Exercise and type 2 diabetes: prevention and control
Physical ActivityKey points
- DPP: lifestyle change lowered diabetes risk by 58%, metformin by 31%.
- DPP goals: 150 minutes of activity a week and 7% weight loss.
- ADA: 150 minutes of moderate activity plus strength training 2 to 3 times a week.
- Interrupt sitting every 30 minutes.
What the Diabetes Prevention Program showed
The Diabetes Prevention Program enrolled 3,234 U.S. adults with prediabetes and overweight. The lifestyle group aimed for at least 150 minutes of physical activity a week and a 7% weight loss. Over an average of 2.8 years, lifestyle change lowered the incidence of type 2 diabetes by 58%, compared with 31% for the drug metformin (Knowler et al., 2002). The benefit was seen in all age and ethnic groups and was largest in people 60 and older.
What the ADA recommends
The American Diabetes Association position statement recommends that adults with or at risk of type 2 diabetes (Colberg et al., 2016):
- get 150 minutes or more of moderate-to-vigorous activity a week, spread over at least 3 days, with no more than 2 days in a row without activity;
- do resistance training 2 to 3 times a week;
- interrupt prolonged sitting every 30 minutes with light activity;
- add flexibility and balance training for older adults.
Muscle strengthening matters too: a meta-analysis of cohort studies found that muscle-strengthening activities were linked to a lower risk of type 2 diabetes, cardiovascular disease, cancer and death (Momma et al., 2022).
In practice
- Walk briskly for 30 minutes on 5 days a week.
- Add two strength sessions with bands, weights or body weight.
- Take a short walk after meals.
- Ask your doctor about joining a National Diabetes Prevention Program.
Frequently asked questions
Is the Diabetes Prevention Program available to me?
Yes. The CDC-recognized National Diabetes Prevention Program is offered in person and online across the U.S., and Medicare covers it for eligible beneficiaries.
Does strength training help blood sugar?
Yes. Muscle is a major site of glucose uptake, and resistance training improves glucose control in people with type 2 diabetes.
Sources
- Knowler (Diabetes Prevention Program Research Group) (2002). Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. New England Journal of Medicine 346(6):393-403. doi:10.1056/NEJMoa012512
- Colberg et al. (2016). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 39(11):2065-2079. doi:10.2337/dc16-1728
- Momma et al. (2022). Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. British Journal of Sports Medicine 56(13):755-763. doi:10.1136/bjsports-2021-105061
- Centers for Disease Control and Prevention. National Diabetes Prevention Program. www.cdc.gov
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Physical Activity tools
IPAQ: International Physical Activity Questionnaire (short)
Calculates your MET-minutes per week and your activity level.
QuizDo you meet the Physical Activity Guidelines? Check
Minutes of moderate and vigorous activity per week, plus strength training.
Quiz30-second chair stand test (for adults 60+)
How many times can you stand up from a chair in 30 seconds? Compared with CDC norms.
PDF · TrackerMonthly step tracker
Write down your daily steps and track your progress.
PDF · Log15-minute home strength workout + training log
A no-equipment routine with an 8-week rep log.
PDF · Card + trackerBalance exercises for adults 60+
A safe balance and leg-strength routine with a 4-week tracker.