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Diabetes and exercise: When to monitor your blood sugar

Exercise is an important part of any diabetes treatment plan. To avoid potential problems, check your blood sugar before, during and after exercise.

By Mayo Clinic staff

Diabetes and exercise go hand in hand, at least when it comes to managing your diabetes. Exercise can help you improve your blood sugar control, as well as boost your overall fitness and reduce your risk of heart disease and nerve damage.

But diabetes and exercise pose unique challenges, too. Remember to track your blood sugar before, during and after exercise. Your records will reveal how your body responds to exercise — and help you prevent potentially dangerous blood sugar fluctuations.

Before exercise: Check your blood sugar before your workout

Before jumping into a fitness program, get your doctor's OK to exercise — especially if you've been inactive. Discuss with your doctor which activities you're contemplating and the best time to exercise, as well as the potential impact of medications on your blood sugar as you become more active.

For the best health benefits, experts recommend 2.5 hours a week of moderately intense physical activities. Examples include fast walking, lap swimming or bicycling. Be sure to check with your doctor to see if these recommendations are safe for you.

If you're taking insulin or medications that can cause low blood sugar (hypoglycemia), test your blood sugar 30 minutes before exercising and once again immediately before exercising. This will help you determine if your blood sugar level is stable, rising or falling and if it's safe to exercise. Consider these general guidelines relative to your blood sugar level — measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).

  • Lower than 100 mg/dL (5.6 mmol/L). Your blood sugar may be too low to exercise safely. Eat a small carbohydrate-containing snack, such as fruit or crackers, before you begin your workout.
  • 100 to 250 mg/dL (5.6 to 13.9 mmol/L). You're good to go. For most people, this is a safe pre-exercise blood sugar range.
  • 250 mg/dL (13.9 mmol/L) or higher. This is a caution zone. To make sure it's safe to exercise, test your urine for ketones — substances made when your body breaks down fat for energy.  Excess ketones indicate that your body doesn't have enough insulin to control your blood sugar. If you exercise when you have a high level of ketones, you risk ketoacidosis — a serious complication of diabetes that needs immediate treatment. Instead, wait to exercise until your urine ketones test kit indicates a low level of ketones in your urine.
  • 300 mg/dL (16.7 mmol/L) or higher. Your blood sugar may be too high to exercise safely, putting you at risk of ketoacidosis. Postpone your workout until your blood sugar drops to a safe pre-exercise range.
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References
  1. Getting started: What should I do to get started on a physical activity routine? American Diabetes Association. http://www.diabetes.org/weightloss-and-exercise/exercise/getting-started.jsp. Accessed Dec. 4, 2008.
  2. Frequently asked questions: Exercise and diabetes. Centers for Disease Control and Prevention. http://www.cdc.gov/diabetes/faq/exercise.htm. Accessed Dec. 4, 2008.
  3. What I need to know about physical activity and diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/physical_ez/index.htm. Accessed Dec. 4, 2008.
  4. Ketoacidosis. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/ketoacidosis.jsp. Accessed Dec. 5, 2008.
  5. 2008 physical activity guidelines for Americans. U.S. Department of Health and Human Services. http://www.health.gov/paguidelines/. Accessed Dec. 4, 2008.
  6. Collazo-Clavell, ML, ed. Mayo Clinic on Managing Diabetes. 2nd ed. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2004:99.
  7. Collazo-Clavell ML (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 16, 2008.

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March 19, 2009

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