Staying healthy and active with diabetes means moving more. As you learn what works best for you, keep in mind that exercise and activity can change your blood glucose (sugar) levels. You'll need to monitor your blood glucose levels often and may need to adjust your diabetes medications along the way.

About 30 minutes after exercise begins, most people's blood glucose level rises. Then it begins to fall.

Things that affect your blood glucose level during exercise include:

• Your physical condition or fitness level
• The time of day
• The type of activity or exercise you do
• Your blood glucose level before you begin exercise or activity
• How long and how hard you exercise or are active

Check your blood glucose before, during and after exercise. This lets you know if your blood glucose level is stable, rising or falling, and whether it's safe to keep exercising. Have a carbohydrate drink or snack on hand in case you need to raise your blood glucose.

If your blood glucose was in goal range before exercise and it falls more than 30 to 50 milligrams per deciliter (mg/dL), eat 15 grams of carbohydrate every 30 to 60 minutes while you are active.

It's not safe to start — or continue — exercising when:

• Your blood glucose is 70 mg/dL (3.9 mmol/L) or lower. In this case, immediately eat or drink something with around 15 grams of fast-acting carbohydrate to raise your blood glucose level. Recheck your blood glucose 15 minutes later. If it's still too low, have another 15-gram carbohydrate serving and test again 15 minutes later.

  Repeat as needed to make sure your blood glucose is in goal range before you start the activity or exercise.

• Your blood glucose is 300 mg/dL (16.7 mmol/L) or higher. Wait to exercise or resume activity until your blood glucose is below 300 mg/dL.
• You feel shaky, weak or confused. These are common symptoms of low blood glucose.
• You are ill. Exercising during these times may cause your blood glucose to go even higher.
• You are going to sleep soon. If evening exercise is necessary, you may need to eat an extra carbohydrate serving after exercise to lessen your risk of hypoglycemia while sleeping.

Physical activity that is more than your usual level of daily activity will increase the release of certain hormones. These hormones may cause your blood glucose to rise briefly before the glucose decreases as you continue the activity.

Stop to check your blood glucose during any new, prolonged or strenuous activity or exercise. This is especially important if you:

• Aren't sure how exercise or activity will affect your blood glucose
• Have never exercised or been very active
• Have not exercised or been very active for a long time
• Exercise or are active longer than usual
• Plan to do strenuous physical activity such as running, vigorous swimming or contact sports
• Plan to do several hours of housecleaning, yardwork or gardening

Follow these precautions for exercise if you take insulin medication:

• Avoid injecting insulin into the limbs you will use during exercise. Injecting insulin into your abdomen gives a more predictable insulin absorption and may help lower the risk of low blood glucose during exercise and activity.
• Tell your provider if your blood glucose values drop below your goal range when you exercise. Together, you can create a plan to adjust insulin if needed.
• Schedule exercise safely. Whenever possible, exercise or be more active when your insulin is not peaking.

It's important to wear medical identification that tells others you have diabetes, especially when you exercise or are active. Always talk with your care team before you start new exercises or activities.