Exercise and type 2 diabetes

Type 2 diabetes mellitus (T2DM) is the most common type of diabetes. It occurs when blood glucose or blood sugar level is too high. Blood glucose is your body's main form of energy and comes from the food you eat. Insulin is a hormone made by the pancreas that helps convert blood glucose into energy.

With T2DM, your body doesn’t make enough insulin, or it doesn’t use it well. This increases the amount of glucose left in the blood.

The risk factors that increase your chances of developing T2DM include being overweight, not doing enough physical activity, having a poor diet, and a family history of diabetes.

What are hypoglycaemia and hyperglycaemia?

Hypoglycaemia means lower than normal blood sugar levels. Hyperglycaemia means higher than normal blood sugar levels.

Normal blood sugar levels range between 4 and 7 mmol/L. Low blood sugar levels are below 4 mmol/L and can cause shaking, sweating, paleness, light-headedness, hunger, and pins and needles around the mouth. High blood sugar levels are above 10 mmol/L and can cause thirst, frequent urination, blurred vision, fatigue, and headaches.

If you use a blood glucose meter, it's important to know what a normal blood sugar level is. Your doctor can help you decide what the best target range is for you.

What can I do?

T2DM is usually managed with lifestyle changes, but medication may be needed as well. Lifestyle changes that help include:

• Following a healthy diet
• Regular exercise
• Regular check-ups with your healthcare team
• Understanding your condition
• Learning how to self-manage your condition
• Getting support (e.g. a diabetes management plan)
• Maintaining a healthy weight
• Managing stress and improving your mental health

The benefits of exercise

Doing the recommended amount of physical activity reduces the risk of developing T2DM by almost 60%. That is why exercise is a vital component of T2DM management and prevention. Some of the benefits of exercise include:

• Improving your muscles' response to insulin, which lowers blood sugar levels
• Boosting your body’s sensitivity to insulin
• Helping to prevent or delay T2DM
• Improving blood sugar control
• Helping you maintain a healthy bodyweight
• Helping you manage cholesterol and blood pressure
• Improving mood and reducing stress

What exercise is best?

Please note that these suggestions are only a guide. See your health care team for a personalised plan. Your exercise plan should remain the same whether you are managing or preventing T2DM.

The right amount and intensity of exercise depends on you. Some people may consider a slow walk on a flat surface to be moderate intensity. Others might consider a brisk walk up a hill to be moderate intensity.

The most important part is that you start moving your body regularly. Commit to a routine you think is achievable, which you can comfortably continue long term.

How much exercise is enough?

The recommended amount of exercise for older people is at least 150 minutes of moderate activity every week. This could mean doing 30 minutes of exercise 5 days a week.

Doing a mixture of aerobic activity and resistance exercises that you enjoy will give you the best results. Try aiming for resistance exercise on at least two days per week.

Practising balance and working on your flexibility will help if your feet have been affected by nerve damage.

Suggested exercises

• Cycling or exercise bike
• Dancing
• Gardening
• Golf
• Bowls
• Ping pong
• Swimming
• Tai Chi
• Walking
• Water aerobics
• Weight training

Further considerations

• Seek advice from your health care team before starting a new exercise program.
• Consider seeing an exercise physiologist for an individualised exercise program.
• If you take insulin check your blood sugar levels before and after exercise.
• Avoid a foot injury and prevent foot ulcers by wearing appropriate footwear.
• Get regular foot checks with a podiatrist.
• Low impact exercise is recommended if you have nerve damage in your feet.
• Avoid high-intensity activity if you are feeling unwell.
• Start slow and progress gradually.
• Exercise with a partner or under supervision to reduce the risks associated with hypoglycaemia.
• Drink plenty of fluids before, during, and after exercise.
• Fluids could be water or a sweetened drink if you need extra carbohydrate.
• Carbohydrate and medication adjustments may be necessary depending on your needs. Discuss this with your doctor.

More helpful information

If you would like to find local exercise classes and social activities, try the LiveUp quiz or get in touch with one of our friendly team for advice on 1800 951 971.

For more detailed information about type 2 diabetes click on the links below:

• Exercise Right Fact Sheet
• Diabetes Australia
• Better Health Channel - Diabetes and exercise
• NDSS - A guide for older people living with diabetes

You can read more about exercise to help manage different conditions on our articles page.

References

Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., Braun, B., American College of Sports Medicine, & American Diabetes Association (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes care, 33(12), e147–e167. https://doi.org/10.2337/dc10-9990

Centers for Disease Control and Prevention. (2023). Older adult activity: an overview. https://www.cdc.gov/physical-activity-basics/guidelines/older-adults.html?CDC_AAref_Val=https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm

Exercise & Sports Science Australia. (2021). Exercise right factsheet: Diabetes. Exercise Right. https://exerciseright.com.au/wp-content/uploads/2021/07/Exercise-Right-Factsheet-Diabetes.pdf

Diabetes Australia. Exercise and Diabetes. https://www.diabetesaustralia.com.au/living-with-diabetes/exercise/ 

Better Health Channel. Diabetes and exercise. Victorian State Government. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-and-exercise

National Diabetes Services Scheme. (2020). Managing diabetes as you age: A guide for people over 65. https://www.ndss.com.au/wp-content/uploads/resources/booklet-managing-diabetes-as-you-age-guide-for-people-over-65.pdf

LiveUp provides free information to help you make informed decisions about your health. This information is for general and educational purposes only, is not intended to provide a comprehensive guide, and does not replace medical advice. Everyone is different, so some of these tips may work better for you than others. You should use your own judgment and seek medical advice when applying this information to yourself, to determine if it is suitable in your circumstances. Your use of, or reliance on, this information is solely at your own risk. Independent Living Assessment Incorporated is not responsible or liable for any injury, loss, or damage caused as a result of your use of, or reliance on, this information.

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