Send to

Choose Destination
Sports Med Open. 2019 Jun 3;5(1):20. doi: 10.1186/s40798-019-0192-1.

Resources to Guide Exercise Specialists Managing Adults with Diabetes.

Author information

Chronic Disease and Post Acute Programs, Diagnostic, Emergency and Medical Services, Gold Coast Health, Queensland Health, Robina, Australia.
Metro North Hospital and Health Service, Community, Indigenous and Subacute Service, Diabetes Service, North Lakes Health Precinct, Queensland Health, North Lakes, Australia.
Division Medicine, Gold Coast Health, Queensland Health, Robina, Australia.
Diabetes Centre, Gold Coast University Hospital, Southport, Australia.
Department of Medicine, University of Melbourne, Melbourne, Australia.
Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia.
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, 4072, Australia.


Exercise is an important element to optimize health and well-being, though navigating exercise safely can be challenging for exercise specialists working with people with diabetes. Measuring glucose levels before an exercise session assists in the determination of whether exercise is safe for a person with diabetes. A number of organizations have recently developed guidelines to provide exercise and diabetes recommendations based on glucose levels and other relevant factors. However, there are limited easy-to-use resources to assist exercise specialists to determine whether exercise should be started and continued by people with diabetes. The type of diabetes, pre-exercise glucose level, medications and their timing, recent food intake and general sense of wellness all warrant consideration when determining the approach to each exercise session. An expert group was convened to review the published literature and develop resources to guide exercise specialists in assessing the safety of an adult with diabetes starting exercise, and indications to cease exercise, based upon glucose levels and other factors. Contraindications to people with diabetes starting or continuing exercise are (1) glucose < 4.0 mmol/L; (2) glucose > 15.0 mmol/L with symptoms of weakness/tiredness, or with ketosis; (3) hypoglycaemic event within the previous 24 h that required assistance from another person to treat and (4) feeling unwell. To optimize diabetes and exercise safety, recommendations (stratified by pre-exercise glucose level) are provided regarding carbohydrate ingestion, glucose monitoring and medication adjustment.


Exercise; Glucose level; Hypoglycaemia; Type 1 diabetes; Type 2 diabetes


Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center