Thomas, 54 years old, had just been diagnosed with type 2 diabetes. His doctor advised him to get more exercise, but Thomas didn’t know where to start. Too much exercise? Not enough? And what happens to his blood sugar when he exercises? Many people with diabetes feel this uncertainty. Yet physical activity is one of the most effective components of any diabetes treatment—as long as you understand a few basic things.
This magazin explains why exercise and sports are so important for people with diabetes, how physical activity affects blood sugar levels, and what people with type 1 and type 2 diabetes should pay special attention to when exercising.
Why is exercise a cornerstone of diabetes treatment?
The German Society for Diabetology is unequivocal: In addition to diet and medication, physical activity is considered a central pillar of any diabetes treatment.
The reason lies in physiology: Muscles that are moving absorb glucose directly from the blood, largely independent of insulin. This means that even a single workout can significantly lower blood sugar and improve the body’s cells’ sensitivity to insulin. Regular exercise is therefore not just a supportive measure, but a fundamental treatment.
Effects on the Entire Body
The positive effects of regular physical activity on people with diabetes are many and varied:
- Lowering blood sugar levels and improving glucose tolerance
- Improved HbA1c Level—The Long-Term Blood Sugar Level as a Measure of Diabetes Control
- Beneficial Effects on Blood Pressure and Blood Lipid Levels
- Protection of the cardiovascular system, which is particularly important because cardiovascular diseases are common in people with diabetes
- Weight Loss and Reduction of Belly Fat
- Reduced insulin requirements due to improved insulin sensitivity
- A Noticeable Improvement in Quality of Life
Exercise as a Preventive Measure: Preventing Diabetes Before It Develops
This also applies to people with an increased risk of diabetes , the following applies: Regular exercise can help prevent the onset of type 2 diabetes or prevent it altogether. A sedentary lifestyle, on the other hand, is considered one of the biggest risk factors. Studies show that people who engage in at least 150 minutes of moderate exercise per week can reduce their risk of developing the disease by up to 58 percent
What happens to blood sugar levels during exercise?
To exercise safely and effectively, it is important to understand how physical activity affects blood sugar levels. The effects depend on the type, intensity, and duration of the activity, as well as whether a person Type 1 or Type 2 diabetes .
Endurance Training: Blood Sugar Drops—Often Even Afterward
Endurance sports such as jogging, cycling, or swimming generally lead to a steady drop in blood sugar. The working muscles consume glucose directly from the blood, the pancreas releases less insulin, and the body becomes more sensitive to the insulin already present. This positive effect lasts for hours after the workout—a phenomenon that experts refer to as the “afterburn effect.”
A typical guideline: If you start jogging with a blood sugar level of 8.0 mmol/l (equivalent to about 144 mg/dl), you can expect to see levels around 5.5 mmol/l (about 100 mg/dl) after 45 minutes, provided your diet and insulin dose are appropriate.
Strength Training and Sprints: When Blood Sugar Rises Temporarily
In strength training or short, intense sprints, the body reacts differently: Stress hormones such as adrenaline and cortisol are released, the liver releases glucose into the bloodstream, and blood sugar levels may rise temporarily. This rise is physiologically normal and no cause for concern. In the long term, strength training is also extremely beneficial for people with diabetes: It increases muscle mass, improves insulin sensitivity, and helps maintain a healthy body weight over the long term.
Type 2 Diabetes and Exercise: Physical Activity as Part of Basic Treatment
For people with type 2 diabetes , physical activity is often so effective that insulin requirements are significantly reduced or medication regimens can be adjusted. The combination of exercise and dietary changes forms the foundation of type 2 diabetes treatment before further therapeutic measures become necessary.
Which sports are particularly suitable for people with type 2 diabetes?
In general, all sports are suitable. The key is consistency and gradually increasing the intensity of your exercise. The following are especially recommended:
- Brisk walking or Nordic walking: gentle on the joints, very effective for the cardiovascular system
- Cycling (including on an exercise bike): easy on the joints, can be adjusted to your fitness level
- Swimming and water aerobics: ideal for people who are overweight or have joint problems
- Strength training: improves insulin sensitivity and increases basal metabolic rate
- Dancing, yoga, qigong: promote coordination, balance, and quality of life
The choice of sport should fit into your daily routine and be enjoyable, because only then will exercise become a permanent part of your life. As Marianne, 61, puts it: “I started dancing because I never enjoyed jogging. My HbA1c level improved by almost one percentage point in a year, and now I look forward to every class in the evening.”
