"You need to be more active." If you have been diagnosed with type 2 diabetes, or told you are heading that way, you have almost certainly heard that sentence. What you probably have not been given is the dose: how many minutes, what kind, how hard, and how to do it safely alongside your medication. That gap is why so many people nod, go home, and nothing changes.
Here is the good news. The research on exercise and type 2 diabetes is some of the cleanest in all of medicine, it comes with actual numbers, and an exercise physiologist exists precisely to turn those numbers into a programme you can do. This article lays it out.
In this article
How common is type 2 diabetes in Australia?
Very. The Australian Institute of Health and Welfare estimates that 6.5% of adults, about 1.3 million people, had diabetes in 2022–24, and that for every six people already diagnosed there is roughly one more walking around undiagnosed. As at 30 June 2025, more than 1.5 million Australians were registered with the National Diabetes Services Scheme, and 86.6% of them, over 1.3 million people, had type 2 diabetes. The number living with type 2 has nearly tripled in two decades.
On Brisbane's southside that is a lot of people who have been handed a diagnosis, a script and a leaflet. Exercise is one of the three pillars of managing the condition, alongside medication and nutrition, and it is the one most often left to "just do it".
If you would like that pillar built properly, our exercise physiology in Mount Gravatt team works with people with type 2 diabetes every week, often on a GP referral.
What does exercise actually do to blood sugar?
The dose matters most
In the same analysis, structured exercise of more than 150 minutes a week lowered HbA1c by 0.89 points, while 150 minutes or less lowered it by 0.36. Physical activity advice on its own only helped when it was combined with dietary advice.
HbA1c is the three-month average blood glucose measure your GP uses to track how well your diabetes is controlled. A reduction of 0.67 points is in the territory of what some diabetes medications achieve, which is why exercise is described as a treatment in its own right rather than a lifestyle extra. It works because muscle is the body's biggest consumer of glucose: contracting muscle pulls sugar out of the blood without needing as much insulin, and regular training makes muscle more sensitive to insulin for the long term.
Not sure where your programme should start? An exercise physiology consult at ACE Sports Medicine in Upper Mount Gravatt turns the numbers into a plan built around your health, your medication and your week.
What is the dose?
The threshold that keeps appearing is 150 minutes a week. Below it, exercise still helps, but the effect on HbA1c was about a third of a point. Above it, the effect more than doubled to nearly 0.9 of a point. That is the difference between "I walk the dog sometimes" and a structured week: for example, five 30-minute walks or bike rides, or three 40-minute sessions plus a couple of shorter walks after meals.
Two practical points. First, the minutes accumulate: three ten-minute walks count. Second, timing can help: a short walk after your largest meal of the day, when blood glucose is rising, is an easy place to put some of those minutes. The programme should be progressive, starting where you are and building, which is the part an exercise physiologist manages so you do not overdo it in week one and stop in week two.
Aerobic, strength or both?
All three worked in the JAMA analysis. Aerobic training (walking, cycling, swimming) lowered HbA1c by 0.73 points, resistance training (weights, bands, body-weight strength) by 0.57, and combined programmes by 0.51. The current recommendation is to do both, because they help in different ways: aerobic work burns glucose during the session and improves fitness, while strength work builds the muscle that stores and uses glucose around the clock. Strength training also protects against the muscle loss that comes with age, which matters doubly if you are over 60.
A typical supervised week might be two or three strength sessions using bands, machines or free weights, plus walking or cycling on the other days. None of it needs to be heroic. It needs to be regular, progressive and safe.
How do you start safely?
This is where supervision earns its place. Exercise lowers blood glucose, which is the point, but if you take insulin or a sulfonylurea medication, that can tip into hypoglycaemia during or after a session, so you need a plan for timing, monitoring and what to carry. Anyone with reduced sensation in the feet needs the right footwear and a foot check, because you may not feel a blister forming. People with eye complications or heart disease should be screened before starting higher-intensity work. Your exercise physiologist will ask about all of this, liaise with your GP where needed, and choose the starting intensity accordingly.
Exercise sits alongside your medication and your eating plan, never instead of them. The JAMA analysis found that activity advice on its own did not move HbA1c unless dietary advice came with it, which is why we work closely with our sports dietitian in Mount Gravatt for people managing diabetes. Never change a medication dose because you have started exercising without talking to your GP first.
When should you seek help?
If you have type 2 diabetes or prediabetes and your activity is not structured, supervised and progressive, there is room to do better, and a good time to start is now.
Consider getting assessed if
You have been diagnosed with type 2 diabetes or prediabetes and told to be more active without being shown how; your HbA1c is not where your GP wants it; you take insulin or a sulfonylurea and are unsure how to exercise safely; you have reduced feeling in your feet, eye complications or heart disease and want to start; or you have a GP chronic disease management plan that includes exercise physiology. Seek urgent care for chest pain, faintness or a suspected hypoglycaemic episode that does not respond to your usual plan.
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Helping You Perform at Your Best
Our exercise physiology and dietitian team at ACE Sports Medicine in Upper Mount Gravatt helps people across Brisbane's southside turn "be more active" into a programme with a dose, a plan and a safety net. Many people see their numbers move once the exercise is structured. Bring your GP referral if you have one, and your questions either way.