Anyone can develop type 2 diabetes, including athletes. However, as regular exercise is one of the main ways to help prevent this form of diabetes, athletes will likely have a lower risk.

Despite this, there is no guarantee that people who frequently engage in exercise will not develop the condition. It is also important to note that although exercise is an important part of type 2 diabetes prevention treatment, it involves some risks for people with the condition. Alongside injuries, these include episodes of low or high blood sugar.

This article discusses the risks that individuals with type 2 diabetes encounter when exercising. It also examines the link between exercise and insulin.

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The National Institutes of Health (NIH) state that type 2 diabetes is the most common type of diabetes. Diabetes is a condition in which blood glucose, or sugar, is too high. Glucose is the body’s main source of energy, and it comes primarily from the diet.

The pancreas makes insulin, which is a hormone that enables glucose in the blood to enter cells and serve as a source of energy. When a person has type 2 diabetes, their body either makes insufficient insulin or does not use the insulin effectively. Consequently, glucose in the blood increases, and an inadequate amount gets into cells.

The NIH adds that the below factors increase the likelihood of developing type 2 diabetes:

Learn more about type 2 diabetes.

Exercise poses certain risks for athletes with type 2 diabetes, even though it is a key part of treatment and management. The same exercise-related risks also affect less athletic people with diabetes. These risks include:

Hypoglycemia

People who take insulin injections or oral medications that stimulate the release of insulin in the body are at risk of exercise-induced hypoglycemia, or low blood sugar. This can happen immediately, or it can occur after a delay. The symptoms of hypoglycemia include lightheadedness, sweating, and weakness.

Hyperglycemia

Another risk is hyperglycemia, or high blood sugar. This can happen when people have diabetes that is not under optimal control. When they engage in intense exercise, the blood sugar can rise too much.

Injury

Despite its benefits, exercise does put people at higher risk of injury. For example, a foot injury can happen when running.

Adverse health effects related to complications

Individuals with complications of diabetes have a higher risk of encountering adverse health effects during exercise. They should check with a doctor what precautions to take. Depending on the complication, these could involve avoiding:

  • strenuous activity
  • heavy lifting
  • high impact activity
  • exercising in extreme cold or heat

According to the Centers for Disease Control and Prevention (DCD), 37 million people in the United States have diabetes. Of these individuals, 90–95% have the type 2 variety. Although type 2 diabetes most often affects individuals over the age of 45 years, it can appear in those of any age.

The symptoms of type 2 diabetes in athletes are the same as those in other individuals. They usually develop slowly over several years and may include:

  • increased thirst and urination
  • tiredness
  • increased hunger
  • sores that do not heal
  • blurred vision
  • numbness or tingling in the hands or feet
  • unexplained weight loss

The NIH recommends the following to manage type 2 diabetes:

  • eating nutritious, well-balanced meals
  • limiting calorie intake to the amount the body needs
  • getting regular exercise
  • regulating blood pressure and cholesterol at optimal levels
  • quitting smoking

As stress is a factor that can make diabetes management more difficult, relaxation and getting enough sleep may also help.

In some cases, medications might also be necessary. The options include medications that people take by mouth and those that they inject under the skin, such as insulin.

Evidence indicates that insulin levels decrease during exercise and increase after exercise.

Exercise increases the body’s demand for glucose. During exercise, the body suppresses insulin secretion so that the liver can release more glucose for energy. The cells require more glucose during exercise, which means that glucose levels in the blood usually decrease slightly, but not to the point of hypoglycemia.

After exercise, insulin levels rise, which stimulates the storage of excess glucose that is in the blood. People with diabetes who do not need to take insulin generally do not have significant episodes of hypoglycemia or hyperglycemia during exercise.

In contrast, people who are dependent on insulin have a higher risk of both. This is due to the presence of insulin that has come from outside the body and the more significant abnormalities in glucose control.

The NIH advises the below measures for type 2 diabetes prevention:

  • Reach a moderate weight: In people with overweight or obesity, the loss of 5–7% of body weight can help prevent the condition. To illustrate, an individual who weighs 200 pounds (lb) could set a goal of losing 10–14 lb.
  • Get regular exercise: Experts recommend engaging in a minimum of 30 minutes of physical activity on at least 5 days of the week.
  • Eat a healthy diet: It is important to choose nutritious foods that are low in fat to help with weight control. Having smaller portions is another way to reduce calorie intake and facilitate weight management.

Uncontrolled blood sugar can lead to an array of complications, including:

  • heart disease and stroke
  • kidney disease
  • eye disease
  • nerve damage
  • gum disease and dental problems
  • foot problems
  • bladder and sexual problems

Exercise offers multiple benefits for people with type 2 diabetes, including increased blood sugar control. However, there are special considerations involved. A person should ask a doctor for advice on:

  • the best types of exercise for them
  • how to prepare
  • what to avoid

The CDC advises people with diabetes to take certain precautions when exercising. These include:

  • drinking plenty of fluids to avoid dehydration
  • wearing cotton socks and properly fitted, comfortable athletic shoes
  • checking the feet for blisters, cuts, sores, and irritation after an exercise session
  • speaking with a doctor about any injuries that do not start healing after 2 days

Check blood sugar before exercising

A person should check their blood sugar before exercising, particularly if they take insulin. If their blood sugar is below 100 milligrams/deciliter (mg/dl), eating a small snack that contains 15–30 grams of carbohydrates may be necessary. This will help prevent blood sugar from getting too low during exercise.

Examples of such snacks include half a cup of fruit juice or 2 tablespoons of raisins. After exercising, a person should check their blood glucose again.

Conversely, if blood sugar is above 240 mg/dl, it may not be safe to exercise. An individual should test the urine for ketones, which the body makes when it breaks down fat.

Elevated ketone levels indicate that someone does not have enough insulin to get glucose out of the blood and into the cells. When cells do not have enough glucose, they break down fat for energy. If people with high ketones exercise, they have a risk of ketoacidosis, a serious diabetes complication that requires immediate treatment.

Anyone can develop type 2 diabetes, including athletes.

Although exercise is an important prevention measure, body weight and the quality of a person’s diet also play a role. Additionally, some nonmodifiable factors, such as a family history of diabetes, may increase the risk.

An individual with type 2 diabetes has a higher likelihood of experiencing adverse effects from exercise than someone who does not have the condition.

Due to the risks involved, people with type 2 diabetes should follow extra precautions when exercising, such as checking their blood glucose before and after a workout and taking any necessary steps to modify it.