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3 Reasons Why Exercise With Long-term Diabetes Can Be Hard

Advice to exercise regularly usually comes along with a type 2 diabetes diagnosis. For most people, the average goal is to achieve 150 minutes per week of aerobic exercise and strength-building activity. As time goes on, however, diabetes can make exercising harder.

In my experience as a CDCES, I've seen physical activity be a positive game changer for the quality of life across many stages of type 2 diabetes. So let's explore 3 reasons why exercise can be more challenging with diabetes complications and what resources are available to ease into exercise.1

1. Experiencing pain and numbness

Neuropathy, or nerve damage, in the feet and legs, can make exercise harder, with pain, numbness, and tingling being common. Peripheral arterial disease (PAD), narrowed or blocked blood vessels in the legs, can make it difficult for your leg muscles to get enough blood flow, sometimes causing pain with activity.2,3

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PAD may impact the healing of sores or cuts on your legs or feet. On the flip side, not feeling pain is worrisome, too. Numbness in your feet might be a sign of Charcot's foot, in which there is damage to the small bones in your feet, thus changing the shape and function of your foot.2,3

2. Difficulty with balance

Physical activity or movement is difficult if you struggle with balance. Changes to your feet and legs, such as neuropathy, Charcot's foot, or amputations, can make you more unsteady.4,5

Other complications, such as damage to the eyes and ears, can also affect your balance. For example, hearing loss is linked to a higher risk of falls and issues with movement.4,5

3. Issues with blood pressure and heart rate

Neuropathy doesn't just impact sensation. It can impact function. Function refers to how nerves keep the body working well. Functional nerve damage changes your body's performance in sex, digestion, and more activities.3,6Cardiovascular autonomic neuropathy (CAN) refers to damage to nerves that keep blood pressure and heart rate in safe ranges. It's estimated that up to 60 percent of people with type 2 diabetes will develop CAN over their life. With CAN, exercise can be difficult and, depending on the severity, even dangerous.3,6

Resources to help with physical activity

Much like any complication of type 2 diabetes, having a trustworthy care team can make a huge difference!

Physical health specialists

Physical medicine and rehabilitation doctors, physical and occupational therapists, pain clinics/specialists, and neurologists are all influential healthcare professionals that can help you address issues like flexibility, function, movement, and pain. Depending on the specialist, they may use equipment, procedures, movement techniques, or medications.

Mental healthcare

Psychotherapists can help you address the mental, social, and emotional burdens that exercise limitations and diabetes complications can bring.

Cardiovascular providers

A cardiovascular doctor can help you manage cardiovascular autonomic neuropathy symptoms and determine the safest exercise intensity for you.


Podiatrists specializing in orthotics can create supportive equipment for your legs or feet. In some instances, orthopedic surgeons can perform surgery to help repair foot complications.

Vision and hearing specialists

Audiologists and ear, nose, and throat (ENT) doctors can help address hearing issues and concerns. Ophthalmologists and optometrists can help diagnose and address vision issues, including connecting you with low-vision clinics and resources.

Understand the impact of complications

Facing type 2 diabetes complications is not easy. Understanding how they can affect your body and the resources available to help support you can be a game changer in your quality of life!

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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