PRO-FORM Physiotherapy

Exercising with Diabetes

Diabetes & Exercise

Did you know?
  • 8 million Australians have diabetes (approx. 30% are undiagnosed)
  • 280 Australians develop diabetes every day (1 person every 5 minutes)
  • It is the fastest growing chronic condition in Australia
What is Diabetes?

Diabetes Mellitus is a metabolic disease which is characterised by an increased fasting blood glucose level due to insufficient ability to use or secrete insulin. There are two types:

  • Type 1 (T1DM)
    • In T1DM the cells in the pancreas which produce insulin are destroyed by the body’s immune system. Insulin is essential in the body’s uptake of glucose (sugar) and transformation to energy. Without this process glucose accumulate sin the blood stream and can damage to body’s organs. The onset of T1DM typically occurs in individuals under 30 but can occur at any age. About 10-15% of individuals with diabetes account for Type 1. Management requires daily injections of insulin to control blood glucose levels.
  • Type 2 (T2DM)
    • In T2DM the pancreas has the ability to produce insulin, except the body’s cells don’t respond effectively to the insulin and is unable to uptake the blood glucoses with conversion to energy. This causes a build-up of glucose in the blood due to insulin resistance. The onset commonly effects older adults although prevalence in younger people is increasing. T2DM affects 85-90% of individuals with diabetes. The management of T2DM includes healthy eating and regular physical activity. Some induvial may need this accompanied with medication and insulin injections.

Risk factors of T2DM:

  • Physical inactivity
  • High blood pressure
  • Increased waist circumference
  • Obesity
  • Family History of T2DM
  • Poor Dietary habits

Although there is a genetic pre-disposition to the occurrence, exercise can assist decreasing risk factors.

How does exercise assist individuals with diabetes?

Exercise plays a vital role in the management of diabetes. Exercise and increasing physical activity levels can help you reduce the risk of T2DM by 60%. Exercises assist the process in which muscles respond to insulin which in turn assist regulate blood glucose levels for hours post exercise (up to 24). Exercise increases the glucose uptake by muscles, with physical activity having the ability to decrease the dose of insulin required by improving the body’s response to insulin. Although there are considerations when exercising with diabetes.

  • Check blood glucose levels prior to exercise
  • Avoid injecting insulin into exercising limbs
  • Foot check prior, supportive shoes
  • Regulated temperature

There are many benefits which will assist individuals with diabetes including:

  • Decreases blood glucose levels and increases sensitivity to insulin
  • Decrease waist circumference
  • Decrease the risk of CVD
    • Decrease BP and cholesterol
  • Maintain/increase strength
  • Improve bone density
  • Optimise heart and lung function
  • Improve functional capacity and independence
  • Improve mental health and wellbeing
What type of exercise is best?

The ACSM Guidelines recognise both aerobic and resistance type training or a combination of both are ideal. In the tables below are the recommended with the type being adaptable to what is enjoyed by you.

Considerations for exercise?
  • Check your BSL before and after!


Safe to Exercise Exercise with Caution Delay Exercise
Type 1 Diabetes 6-15mmol/L >15mmol/L – no ketones and feeling well >15mmol/L –with ketones present
Type 2 Diabetes 6-15mmol/L >15mmol/L –feeling well >15mmol/L –feeling unwell


  • Begin short and slow, with a gradual increase.
  • Drink plenty of fluids before, during and after.
  • Avoid Valsalva Manoeuvre (holding your breath) as this can cause large changes in blood pressure.
What are my next steps?

Seek professional help before starting. Gain advice from your GP to ensure your BGLs are under control, and you are fit to begin exercise. Seek out a Clinical Exercise Physiologist to guide you and get your routine started.



About diabetes – Diabetes Australia. (2021). Retrieved 5 October 2021, from
American College of Sports Medicine, et al. ACSM’s Guidelines for Exercise Testing and Prescription. Tenth edition. Philadelphia: Wolters Kluwer, 2018.
Diabetes NSW & ACT – Homepage. (2021). Retrieved 4 October 2021, from