Diabetic patients are generally not suitable for exercising on an empty stomach, as it may increase the risk of hypoglycemia. However, some patients with good blood glucose control and no complications may perform mild fasting exercise under medical guidance.
When diabetics exercise on an empty stomach, high insulin levels and insufficient glycogen stores can cause a rapid drop in blood glucose. Typical symptoms include palpitations, sweating, and shivering; in severe cases, confusion or even coma may occur.It is recommended to monitor blood glucose before exercise. If it is below 5.6 mmol/L, first supplement with 15 grams of carbohydrates.
Low-intensity exercises such as brisk walking and Tai Chi are safer, with duration limited to within 30 minutes. Avoid exercising during the early morning cortisol peak.
For patients with long-term stable blood glucose (4–10 mmol/L) and no autonomic neuropathy, fasting exercise may help improve insulin sensitivity. This group needs a personalized plan after medical evaluation and should carry glucose tablets for emergencies during exercise.
Fasting exercise is strictly prohibited for patients with gestational diabetes or those using insulin therapy.
It is recommended that diabetics arrange exercise 1–2 hours after meals, wear breathable shoes and socks to prevent foot injury, and monitor blood glucose before and after exercise.Interval training (e.g., alternating walking and resting) is recommended to avoid prolonged continuous exercise.Carry a diabetes identification card and sugary foods with you, and supplement protein and complex carbohydrates promptly after exercise.Regular exercise tolerance assessments should be performed, adjusting exercise intensity and duration according to blood glucose responses.