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How to Start Exercising

A 12-step guide to working out with diabetes.

Total Diabetes Wellness
Updated on February 18, 2024
Science Based
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Regular exercise is one of the best things you can do for your health. If you have diabetes, exercise is important for helping control your blood sugar, increasing insulin sensitivity, and reducing the risk of disease and nerve damage.

Walking is an excellent form of exercise that offers many health benefits. If starting a workout program is intimidating, we recommend that you first focus on walking and increasing your daily movement.

Even with knowing how important exercise is for diabetes, it can be difficult to get started. Follow this 12-step guide to starting an exercise routine and sticking to it.

1. Talk to Your Doctor

Exercising while having diabetes must be done with care and preparation. This is because exercise can both raise (hyperglycemia) and lower (hypoglycemia) your blood sugar to dangerous levels.

Always discuss exercise with your doctor BEFORE starting any kind of exercise program. This is especially important if you are on medications. Full disclaimer here.

It is worth noting that exercise can significantly improve your blood sugar maintenance. However, Total Diabetes Wellness recommends that you ensure these steps first:

You have met with your doctor to discuss your plans and any risk or health implications your exercise program may pose.
Your blood sugar is under 250 mg/dL (13.9 mmol/L) and over 100 mg/dL (5.6 mmol/L).
You have first implemented a consistent sleep schedule and diet regime to help stabilize your blood sugar levels throughout the day (See our guides on DIET and SLEEP to learn more).
You have a good sense of balance (diabetes can cause nerve damage that affects balance).
You are completely prepared, have a plan, and understand how exercise affects your blood sugar before, during, and after exercise.

Learn more about how exercise impacts your blood sugar:

If you experience any of these symptoms, stop exercising immediately:

Shaky
Weak
Dizzy
Confused
Blood sugar of 70 mg/dL (3.9 mmol/L) or lower. According to Mayo Clinic, consume 15 grams of fast-acting carbohydrates if this happens. Check your blood sugar every 15 minutes, and do not resume exercise until your blood sugar is over 70 mg/dL (3.9 mmol/L). Glucose tablets are an excellent option for fast-acting carbohydrates.

People with diabetes taking medication must be careful during exercise and closely monitor blood sugar levels while exercising. For these reasons, you must consult your doctor before making any significant changes, especially exercise, if you have diabetes.

2. Determine Who You Want to Become

Making changes involves more than just deciding you will try something new. Think about your current life and where you would like it to go. Close your eyes and envision a new lifestyle with your new changes. What does it look like? What are you doing? How do you feel? What changes would you need to make?

Thinking about the big picture is critical to ensure the likelihood that you will reach your goals. For example, saying, “I want to walk 10,000 steps every day,” is great. However, deciding to lower the risk of developing life-altering diseases due to diabetes by eating well, being active, and enjoying life gives a sense of purpose and direction.

3. Determine Your Starting Fitness Level

Being safe should always be your top priority in anything that you do. Having diabetes makes this an essential part of anything that you do. By determining your starting fitness level, you are establishing a baseline to help keep you safe.

Here are some examples of what you can do:

If your goal is to walk at least 10,000 steps daily, then track how many steps you take over a week. Use this data to help determine how many steps are realistic for you during your first week of working towards reaching your goal.
Are you prone to injury? Perhaps part of your exercise program involves a warmup and cooldown, doing some physical therapy exercises, focusing on flexibility, or just taking very small incremental steps toward your end goal. Being well-rounded helps establish a more complete body of work, which then helps reduce the overall risk of injury.

4. Determine Your Fitness Program

Have a plan! Fitness isn’t just exercise. Sleep, diet, stress, and exercise all impact your overall health and fitness. With diabetes, it is important to focus on all of these areas in your life.

Be sure to design your program around sleep. It is important, as an adult, to get 7-9 hours of sleep. Teenagers and children require more sleep. If you encounter a lot of stress or are going through a difficult time, consider including mindfulness, yoga, or tai-chi as part of your program.

