A major new study shows that lack of physical activity is not just a risk factor for type 2 diabetes, it’s a powerful driver of the serious complications that follow. By analyzing data from nearly 2.4 million people across 27 studies worldwide, researchers found that up to one in ten major diabetes complications including strokes, diabetic eye disease (retinopathy), heart failure and other cardiovascular diseases can be attributed to sedentary behaviour rather than the disease itself. This challenges the long-held notion that complications are almost “inevitable” consequences of diabetes and reframes physical activity as a core component of preventing long-term harm. Moderate-to-vigorous exercise such as brisk walking, slow cycling, active yoga or even vigorous tasks like swimming and running can make a measurable difference in risk, and is a manageable target for many people living with diabetes.

      The impact of inactivity isn’t evenly distributed: women and people with lower levels of education consistently showed higher proportions of complications linked to sedentary behaviour, pointing to deep social and gender inequalities in diabetes outcomes. While structured exercise may look different around the world, leisure activity in wealthy countries vs. work-related movement in others the message is clear. Even achievable increases in weekly activity (such as the recommended 150 minutes of moderate exercise) could reduce hospitalisations, disability and healthcare costs, while improving quality of life for millions with diabetes. Governments and health systems are urged to make physical activity a routine part of diabetes care and public health strategies to tackle the global burden of complications.