Physical Inactivity Linked To Diabetes Complications Like Stroke, Eye Disease

• A recent study has found that many of the complications associated with diabetes, such as stroke and eye disease, are linked to low levels of physical activity. 
• The researchers suggest that diabetes complications may be preventable with increased activity. 
• The CDC recommends that adults over the age of 18 get at least 150 minutes per week of moderate-intensity activity. 

Physical activity is an important part of overall health. This may be especially true for people with type 2 diabetes. 

A recent study published in the Journal of Sport and Health Science found that a lack of physical activity may drive certain health issues associated with type 2 diabetes. 

“Diabetes complications are often seen as inevitable consequences of the disease,” Jayne Feter, lead author of the study and a medical researcher with the Federal University of Rio Grande do Sul in Brazil, said in a press release. 

“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,” she added. 

Yesika Garcia, MD, board certified endocrinologist, who was not involved in the study, agreed. 

“The study’s conclusions are highly consistent with what we see clinically; a meaningful portion of diabetes complications can be prevented with regular movement. 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. 

10% of diabetes complications linked to sedentary behavior

According to the International Diabetes Federation (IDF), 589 million people had diabetes worldwide in 2024. They predict that this will rise to 853 million by 2050. 

Having diabetes can increase your risk of developing complications, such as: 

• cardiovascular disease
• stroke 
• peripheral artery disease
• chronic kidney disease
• atherosclerosis
• diabetic retinopathy

This recent study pooled data from over 2.3 million people from 27 previous health studies conducted around the world. 

The researchers used this data to track the physical activity levels among people with diabetes, as well as any diabetes-related complications they developed. 

They estimated that up to 10% of these complications could be attributed to physical inactivity. 

Some of the key findings from this research found that physical inactivity accounts for the following, globally:

• 10.2% of strokes
• 9.7% of diabetic retinopathy
• 7.3% of heart failure
• 5% to 7% of coronary heart disease and cardiovascular disease among people with diabetes 

David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study, cautioned against taking these findings as evidence of direct cause and effect. 

“There was great variability of the effect of physical activity depending on ethnicity and geographic location. Physical activity was categorized in a binary (active vs inactive) method of accounting, which is not useful for identifying how much activity is needed to reduce risk,” Cutler told Healthline. 

“The definition of diabetes was variable in different countries. Several confounders were not consistently measured, such as obesity, hypertension, healthcare access, glycemic control, and medication adherence,” he added. 

However, Culter agreed that physical activity is one of the major tools people have to help manage diabetes.  

Garcia noted that physical activity can help manage diabetes in the following ways: 

• Enhances insulin sensitivity: Muscles use glucose more efficiently during and after movement such as walking, jogging, cycling, or swimming.
• Reduces cardiovascular risk: Exercise lowers blood pressure, cholesterol, and inflammation- all factors linked to cardiovascular risk.
• Improves body composition: More muscle mass means better and faster metabolism and greater glucose utilization.

Clinical guideline practices from the Canadian Journal of Diabetes state that moderate to high levels of physical activity are associated with lower morbidity and mortality in people with diabetes. The guidelines also stated that prolonged and habitual sitting is associated with an increased risk of major cardiovascular events and death.  

Feter noted in a press release that their study “reframes physical activity as a core component of diabetes complication prevention.”

“Promoting physical activity among people with diabetes could reduce hospitalizations, disability, and healthcare costs, while improving quality of life,” Feter added. 

How much physical activity do you need? 

The Centers for Disease Control and Prevention (CDC) recommends that adults ages 18 and older get 150 minutes of moderate-intensity activity each week. It also recommends adding two days of strength training activities. 

Examples of moderate-intensity physical activity include: 

• brisk walking
• recreational swimming
• active forms of yoga
• ballroom or line dancing
• general yard work or house repairs
• exercise classes like water aerobics

As a rule of thumb, if you are doing moderate-intensity activity, you should be able to talk but not sing. 

The study considered inactivity as not achieving the goal of 150 minutes of moderate-intensity activity per week. 

“The bottom line is that physical activity is associated with improved outcomes in diabetes because it improves insulin sensitivity, lowers glucose, reduces cardiovascular risk, and enhances overall metabolic health. Exercise is not just supportive therapy; it is core treatment for diabetes,” noted Cutler. 

Physical activity may help improve glucose management and facilitate weight loss. However, even if your weight doesn’t change, it can still have various other benefits, including: 

• increased cardiorespiratory fitness
• increased energy
• improved glycemic control
• improved lipid profile
• decreased insulin resistance
• improved blood pressure

“A powerful message in this research is its message of empowerment. The narrative of “inevitable” diabetes complications is challenged. We now understand that a meaningful portion of complications are modifiable and directly depend on our lifestyle,” stated Garcia.