Increasing Physical Activity: Start Slowly, Stick with It Consistently
If you haven't been very active for a long time, you should increase the intensity gradually. A tried-and-true rule of thumb: Start with 10 to 15 minutes a day and increase by 5 minutes every two weeks. The goal is 150 minutes of moderate physical activity per week, spread over at least three days.
Important: Discuss your exercise program with your doctor or diabetes specialist, especially if you have other health conditions, such as cardiovascular disease.
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Type 1 Diabetes and Sports: Planning for Greater Freedom
For people with type 1 diabetes, exercise is also an important part of life, but it requires a little more planning and monitoring. Since the pancreas does not produce its own insulin, the amount of insulin must be carefully adjusted before, during, and after exercise.
The Risk of Low Blood Sugar During Exercise
The greatest risk for people with type 1 diabetes when exercising is hypoglycemia. It occurs when blood sugar drops too low due to physical activity while there is still too much insulin in the blood. Typical signs include trembling, sweating, a racing heart, and difficulty concentrating. People with type 1 diabetes who exercise should always carry fast-acting carbohydrates with them, such as glucose tablets, fruit juice, or special energy gels.
Strategies for People with Type 1 Diabetes When Exercising
These measures help people with type 1 diabetesstay active safely:
- Check your blood sugar before your workout
- Be sure to check the insulin dose
- Adjust your carbohydrate intake: Plan for additional carbohydrates depending on the intensity
- Check your blood sugar again after exercising: Your blood sugar level may still drop even 8–12 hours later
- Training partner or companion: It's a good idea to have a companion when trying new sports or during long workouts
Klaus, who has had type 1 diabetes since he was 17, is running a marathon today: “I’ve learned to listen to my body. Every workout is a little journey of discovery, but it’s worth it. I feel fitter than ever, and my endocrinologist is thrilled with how well I’m managing my diabetes.”
Cardiovascular System: Special Attention for People with Type 1
People with type 1 diabetes have an increased risk of cardiovascular disease, especially if they have had the condition for a long time. Regular exercise actively protects the cardiovascular system: it lowers blood pressure, improves blood lipid levels, and strengthens the heart. Before starting an intensive exercise program, it is advisable to undergo a checkup with an internist, especially if you have been relatively inactive in your daily life.
Practical Tips for Getting More Exercise in Your Daily Life
Physical activity doesn't always have to be exercise in the traditional sense. Everyday activities also count and have measurable effects on blood sugar. People with diabetes who lead more active lifestyles benefit just as much as those who exercise regularly.
Small Steps, Big Impact
- Stairs Instead of an Elevator: Every Floor Counts
- Walk short distances or ride a bike
- Take a 10–15-minute walk after a meal: This has been shown to lower postprandial blood sugar
- Take breaks to stand up when sitting for long periods: Stand up briefly every 30 minutes
- Gardening, cleaning, playing actively with children or grandchildren: It’s all part of daily exercise
Take Advantage of Diabetes Education and Structured Exercise Programs
Many health insurance companies offer structured diabetes education and exercise programs specifically tailored to people with diabetes. These programs not only provide theoretical knowledge about the relationship between exercise and diabetes, but also offer practical guidance on how to get started with more physical activity.
Conclusion: Exercise is therapy—start today
Exercise for people with diabetes is not just an option—it is an essential part of treatment for both people with type 2 diabetes and those with type 1 diabetes. The positive effects on blood sugar, HbA1c levels, blood pressure, blood lipid levels, body weight, and the cardiovascular system have been impressively demonstrated by scientific evidence. What’s more, exercise noticeably improves quality of life.
As Thomas from our opening example says today: “I started small, with a walk after dinner. Now I jog three times a week, and my endocrinologist has already reduced my insulin dose twice. I never would have thought it would make such a difference.”
Talk to your doctor or diabetes specialist about a personalized exercise program. Because whether it’s jogging, strength training, dancing, or walking, the first step is the most important one—and it’s worth it.
Note: This magazin is not a substitute for individual medical advice. Please always discuss any changes to your exercise routine or treatment plan with your doctor or endocrinologist.
