Type 2 diabetes: What kind of exercise helps lower risk?

September 30, 2026 6 min read

Physical inactivity is a known risk factor for type 2 diabetes. There are around 40 million people in the United States with some type of diabetes, and type 2 diabetes accounts for around 90% to 95% of all diabetes cases.

Type 2 diabetes can develop if the body does not make enough insulin or if it does not respond to insulin correctly. Overweight, age, and conditions such as prediabetes and metabolic dysfunction-associated steatotic liver disease (MASLD) are also risk factors.

New research published in August in Diabetes, Obesity and Metabolism suggests that moderate-to-vigorous physical activity (MVPA), in particular, could help reduce the risk of type 2 diabetes in adults.

The researchers examined data from almost 88,000 participants in the UK Biobank. They found that individuals in the lower-MVPA group had twice the relative risk of developing type 2 diabetes compared with those in the higher-MVPA group.

The largest relative risk reduction was observed in adults under 63 years of age.

With a hazard ratio of 2.07, lower MVPA volume was associated with almost twice the risk of type 2 diabetes compared with higher MVPA volume.

The higher MVPA group accumulated a median of 409 minutes of exercise per week. The study authors note that all participants in this group met the World Health Organization (WHO)’s guidelines of at least 150 minutes of moderate aerobic activity per week.

The lower MVPA group accumulated a median of 121 minutes of exercise per week. Around 37% of participants in this group reached the WHO’s minimum recommendation of 150 minutes per week.

Opel Baker, MBChB, general practitioner at the Mayfield Clinic, spoke with Medical News Today about the significance of these findings.

“An HR of 2.07 is clinically meaningful. […] Importantly, this is an observational study, so it shows a strong association rather than proving that lower activity directly caused diabetes,” said Baker, who was not involved in the study.

“Nevertheless,” Baker added, “it reinforces something we see in general practice: physical activity is one of the most powerful and accessible tools we have for improving insulin sensitivity and reducing diabetes risk.”

David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, who was also not involved in the study, told MNT:

“An HR of 2.07 doesn’t mean that an individual person’s probability of diabetes literally doubles. It means that the rate of developing diabetes was approximately twice as high in the lower-activity group after adjustment.”

He added, “This data reinforces the message that physical activity isn’t merely a treatment for diabetes — it is an important component of diabetes prevention. This is not new information. Regular exercise improves insulin sensitivity, helps control visceral fat, improves skeletal-muscle glucose uptake, and favorably affects lipid metabolism.”

The study found that the relationship between physical activity levels and type 2 diabetes was stronger among younger adults.

Compared with people who had higher levels of MVPA, those aged 62.7 years or younger with lower levels of MVPA were 2.44 times more likely to develop type 2 diabetes.

Among adults aged 62.7 or older with low MVPA, they were 1.65 times more likely to develop the condition.

‘[O]ne of the most interesting findings in this study is the impact of age on the benefits of moderate-to-vigorous physical activity,” said Cutler.

“At first glance, the lower HR (hazard ratio) in older participants (1.65 vs 2.44 in younger participants) might suggest exercise is less beneficial in the elderly. But those numbers can be misleading. The authors found that, although the relative association became weaker with age, the absolute difference in diabetes incidence became larger with age. That’s an important clinical distinction.”

Baker also spoke with MNTabout these findings.

“What I find particularly interesting is that the relationship wasn’t identical across different age groups. The relative association between lower activity and diabetes risk was stronger in younger participants. […] But that doesn’t mean exercise becomes less important as we age,” he said.

“In fact, the absolute difference in diabetes rates between the more and less active groups became larger with age. It suggests that staying active throughout life may be particularly important because baseline diabetes risk rises with age. It is never too late to become more active,” he added.

The study authors note that higher MVPA volume was associated with a lower risk of type 2 diabetes among people with prediabetes.

Baker said that exercise with prediabetes should be thought of as “management rather than simply prevention.”

He explained that “[e]xercise improves insulin sensitivity, meaning the body becomes better at using glucose. For someone with prediabetes, increasing activity can therefore help bring blood glucose back toward the normal range and reduce progression to type 2 diabetes.”

He added, “The important point is that there isn’t necessarily a completely different exercise prescription for someone with prediabetes. The starting point should be realistic and sustainable, then gradually built up according to the person’s fitness, health, and goals. Strength training is also valuable because maintaining and building muscle helps with glucose disposal.”

The research did not focus on the type of exercise. Instead, it looked at the intensity of the workouts, with greater amounts of moderate to vigorous physical activity generally yielding stronger results.

Cutler advises that, “[f]or diabetes prevention, there is good rationale for combining aerobic exercise (brisk walking, cycling, swimming, jogging, hiking) with resistance exercise (weights, resistance machines, bands, body weight exercises).”

He added that “[r]esistance exercise is particularly interesting because skeletal muscle is a major site of glucose disposal. Increasing or maintaining muscle mass and improving muscle insulin sensitivity can therefore be metabolically important.”

The study authors found that participants in the higher MVPA group had a median of 409 minutes of exercise each week, compared with 121 minutes in the lower MVPA group.

We asked Baker how achievable these numbers are for the average person compared with the WHO’s recommendation of 150 to 300 minutes of moderate aerobic activity per week for optimal health and well-being.

“I wouldn’t want people to look at the 409-minute figure and think they have failed if they aren’t exercising for nearly seven hours a week. That was the median activity level of the higher-MVPA group in this particular study, not a recommended target,” Baker explained.

“The researchers also defined their higher and lower activity groups according to the age-specific median, rather than using 409 minutes as a clinical threshold. For the average adult, 150 minutes of moderate activity a week remains a very sensible and achievable target, alongside muscle-strengthening activity on at least two days.”