Diabetes is complex. Don't rely on advice from the "experts" at your local gym. (HEALTH/ISTOCKPHOTO)

Exercise is safe—and highly recommended—for most people with type 2 diabetes, including those with complications. It's an important tool that will help you lower blood sugar (along with diet and medication) and lose weight if you need to do so.

However, check with your health-care provider before starting an exercise program. There are some type 2 diabetes complications, such as heart disease, retinopathy, and neuropathy, that may require fine-tuning of your exercise program.

"A few precautions would allow almost anyone with diabetes to exercise," says Gerald Bernstein, MD, director of the diabetes management program at the Gerald J. Friedman Diabetes Institute at Beth Israel Medical Center in New York City. You should always get approval from your doctor, he adds, and you may also need to take a stress test before starting an exercise program.
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Don't rely on the "experts" at the local gym for advice on what is safe, says Jacqueline Shahar, a certified diabetes educator and manager of the exercise physiology department at the Joslin Diabetes Center in Boston.

"Club managers who don't know about diabetes complications are probably not able to advise you on what is safe for any complications you might have," she says. "Your risk, depending on complications, can include bleeding from the eye, increases in high blood pressure, falling (because the nerves in your feet may be numb), and wounds that could become infected if your socks and shoes don't fit well and feel comfortable."

"I definitely recommend to meet with a certified diabetes educator to get an activity plan that is tailored to your diabetes complications or other medical issues you may have," Shahar adds.

She recommends the following:

  1. Wear your medical identification or other ID.
  2. Always carry food or glucose tablets so that you'll be ready to treat hypoglycemia (low blood sugar is more common if you are taking insulin or certain oral medications).
  3. Carry your glucose meter with you and check your blood glucose before and after you exercise. If you'll be exercising for more than an hour, check your blood glucose at regular intervals during your workout. You may need snacks before you finish. You should also be sure to check after you finish, as hypoglycemia can occur up to five hours after exercise.
  4. Be sure to wear socks and sneakers that are comfortable and fit well to help prevent foot irritation. And after you exercise, check your feet for blisters, sores, and cuts. Left unattended, foot irritations can lead to a serious infection.
  5. Drink plenty of fluids during your exercise regimen; dehydration can cause your blood sugar levels to rise.