Finding your way back to movement: Exercise and life with diabetes
We all know that being physically active is good for us. It supports our hearts, strengthens our muscles, helps us sleep and can make everyday life feel a little easier.
But knowing something is good for you doesn’t necessarily make it easy to do.
For people living with diabetes, exercise can involve considerations that others rarely have to think about. Blood glucose might fall during a walk, rise during a demanding workout or change unexpectedly several hours later.
And sometimes, the barriers have very little to do with glucose.
In our household, exercise is one of those subjects we keep coming back to. My partner lives with type 1 diabetes, and while we both understand the importance of staying active, finding a comfortable way to exercise isn’t always straightforward.
Health anxiety can make the physical sensations of exertion — a faster heartbeat, heavier breathing, feeling warm — difficult to distinguish from something more worrying.
It’s a reminder that exercise isn’t always as simple as putting on a pair of trainers and getting started.
So what does being active actually look like when you’re living with diabetes? And how can you find a way to move that feels manageable, rather than overwhelming?
Why movement matters when you have diabetes
Physical activity benefits almost everyone, whether they have diabetes or not.
Regular movement can improve cardiovascular fitness, support muscle and bone health, help manage blood pressure and contribute to better sleep and emotional wellbeing.
For people living with diabetes, it can also influence how the body uses glucose.
When muscles are active, they need energy. They can take up more glucose from the bloodstream, and regular activity can improve the body’s sensitivity to insulin.
This can be beneficial for people with type 1 and type 2 diabetes, although the effects on glucose levels and treatment needs differ.
Exercise can also support long-term cardiovascular health, an important consideration because diabetes is associated with an increased risk of heart disease.
But these benefits aren’t reserved for people who run marathons or spend hours at the gym. Walking, gardening, dancing, cycling, swimming and carrying shopping all count as physical activity. The important thing is finding something you can return to.
Exercise and blood glucose: Why the response isn’t always predictable
One of the more complicated aspects of exercising with diabetes is that different activities can affect blood glucose in different ways.
For someone living with type 1 diabetes, a gentle walk might gradually lower glucose levels, while an intense workout could temporarily send them higher.
This happens partly because different forms of activity place different demands on the body.
Aerobic exercise
Aerobic activities include walking, cycling, swimming and jogging.
During sustained aerobic activity, muscles use glucose for energy. For people taking insulin, this can increase the likelihood of glucose levels falling, particularly when there is active insulin in the body.
The effects can continue after exercise, sometimes increasing the risk of a delayed hypo.
Strength and resistance training
Resistance training involves making muscles work against a load, whether that’s a weight, a resistance band or your own body weight.
Depending on the intensity, this type of exercise can produce a different glucose response.
More demanding resistance sessions may temporarily raise glucose levels because the body releases stress hormones, including adrenaline.
Other sessions may have little immediate effect or contribute to lower glucose levels later.
Higher-intensity exercise
Short bursts of intense activity can also cause glucose levels to rise temporarily. This doesn’t necessarily mean the exercise has been harmful or ineffective. It reflects the body’s response to physical exertion.
The important distinction is that exercise doesn’t always lower blood glucose immediately, and a temporary rise doesn’t automatically mean something has gone wrong.
Understanding these differences can help make glucose patterns feel a little less mysterious.
Why building muscle deserves more attention
When people talk about getting fitter, the conversation often centres on cardiovascular exercise. Running, cycling, swimming and anything that gets the heart pumping tend to receive most of the attention.
But building and maintaining muscle is just as important. Muscles help us move, maintain our balance, support our joints and carry out ordinary daily activities. They’re also an important part of how the body uses and stores glucose.
Resistance training can improve strength and physical function, and regular strength-building activity may contribute to better insulin sensitivity.
And you don’t necessarily need a gym membership or a collection of heavy weights.
Exercises using resistance bands, light dumbbells, body weight or everyday objects can all be useful starting points. Even activities such as carrying shopping, gardening or climbing stairs can help challenge muscles.
For someone who finds sustained cardiovascular exercise intimidating, strength training may offer another way to begin building confidence.
It can be approached gradually, with manageable movements and rest between sets.
Of course, strength exercises still place demands on the cardiovascular system, and some can raise heart rate considerably. The appropriate starting point depends on someone’s health, fitness and any medical restrictions.
But the wider message is encouraging: getting stronger doesn’t have to begin with running or an intense workout.
When exercise feels frightening
There’s another aspect of physical activity that deserves more attention: the way it feels.
Exercise naturally changes the sensations we experience in our bodies. Our heart beats faster. We breathe more deeply. We might sweat, feel warm or notice our muscles becoming tired.
For someone experiencing health anxiety, those sensations can feel unsettling. A racing heart might be interpreted as a warning sign rather than an expected response to exertion.
And when diabetes is part of the picture, there can be an additional layer of uncertainty.
