You may not automatically associate playing video games with fitness. You may think, “Isn’t that how kids waste time when they should be outside getting fresh air and exercise?” Not necessarily. Over the past decade or so, a number of developers have created video games designed to get players of all ages on their feet.

Being active every day is a key part of managing blood glucose, or blood sugar, and reducing the risk for cardiovascular disease. But finding the time and staying motivated can be tricky. Like exercise videos, fitness video games are an excuse-proof exercise because they let you work out in the comfort of your own home. Unlike regular exercise videos, however, video games have sneaky ways to keep you coming back. The value is that there’s an interactivity with the game—so you can win or lose. There’s often competition, either with yourself or a participant. There’s a leaderboard and other reward mechanisms.

Exercise video games, or “exergames,” are highly customized to individual users, thanks to sensors that track a player’s movements. If you complete certain actions, you win points or fun rewards. Don’t like the shirt your onscreen character (or avatar) is wearing? Do a few more leg lifts and you’ll have enough points to choose a new one.

Arguably the best part: Many exergames don’t feel like exercise. These games are designed first and foremost to be fun. Getting the workout is a side effect of playing the game.

Level up

Exergames are an ideal way to break sedentary habits, especially for older adults with diabetes. For people who are inactive, video games can help them burn a lot more energy than they normally do and help establish a baseline fitness level.

And they can be the ticket to satisfying physical activity guidelines. The American Diabetes Association recommends that adults break prolonged sitting streaks every 30 minutes and log at least 150 minutes of moderate-intensity aerobic (when your breathing gets harder, but you’re not out of breath) activity per week.

Researchers use metabolic equivalent of task (MET) to measure the intensity of a given exercise. Any activity measuring between three and six METs is considered moderate intensity. Multiple studies have shown that exergames generally clock in at three METs, and while this may be the lowest level of moderate activity, a study published in BioMed Research International suggests that exergames can help adults meet their physical activity targets.

Kids who are overweight and at risk for prediabetes or type 2 diabetes can also benefit. In a study published in Pediatric Obesity, overweight and obese children who played exergames regularly for 24 weeks lost weight and improved their blood pressure and cholesterol levels. Plus, the kids reported having fun while doing it, which may be why so many of them stuck with the program.

Playing safely

It may all sound like fun and games, but you want to take the same precautions when playing exergames that you would during any other physical activity. That includes accounting for exercise’s ability to lower blood sugar (blood glucose).

Somebody who’s taking insulin will need to cut back or have more carbs when they engage in these games. You should consider it physical activity like any other, where you have to make some adjustments to keep your blood sugar in a healthy range.

Reduce your risk for injury by reading the game’s instructions before you hit start. Most exergames are designed to be played while standing, but you can play from a seated position if you have balance issues or if you have cardiac autonomic neuropathy, a heart-related complication of diabetes that can cause dizziness from too much sudden movement. That’s especially true for virtual reality exergames, which obscure your vision with a headset.

Getting started

Be sure to check with your health care provider before beginning or changing your exercise routine.

To get started, you’ll need a gaming console. They usually range in price from $300 to $500. Electronics stores often have video game demonstrations set up for customers to try.

Once you have a gaming console, pick the individual games. Some are specific to one device, while others work across multiple consoles. No matter which exergame you pick, be sure to exercise safely and talk with your diabetes care team if you have any concerns.