Combining a ketogenic diet with exercise is a powerful way to reduce blood glucose levels and achieve weight loss.

Some people may be concerned that a ketogenic diet and exercise may be incompatible, however, this is far from being the case as we will investigate in this guide.

We will also look into the important topic of safety when exercising on a ketogenic diet which applies if you are ion any diabetes medications that can cause hypos.

How the body copes with exercise on little carbohydrate

For years, the world’s leading exercise and diet science institutes have advocated consuming a high level of carbohydrate prior to exercise.

However, modern research is showing that a very-low-carbohydrate ketogenic diet can unlock your body’s capability to tap into your own storage fat for energy.

A great benefit of this is that this source of energy is almost inexhaustible, as each of us are carrying tens of thousands of calories as body fat.

Famous athletes, like Chris Froome , and other endurance athletes, have been able to excel in their sport thanks to a low-carbohydrate diet.

Exercise at the start of a ketogenic diet

In the first weeks on a ketogenic diet, you may find you need to go easy on the exercise until your body has adapted to the diet. This reportedly takes around two to four weeks.

After you’ve become ‘keto-adapted’, you should be able to step the exercise up.

Is this style of eating in combination to exercise an easy transition?

It is important to keep in mind that both a ketogenic diet and exercise can be effective for lowering blood glucose levels

Therefore, if you are currently on hypo-causing medication, you should speak with your health team about how to manage exercise on a ketogenic diet.

Benefits of exercise and keto on diabetes and heart health

Combining exercise with a ketogenic diet can be useful in terms of controlling blood sugar levels, reducing insulin resistance and losing weight.

The ketogenic diet is designed to burn body fat and adding exercise on top can help to accelerate the process.

The benefits of going low carb or ketogenic don’t stop at fat loss or better glucose control. Following a ketogenic diet and exercising can also help maintain balanced cholesterol levels , especially higher levels of protective HDL cholesterol.

Whilst ketogenic diets are these days acknowledged as being beneficial, there is currently a lack of research studies examining just how beneficial the combination of exercise on a ketogenic diet is.

Exercise and keto when on insulin or other hypo causing medication

If you are on insulin , or other hypo causing medication, the advice is usually to take carbohydrate before exercise to prevent hypos occurring.

However, on a ketogenic diet, you’re meant to limit carbohydrate intake which can present a question of what is best to do.

If you’re able to plan exercise in advance, then you may be able to reduce your medication prior to exercise.

If you’re on an insulin pump , this gives you the advantage of being able to reduce your insulin just before exercise.

Note that some forms of activity involving sprinting or upper body exercise can initially increase sugar levels. If you know you get this effect, then you may find you don’t need to take carbohydrate or reduce your medication before exercise.

If you have been following a ketogenic diet for long enough to become keto-adapted (typically two to four weeks), you may find your body is able to largely run on ketones rather than glucose and therefore you may have a lower risk of hypos during and following exercise.

If weight loss is not a primary goal, then having carbohydrate around exercise should not be such an issue and is worthy of consideration if you are going low during or after exercise.


People on diabetes medication that can cause hypos need to be careful in monitoring their sugar levels around exercise, when on a ketogenic diet, to prevent hypos from occurring.

Note that exercise can increase insulin sensitivity for up to 72 hours which can increase the risk of hypos within this period.

The blood glucose lowering effect of exercise may be more significant if you are exercising longer or harder than usual, or if you’re getting back into exercise after a break of several days.

Exercise on insulin and hypo causing medication is a complicated topic with a number of factors to consider. For individual advice, discuss your goals and precautions to take with your diabetes health team.

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