Is that shakiness caused by exercise, anxiety or falling glucose? Is the tiredness ordinary exertion or something that needs attention?
These aren’t always easy questions to answer in the moment. It can be tempting to avoid activity altogether, particularly if previous experiences have been uncomfortable. But avoiding movement indefinitely can make it harder to rebuild fitness and confidence.
The answer isn’t necessarily to push through frightening sensations. Instead, it may help to work with a healthcare professional to establish what’s medically safe, understand which symptoms need attention and develop a gradual approach to activity.
For someone with persistent health anxiety, psychological support, including cognitive behavioural therapy, may also help address the fear surrounding physical sensations.
There’s no requirement to jump straight into an intense fitness programme. Sometimes the first goal is simply becoming comfortable with movement again.
Starting small still counts
The NHS recommends that adults aim for at least 150 minutes of moderate-intensity activity each week, or 75 minutes of vigorous activity, alongside muscle-strengthening activities on at least two days.
Those are useful long-term goals. But they aren’t a minimum threshold you must reach before movement becomes worthwhile.
If you’ve been inactive for some time, a short walk, a few gentle exercises or some time spent gardening can be a perfectly reasonable beginning.
You might gradually increase how often you move, how long you’re active or how challenging the activity feels.
And if you’re managing diabetes alongside other health conditions, it’s sensible to discuss your plans with your healthcare team before starting or increasing exercise.
The aim is to find a level of activity that is appropriate for your circumstances and build from there.
Exercising safely with diabetes
For people using insulin or medications that can cause hypoglycaemia, physical activity may require additional planning.
That doesn’t mean exercise needs to become complicated or intimidating. But having an individual plan can make it safer and more predictable.
Understand your glucose patterns
Checking glucose before, during and after activity can help you learn how different forms of movement affect you. Continuous glucose monitors can be useful for observing trends, although readings may lag behind blood glucose during rapid changes.
There isn’t one glucose number that’s automatically safe for every person and every workout. Your diabetes team can help you understand when it’s appropriate to exercise, when additional carbohydrate may be needed and when activity should be postponed.
High glucose accompanied by ketones can make exercise unsafe, so it’s particularly important to follow your sick-day and ketone guidance.
Keep hypo treatment available
If you’re at risk of hypoglycaemia, carry your usual fast-acting carbohydrate treatment.
It’s also sensible to have your phone available and, where appropriate, make sure someone nearby understands how to help if you experience a hypo.
Remember the hours afterwards
Exercise can affect glucose levels long after the activity has finished. For people using insulin, this may mean an increased risk of delayed hypoglycaemia, including overnight.
Monitoring and any changes to insulin or carbohydrate intake should follow an individual plan agreed with the diabetes team.
Know when to stop
Exercise should be stopped if you develop concerning symptoms, including chest pain, faintness or unusual breathlessness.
Seek urgent medical assessment for symptoms that could indicate a heart problem.
And if you have an established cardiovascular condition, diabetes complications or other health concerns, ask your healthcare team what activities and intensity are appropriate.
Finding an activity you actually enjoy
Perhaps the most overlooked part of exercise advice is enjoyment.
We’re often encouraged to choose the most effective workout, the most efficient routine or the activity that burns the most calories. But an exercise programme isn’t particularly useful if you dread every minute of it.
Some people love running. Others would rather spend an afternoon in the garden. Some enjoy the structure of a gym, while others prefer a quiet walk through the countryside. And some might discover that strength training feels more satisfying than traditional cardio.
There isn’t one correct way to be active.
What matters is finding something that suits your abilities, your health needs and the life you want to live. That might change over time, too.
An activity that feels intimidating today may become more approachable with experience, support and improved confidence. Equally, there’s nothing wrong with discovering that another form of movement suits you better.
A different way to think about progress
It’s easy to measure exercise through numbers. Minutes completed. Steps taken. Weight lifted. Calories burned. Heart rate achieved. And those measurements can be useful. But they’re not the only signs of progress.
Perhaps you can carry the shopping more comfortably. Perhaps climbing the stairs feels easier, or you notice that your balance has improved.
Perhaps you’ve found an activity you look forward to rather than one you feel obliged to complete. Or perhaps you’ve simply started moving again after a long period of finding it difficult.
Those things matter.
Living with diabetes already involves a considerable amount of monitoring, planning and decision-making. Exercise doesn’t need to become another area where perfection is expected. It’s something that can support health, independence and enjoyment throughout life.
And sometimes, the most meaningful starting point isn’t asking how much exercise you should be doing. It’s asking what kind of movement might make you feel a little stronger, more capable and more at home in your body.
This article provides general information and is not a substitute for personalised medical advice. People using insulin or other medications that can cause hypoglycaemia should discuss exercise-related glucose management with their diabetes healthcare team. Anyone with cardiovascular symptoms, relevant diabetes complications or concerns about exercising safely should seek appropriate medical assessment before increasing activity.