In terms of an exercise program, here are some suggestions of what to include in your exercise program to help with diabetes:

Warmup

The warmup should prepare you for your workout. If you are going to run or do high-intensity work, then it is critical to get your heart rate up and increase your body’s temperature to help avoid injury and risk. A proper warmup should adequately prepare your body for the workout you will be performing and should only require 5-10 minutes of your time if done correctly. Dynamic stretches are usually best done before your workout but after the warmup when your muscles are warm and loose.

Balance

Balance refers to maintaining control of your body while remaining in a static (still or fixed) position. Balance poses in yoga include the tree pose, dancer’s pose, and warrior 3. The keyword here is pose, which means a particular way of standing or sitting.

Since diabetic neuropathy can damage nerves in the foot, balance exercises become valuable for people managing diabetes because they help improve your balance and coordination to help prevent falls.

Stability

Stability refers to maintaining control of your body through dynamic (changing) movements or while your body is in motion. The focus here is that we are restricting the body from moving in certain ways during an exercise, such as keeping a knee from hyperextending when performing an exercise. Stability movements include lunge, deadbug, and bird dog exercises.

Mobility

Mobility refers to the joint’s ability to move through a certain range of motion. Joints include the ankle, knee, hip, lower back, upper back, wrist, elbow, and shoulder. Mobility exercises include arm circles, thread the needle, and 3-way ankle mobilization. Diabetes is known to impair mobility, so it is important to include mobility in your exercise program.

Flexibility

Flexibility refers to the ability of a joint or series of joints to move through an unrestricted and pain-free range of motion. Flexibility helps maintain joint and overall body health. Flexibility is important as it helps joints through a full range of movement, prevents muscles from tiring quickly, reduces stress on the body, and reduces the risk of injury. Flexibility is often improved through static and dynamic stretching.

Static (still or fixed) stretching exercises include the figure four stretch, butterfly stretch, and the lying knee to chest stretch. Dynamic (changing) stretch exercises include walking straight-leg kicks, walking knee to chest, and leg swings.

Core

The core set of muscles refers to the central muscles in your body, which include the pelvis, lower back, hips, and stomach. Core exercises are important in a well-rounded fitness program, as stronger core muscles help improve balance and stability. Core exercises include dead bug, breakdancer, and hip dip.

Strength

Strength training or resistance training refers to using some form of resistance to contract muscles within the body to build strength through anaerobic exercise and increase muscle mass. Any exercise that involves push, pull, or lift against an outside force is considered resistance training.

Strength exercises include squats, pushups, and burpees.

Learn more about the benefits of resistance training and managing diabetes:

Mindfulness

Mindfulness refers to the quality or state of being conscious or aware of something. Mindfulness is a term used often in the health industry to help reduce stress by being present and aware of your feelings, thoughts, and sensations the body is experiencing. Mindfulness exercises include exercises that focus on breathing and meditation, which can be experienced through Yoga or Tai Chi.

Cardio

Cardio is an aerobic (with oxygen) exercise that usually lasts more than 30 minutes. Running, brisk walking, cycling/biking, swimming, rowing, dancing, and cardio machines are types of exercises that provide aerobic/cardio benefits. Benefits include losing weight, increasing stamina, increasing your immune system, reducing health risks, strengthening your heart, improving chronic conditions, boosting mood, and increasing life expectancy.

Cool Down

The cool down should be done at the end of your exercise session to help lower the body’s temperature, heart rate, lactic acid, and blood pressure, as well as help regulate blood flow. The cool down should only require 5-10 minutes of your time if done correctly. Static stretches are best done at the end of a workout and can be part of your cool down.

5. Determine Your Equipment Needs

It is important to know what type of equipment you will need and how to determine the specific details of the equipment. Basic equipment to consider includes something to track steps, such as a pedometer, smartwatch, or fitness tracker. Fitness items for the specific workout could include resistance bands, yoga mat, foam roller, blocks, wheels, agility ladder, dumbbells, kettlebells, etc.

