An Exercise Physiologist's Guide to Exercise for Type 2 Diabetes
Your muscles are the biggest sugar sink in your body. Every time they work, they pull glucose out of your blood, and the more muscle you have, the more they can store. That makes exercise one of the most powerful tools for managing type 2 diabetes, alongside medication and diet.
At In Between Performance, our exercise physiology clinic in Darlinghurst, Sydney, we help people with type 2 diabetes and prediabetes use exercise as medicine: the right type, at the right dose, built around their life and their health.
Here's how exercise lowers blood sugar, what the evidence says, and how to get started safely.
How exercise lowers blood sugar
In type 2 diabetes, your body doesn't respond to insulin as well as it should, so glucose stays in your blood instead of moving into your cells. Exercise works around that problem in two ways.
An instant side door. Working muscles can pull glucose out of the blood without needing much insulin at all. That's why blood sugar often drops during and after a session.
A lasting upgrade. After exercise, your muscles stay more sensitive to insulin for a day or more. Train regularly, and that improved sensitivity becomes your new normal.
Strength training adds a third benefit: more muscle means a bigger storage tank for glucose. Think of muscle as a sponge. The bigger and more often you wring it out, the more sugar it can soak up.
What the evidence says about exercise for type 2 diabetes
Structured exercise lowers HbA1c, the three month blood sugar marker your GP tracks, by a clinically meaningful amount. A meta-analysis in JAMA of 47 trials and more than 8,500 people with type 2 diabetes found structured exercise programs cut HbA1c by 0.67 percentage points on average.
Dose mattered. Programs with more than 150 minutes of exercise a week reduced HbA1c by 0.89 points, compared with 0.36 points for 150 minutes or less. Advice to be more active, on its own, made no difference unless it came with dietary advice. The lesson: structure and supervision beat a pamphlet.
Short bursts help too. A 2022 review of seven studies found that light walking breaks during a day of sitting lowered blood glucose by about 17% compared with sitting still. A few minutes of walking after a meal blunts the sugar spike that follows.
The best exercise for type 2 diabetes
The best program combines aerobic exercise and strength training, spread across the week, with more than 150 minutes in total. Here's what that looks like in practice:
Aerobic exercise most days. Walking, cycling, swimming or rowing at a pace that gets you breathing harder. Try not to go more than two days in a row without it, because the insulin-sensitising effect fades.
Strength training two to three times a week. Squats, deadlifts, step-ups, presses and rows, using loads that feel genuinely hard by the last few reps. This builds the muscle that stores glucose.
Move after meals. A 10 to 15 minute walk after your biggest meal is one of the simplest ways to flatten the blood sugar spike.
Break up sitting. Stand up and move for a few minutes every half hour, especially on desk-bound days.
Progress over time. As your fitness improves, sessions get longer, harder or heavier. That progression is where the long-term results come from.
If 150 minutes sounds like a lot, start smaller. Every session counts, and we build up from wherever you are.
How an exercise physiologist in Darlinghurst can help
Accredited Exercise Physiologists (AEPs) are university-trained allied health professionals who prescribe exercise for chronic conditions, and type 2 diabetes is one of the conditions we see most. At In Between Performance, we:
Assess you properly. Your health history, medications, blood sugar patterns, complications, fitness and strength.
Build a program around your life. Aerobic and strength work you can actually fit into your week, at the clinic, at home or both.
Coach and monitor. We teach good technique, monitor your response and adjust for medications and blood sugar.
Track progress. We re-test your fitness and strength and keep your GP updated, so you can see the changes alongside your HbA1c.
Our clinic is in Darlinghurst, an easy trip from Surry Hills, Paddington, Potts Point, Woolloomooloo and the Sydney CBD. If getting in is hard, we also run online sessions and mobile visits across Sydney.
Type 2 diabetes and exercise: FAQs
Can exercise reverse type 2 diabetes?
Exercise, especially combined with weight loss and diet changes, can bring blood sugar back into a healthy range for some people. Whether that's possible for you depends on how long you've had diabetes and other factors. Either way, it improves control and reduces your risk of complications.
Is walking enough?
Walking is a great start, especially after meals. Adding strength training gives you more muscle to store glucose, so a combination works best.
When is the best time to exercise?
The best time is when you'll do it consistently. That said, moving within an hour or so after a meal is particularly effective at lowering the blood sugar spike.
Should I check my blood sugar before exercising?
If you use insulin or medications that can cause hypos, yes. Check before and after, and carry fast acting glucose. Your GP or diabetes educator can give you target ranges.
Do I need a referral, and can I use Medicare?
You can book directly without a referral. If your GP sets up a chronic condition management plan, you may be eligible for Medicare rebates. People with type 2 diabetes can also be referred for an assessment plus up to eight Medicare-subsidised group exercise sessions a year, on top of the individual sessions. Ask your GP whether you're eligible.
Own the in between
Type 2 diabetes is managed day to day, in the hours between appointments and test results. That's where exercise does its work: the walk after dinner, the strength session on a Tuesday, the habit that keeps going when nobody is checking. Build enough muscle and move often enough, and your body becomes better at handling sugar on its own.
If you want a program built around your diabetes, your medications and your life, book an assessment at our Darlinghurst clinic, or ask about online sessions and mobile visits across Sydney.
This article is general information, not medical advice. Speak with your GP or diabetes team before starting a new exercise program, especially if you use insulin or have diabetes complications.
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