreational basketball, flag football, frisbee, volleyball, pickleball, softball or kickball will get you moving and boost both your health and mood. Sports are great for those who want to exercise without thinking consciously about the workout.
Resistance training: Also known as strength training or weight training, there’s a lot of evidence resistance training has a positive impact on metabolic health, including improving glycemic control.4 It can enhance muscle mass, bone density, and may lead to weight loss. On top of that, it benefits cardiovascular health, can help prevent certain chronic conditions, and can even improve balance and posture.5
Yoga: Yoga is great for mobility, flexibility and balance, not to mention it can help manage glucose levels,6 lower blood pressure, improve cardiovascular health and breathing, reduce stress, and boost your mood and mental health.
Pilates: Pilates is a low-impact exercise that improves core strength, flexibility, and posture. It also enhances muscle tone and mental awareness. Think of it as a mind-body exercise that emphasizes muscle control, posture, and breathing–all beneficial for overall health. Pilates can also help reduce back pain, improve balance, and prevent injuries.
High Intensity Interval Training (HIIT): HIIT involves bursts of intense exercise alternating with brief recovery periods. The National Institutes of Health found HIIT can promote improvement in glucose control and cardiovascular/metabolic fitness for those who have Type 2 diabetes.7
Q: Is there anything else I should be aware of before jumping into an exercise routine?
A: Before jumping into an exercise routine, there are a few things to keep in mind to ensure your safety and effectiveness:
Exercise can sometimes cause hypoglycemia, so it's wise to let someone know (or share your glucose values and have them follow*-along!) you're exercising and keep snacks on hand in case you need them. Choose something convenient and easy to carry, like fruit snacks or juice, which can quickly raise your blood sugar. Also, consider having a protein source to sustain you longer. Protein bars are great but aim for a balanced protein-to-carb ratio.
I use an insulin pump, so I like to check my insulin on board (IOB)–the amount of active insulin in my system– before exercising. For example, if I'm about to walk my dog and I'm starting out at with glucose at 160 mg/dL and I have three units active, I'm likely to see a drop in glucose on my Dexcom G7. By checking IOB before, and monitoring my Dexcom G7 throughout, it helps to anticipate and manage changes in my levels without interfering with my activity.
For those using an AID (Automated Insulin Delivery) system, consult your doctor about your options. Different activities may require different settings. For instance, you might have one setting for running and another for weightlifting. Adjusting your basal insulin profiles based on your activity is crucial, and your doctor can help you tailor these settings.
This goes back to the concept of timing around exercise and fitting your personal goals into your lifestyle. Think of your exercise routine as a well-planned journey. Just like you wouldn't set off on a road trip without checking your fuel and packing essentials, you shouldn't start exercising without preparing your body and having the right tools on hand. This way, you can enjoy the journey safely and effectively!
Q: How can Dexcom CGM help me with exercise?
A: Your Dexcom CGM is like your GPS or compass, guiding you to stay on track and reach your destination safely. Dexcom CGM can help you decide what snacks and insulin or medication you’ll need for your workout. By showing you when you’re going low or high, your CGM allows you to make necessary adjustments, like grabbing a snack or taking insulin. If you use a pump or smart insulin pen, checking your insulin on board (IOB) before starting can be helpful. Considering your IOB along with your current CGM reading helps determine the right type and amount of snacks. Ideally, IOB should be low before exercise, and your CGM can help you monitor and adjust as needed.
Your Dexcom CGM System also assists you during and after workouts, enabling real-time treatment decisions based on your current glucose level. Remember, different types of exercise affect blood glucose differently; for example, high-intensity or anaerobic workouts can cause spikes.
Pay attention to how your body reacts to different workouts by regularly checking your CGM readings and trend arrows. Always discuss treatment decisions with a healthcare professional. You can share your Dexcom CGM data with your doctor using Dexcom Clarity† to guide and inspire your discussions.
Get a Free Dexcom G7 Sample
Are you living with diabetes and not using CGM? Talk to your doctor about Dexcom G7. We can also help you get started with a free benefits check. Click the button below to send us some basic information.
*A separate Dexcom Follow app and internet connection required. †An internet connection is required to send data to Dexcom Clarity.
1 Centers for Disease Control and Prevention. (n.d.). Benefits of physical activity. Centers for Disease Control and Prevention. https://www.cdc.gov/physicalactivity-basics/benefits/index.html. 2 Colberg SR, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016 Nov;39(11):2065-2079. doi: 10.2337/dc16-1728. PMID: 27926890; PMCID: PMC6908414. 3 Exercise and glucose levels in diabetes. Blood Glucose and Exercise: Managing Post-Exercise Hyperglycemia & Glucose Spikes. (n.d.). https://diabetes.org/health-wellness/fitness/why-does-exercisesometimes-raise-blood-sugar 4 Strasser B, Pesta D. Resistance training for diabetes prevention and therapy: experimental findings and molecular mechanisms. Biomed Res Int. 2013;2013:805217. doi: 10.1155/2013/805217. Epub 2013 Dec 22. PMID: 24455726; PMCID: PMC3881442. 5 Mayo Foundation for Medical Education and Research. (2023, April 29). Strength training: Get stronger, leaner, healthier. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670. 6 How yoga can help you reach your blood glucose goals. How Yoga Can Help You Reach Your Blood Glucose Goals | American Diabetes Association. (n.d.). https://diabetes.org/health-wellness/fitness/yoga-blood-glucose-goals. 7 Francois ME, Little JP. Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes. Diabetes Spectr. 2015 Jan;28(1):39-44. doi: 10.2337/diaspect.28.1.39. PMID: 25717277; PMCID: PMC4334091.
BRIEF SAFETY STATEMENT: Failure to use the Dexcom Continuous Glucose Monitoring System and its components according to the instructions for use provided with your device and available at https://www.dexcom.com/safety-information and to properly consider all indications, contraindications, warnings, precautions, and cautions in those instructions for use may result in you missing a severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) occurrence and/or making a treatment decision that may result in injury. If your glucose alerts and readings from the Dexcom CGM do not match symptoms, use a blood glucose meter to make diabetes treatment decisions. Seek medical advice and attention when appropriate, including for any medical emergency. Dexcom, Dexcom Clarity, Dexcom Follow, Dexcom One, Dexcom Share, and any related logos and design marks are either registered trademarks or trademarks of Dexcom, Inc. in the United States and/or other countries.
MAT-8243