A recent study in the Journal of Sport and Health Science found that low levels of physical activity are linked to many complications of type 2 diabetes, including stroke and eye disease. The researchers pooled data from more than 2.3 million people across 27 prior studies worldwide and estimated that up to 10% of diabetes complications could be attributed to physical inactivity.
“Diabetes complications are often seen as inevitable consequences of the disease,” said Jayne Feter, the study’s lead author at the Federal University of Rio Grande do Sul in Brazil. “Our findings challenge this idea by showing that a meaningful proportion of these complications could be prevented through achievable increases in physical activity among people living with diabetes.”
Yesika Garcia, MD, a board-certified endocrinologist not involved in the study, said the conclusions align with clinical experience: regular movement can prevent a meaningful portion of complications. “As an endocrinologist, I increasingly prescribe physical activity the same way we prescribe medications because of the huge impact exercise has on quality of life,” Garcia told Healthline.
Global context and caution
The International Diabetes Federation reported 589 million people with diabetes in 2024 and projects 853 million by 2050. Having diabetes raises the risk of complications such as cardiovascular disease, stroke, kidney disease, and diabetic retinopathy. The new analysis links a sizable share of these outcomes to inactivity but does not prove direct causation for every case.
David Cutler, MD, a family medicine physician, urged caution in interpreting the findings. He noted variability in effects by ethnicity and location, binary activity categorization (active vs. inactive), and inconsistent measurement of confounders like obesity, hypertension, healthcare access, glycemic control, and medication adherence. Still, he agreed that physical activity remains a major tool for diabetes management.
How activity helps
Garcia highlighted mechanisms by which exercise benefits people with diabetes:
– Enhances insulin sensitivity: muscles use glucose more efficiently during and after activity.
– Reduces cardiovascular risk: exercise lowers blood pressure, cholesterol, and inflammation.
– Improves body composition: increased muscle mass boosts metabolism and glucose use.
Clinical guidelines from sources including the Canadian Journal of Diabetes associate moderate to high physical activity with lower morbidity and mortality in people with diabetes and note that prolonged sitting increases cardiovascular risk and death.
Practical guidance
The U.S. Centers for Disease Control and Prevention recommends adults age 18 and older get at least 150 minutes per week of moderate-intensity activity, plus two days of strength training. Moderate activities include brisk walking, recreational swimming, active yoga, dancing, yard work, and water aerobics. A simple rule: during moderate activity you should be able to talk but not sing.
The study defined inactivity as not meeting the 150-minute-per-week moderate-intensity goal. Beyond weight loss, regular activity can increase cardiorespiratory fitness and energy, improve glycemic control and lipid profiles, decrease insulin resistance, and lower blood pressure.
Implications
Feter said the findings “reframe physical activity as a core component of diabetes complication prevention,” and noted that promoting activity among people with diabetes could reduce hospitalizations, disability, and healthcare costs while improving quality of life. Garcia emphasized the empowering message: a meaningful portion of diabetes complications are modifiable and directly influenced by lifestyle.