Shoes and socks are equally important, especially given the number of steps recommended daily, which is 10,000 steps. Socks should be made from dry-fit material to help keep your feet dry and to help prevent blisters. Shoes should fit properly and be appropriate for where they will be used. This includes what the terrain is like, if they will be used for running, if you experience certain injuries, how flexible you are, and how your feet respond when you walk or run. We recommend starting with Brooks shoes, as they have a 90-day money-back guarantee and provide a system to help you find the right shoes for your needs.

6. Be Prepared

Make sure your blood sugar is in a safe range before exercising, which is over 100 mg/dL (5.6 mmol/L) and under 250 mg/dL (13.9 mmol/L). Make sure you have everything on you in case of an emergency. Be sure to carry any medical cards on you while working out. Have some form of glucose on hand in case your blood sugar gets too low.

7. Choose Activities You Enjoy

Hopefully, you’ve considered who you want to become and what that life may look like. Hopefully, you have identified something you enjoy and can maintain. Remember, your plans should be based around sustainable changes. For example, if you hate to run, then don’t choose running as a way to get into shape.

Once you have decided what you want to do, you need to figure out how to make it happen. If you are social and know that working out in a group setting would motivate you, consider finding some group classes. If being around other people causes stress, look for a home workout program you think you will enjoy that meets your needs and goals.

8. Mix It Up

Don’t do the same thing every day. It is important to become well-rounded. Balance, stability, mobility, flexibility, core, strength, mindfulness, and cardio can be part of your program in many different ways. Mixing things up helps with motivation, prevents plateaus, helps you develop into a more well-rounded athlete, and prevents burnout.

Start small. Make sure that you don’t overdo it. Safety is your main priority. Feel free to start with only steps, or steps and SPA (Spontaneous Physical Activity). You are in no hurry to get into shape. Injuries cause setbacks, so it’s better to go slow and stay healthy than to push yourself and get hurt.

9. Monitor Your Blood Sugar

Exercise causes blood sugar to rise and lower, so it is important to monitor your blood sugar levels. If your blood sugar reaches 70 mg/dL (3.9 mmol/L), consume 15 grams of fast-acting carbohydrates. Then, check your blood sugar every 15 minutes, and do not resume exercise until your blood sugar is over 70 mg/dL (3.9 mmol/L).

10. Listen to Your Body

Stop exercising immediately if you feel shaky, sweaty, dizzy, confused, or light-headed. Find a heart monitor to monitor your heart rate if you have heart concerns. Expect bad days. Not every day will go as planned. This is fine. Take a break and try again tomorrow. Don’t push it, especially regarding weight, balance, and intensity. If anything feels off or different, consider stopping your workout. Contact a doctor if you are concerned. It’s perfectly fine to give your workout another try tomorrow.

Make sure to focus on form when doing an exercise. As you become tired, your form can become bad to the point where injury becomes much more of a risk. If you feel tired and weak, take a break to recover before finishing your workout.

11. Drink Plenty of Water

The Institute of Medicine recommends that men drink around 13 cups (104 oz.) of water and women drink around 9 cups (72 oz.) of water daily. If you want some variety, consider adding lemon juice, lime juice, cucumbers, mint, lavender, or spearmint to your water. Just make sure that you aren’t adding sugars to your water. Drinking plenty of water will help maintain healthy blood sugar levels and reduce unhealthy food cravings throughout the day.

12. Record Your Progress

Recording your progress helps with several aspects of your health. Recording progress provides a feedback tool to help you make adjustments to your program or to help determine safe levels of exertion. It helps with accountability for reaching goals and should help you become more efficient with your workouts.

The Bottom Line

There are many moving parts, but take your time, go slow, and focus on your form. Slow is smooth, and smooth is fast. Get each part right and do it well. Continue to build off what has already been done while you think about where you want to go. Do this, and do it well.