Physical Activity & Type 2 Diabetes – Starting the Conversation
A resource for healthcare heroes
FOR HEALTHCARE PROFESSIONALS
Healthcare providers can transform people’s relationship with movement
Whether it’s daily movement like cleaning the house or structured activities like a cycling class, physical activity (PA) is important for people living with type 2 diabetes (T2D). Regular PA can help improve insulin sensitivity, glycemic management, overall well-being, and reduce the risk of diabetes-related complications.1 These benefits are especially meaningful when managing T2D through behavioral approaches, with or without medication.
Getting started can feel intimidating or isolating. For many, starting a gym membership or high-intensity organized sports may feel unapproachable. Others may have concerns about safely managing blood glucose levels during PA, especially if taking insulin or other glucose-affecting medications. Understanding the barriers people with T2D face can help you tailor these conversations to each person’s unique needs, goals, and circumstances.2-4
Barriers to engaging with physical activity
It’s complicated!
Lack of access to personalized guidance on how to manage T2D during PA can make it hard to get started. Common questions include:
- How can I safely manage blood sugar when different exercises have different effects on blood sugar
- What are the impacts of glucose-lowering medications like insulin or GLP-1s during exercise?
Diabetes stigma.
People are often judged, blamed, or shamed for having T2D, which is known as diabetes stigma. People experiencing diabetes and/or weight stigma are more likely to self-exclude from sports or PA. People with T2D deserve access to safe and judgment-free spaces to participate in sports or other forms of PA.
Physical challenges.
Some people may be navigating physical barriers to participating in PA, such as:
- Living in a larger body size or fitting standard-size exercise equipment
- Living with a diabetes-related complication like peripheral artery disease or vision loss.
- Experiencing pain or a restricted range of motion.
You can help people identify and explore forms of movement that feel good and can be completed comfortably and consistently.
4 ways to start the conversation about movement
Ask permission to discuss movement, physical activity, and weight management.
PA can be a challenging subject for many people to discuss, especially if someone has had past stigmatizing experiences. Additionally, people in larger bodies or who take weight management medications often face added stigmas or assumptions about their health goals and management approach. Ask people for their preferences on when and how to discuss these topics, and tailor the conversation to each individual’s goals.
Try this: “Would you be open to discussing body weight today? I want to hear about your goals and how I can help.” or “It’s important we find some time to discuss movement today. When in the visit would you like to make time for that?”
Explore potential barriers.
The barriers highlighted here are just a few of the many that people with diabetes may experience. If someone is feeling reluctant to discuss PA or having difficulty engaging with exercise regularly, explore potential barriers like stigma, scheduling challenges, access to recreational spaces, or affordability, to name a few.2-4
Try this: “Is there anything else I can help with that has been getting in the way, such as making time or affording a gym membership?”
Personalize every goal and build upon what is working well.
Work with each individual to identify strong sources of motivation and the forms of movement that they enjoy and that easily fit into their daily lives. It can be something as simple as a short walk with the dog each morning or switching to taking the stairs. Then, build from those successes and adapt as needed. Don’t be afraid to get creative about movement!
Try this: “I see you working really hard on getting more steps in during the work day, how can we make that easier?” or “I remember you enjoy gardening, did you know gardening can have similar benefits to exercise?”
Offer additional tools and support.
For many people, their healthcare providers are the only reliable source of information they have to learn about exercise. When possible, help people feel confident in their management skills by equipping them with tools like CGMs for easier glucose monitoring or educational resources about how different activities impact blood glucose levels.
Try this: “Would you like to hear about some more resources that could help make [activity] easier?”
This resource was created for dStigmatize, a diaTribe Foundation program, with support from Novo Nordisk. In collaboration with Dessi Zaharieva PhD, CEP, CDCES (Stanford University) and Chris Bright BSc (Hons), MRes, Honorary Fellow at the University of Worcester (UK) (Breakthrough T1D), together with INSPIRE T1D.
Citations
- American Diabetes Association Professional Practice Committee for Diabetes. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026. Diabetes Care. 2026; 49 (Supplement_1): S89–S131.
- Zhao et al. Barriers and Facilitators to Physical Activity in People With Young-Onset (Aged 18-40 Years) Type 2 Diabetes: A Qualitative Study. J Clin Nurs. 2025;34(6):2386-2399.
- Manallack et al. Associations between weight self-stigma and healthy diet and physical activity among adults with type 2 diabetes: Cross-sectional results from the second Diabetes MILES – Australia (MILES-2) study. Diabet Med. 2025;42(1):e15440.
- Speight et al. Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol. 2024;12(1):61-82.
- Adolfsson et al. ISPAD Clinical Practice Consensus Guidelines 2022: Exercise in children and adolescents with diabetes. Pediatr Diabetes. 2022;23(8):1341-1372.
Photo Credit: Several images from this resource are sourced from the Stop Weight Bias Image Gallery by Obesity Action Canada.