How exercising can help protect heart health in people with diabetes
Regular physical activity is a cornerstone of diabetes management and is consistently supported across clinical guidelines. Even modest increases in movement can lead to clinically significant improvements in cardiometabolic health. Evidence shows that as little as 10 minutes of physical activity per day can improve cardiovascular function, insulin sensitivity, and overall metabolic efficiency. For many patients who feel daunted by structured exercise programs, reframing activity as brief walking periods, light gardening, or other lifestyle‑integrated movement can enhance confidence and adherence.
Why movement matters in diabetes
The link between diabetes and cardiovascular disease is well‑established, with people living with diabetes facing a markedly higher risk of hypertension, dyslipidaemia, atherosclerosis, and heart failure. Because of this elevated cardiometabolic risk profile, supporting patients to move more is critical. Regular physical activity improves endothelial function, enhances nitric oxide availability, reduces arterial stiffness, and supports a favourable lipid profile—all key mechanisms in lowering long‑term cardiovascular disease burden.
Movement also enhances glycaemic control by increasing GLUT‑4–mediated glucose uptake in skeletal muscle, improving insulin sensitivity for up to 24–48 hours after exercise. This makes activity a powerful adjunct to both lifestyle modification and pharmacotherapy.
Aerobic training
Aerobic exercise (cardio) forms the foundation of cardiovascular conditioning and is accessible to most people. These activities rely on efficient cardiopulmonary function and typically raise heart rate, ventilatory demand, and systemic oxygen delivery.
Examples include: walking, cycling, swimming, rowing, and jogging.
Regular aerobic training supports:
- Lower resting heart rate
- Improved blood pressure regulation
- Reduced myocardial workload
- Enhanced tissue oxygenation and nutrient delivery
These adaptations contribute to better functional capacity, improved quality of life, and reduced long‑term cardiometabolic risk.
High‑Intensity Interval Training (HIIT)
HIIT is an efficient and highly effective modality for improving cardiac fitness, insulin sensitivity, and metabolic flexibility. However, due to its higher physiological load, health professionals should advise appropriate screening and ensure suitability, particularly for clients with cardiovascular complications, neuropathy, or musculoskeletal limitations.
Guideline‑based exercise prescription
Current guidelines recommend:
- 150–300 minutes/week of moderate‑intensity aerobic activity, or
- 75–150 minutes/week of vigorous‑intensity activity
The talk/sing test remains a practical clinical tool:
- Can talk → moderate intensity
- Cannot speak in full sentences → vigorous intensity
Reducing sedentary behaviour
For people unwilling or unable to participate in structured exercise, interrupting sedentary time with short movement breaks, standing intervals, or light movement still yields considerable metabolic benefit. Frequent low‑intensity movement reduces post‑prandial glucose excursions, supports musculoskeletal health, and aligns with guideline‑based recommendations to minimise prolonged sitting.
The clinical bottom line
Supporting clients with diabetes to move more, whether through structured exercise, lifestyle‑integrated activity, or reduced sedentary time, provides substantial benefit across glycaemic control, cardiovascular health, emotional wellbeing, and long‑term disease prevention. When combined with tailored medication counselling, physical activity becomes a highly effective and empowering tool in diabetes management.
For further resources including recipes, action plans, and factsheets: Take Diabetes 2 Heart – Diabetes Australia