Physical activity

Studies have shown that physical activity can delay the progression of prediabetes to Type 2 diabetes, when combined with dietary changes. Regular physical activity significantly improves glycaemic control. In addition, it improves cardiovascular risk factors (cholesterol and blood pressure) and may reduce medication dosages, including insulin.

Regular physical activity may also improve symptoms of depression and improve health-related quality of life.

A recommendation of 150 minutes per week of moderate-intensity aerobic physical activity is given, with the aim of achieving and maintaining a heart rate that is 50 – 70% of the maximum heart rate. To determine your maximum heart rate, minus your age from 220.

Resistance training

In the absence of contraindications (back or neck problems), you should aim to do resistance training three times per week. Resistance exercise increases strength and vigour, reduces body fat, and increases resting metabolic rate. 

The studies reporting the greatest impact of resistance exercise on HbA1C had subjects progress to three sets (with approximately eight repetitions per set) of resistance type exercises at moderate to high intensity (the maximum weight that can be lifted eight times while maintaining proper form).

If you wish to begin resistance exercise, you should seek initial instruction and periodic supervision by a qualified exercise specialist (biokineticist) where possible, to maximise benefits while minimising risk of injury. Not unexpectedly, studies have shown that resistance exercise with less supervision reported less beneficial impact on glycaemic control, insulin resistance and body composition than with greater supervision.


Walking is often the most popular and feasible type of aerobic exercise. For those who struggle with pain upon walking for any reason, semi-recumbent cycling may provide an alternative. Moderate brisk walking on level ground or semi-recumbent cycling would be an example of moderate aerobic exercise, while brisk walking up an incline or jogging would be vigorous aerobic exercise. 

Also try to increase the number of activities of daily living, such as housework, gardening and walking around shopping centres. Ideally reduce sedentary time, particularly in the workday, by breaking up extended amounts of time spent sitting. Every hour or hour and a half move around for a few minutes.

Hypoglycaemia during exercise

Physical activity can cause hypoglycaemia in some individuals. 

If your blood glucose tends to drop with exercise, consume some carbohydrates before starting to exercise. The exact amount needed will vary widely between people and can vary depending on the type of exercise, time of day and even the ambient temperature. Work with your doctor or DE to calculate what amount of carbohydrate works for you. 

A useful rule of thumb is to add 250ml fruit juice to 250ml water and sip frequently during the training session. This is for a session of longer than 45 minutes. However, an individualised approach is usually needed. You shouldn’t exercise vigorously if the blood glucose level is > 15mmol/L as this can cause damage to your muscles. 

Having social support (exercising with a friend, partner or in group classes) facilitates and aids in motivating regular physical activity.

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