Movement for Every Body—Finding Joy in Physical Activity

Physical Activity in Diabetes Surge

Diabetes prevalence in the United States has reached alarming levels, with 40.1 million people—12% of the population—affected in 2023 data, including both diagnosed and undiagnosed cases. This includes sharp disparities by race and ethnicity, with rates as high as 15.7% among American Indian or Alaskan Native adults. Globally, projections point to 853 million cases by 2050, underscoring an accelerating epidemic driven by obesity, aging populations, and sedentary lifestyles.

The American Diabetes Association's Standards of Care in Diabetes—2026 introduced notable updates in December 2025, particularly strengthening recommendations around physical activity. These include urging higher volumes of moderate-to-vigorous aerobic exercise—aiming for at least 60 minutes daily in many cases—combined with resistance training multiple times per week to maintain lean body mass, especially during weight loss from medications or surgery. The guidelines also stress interrupting prolonged sitting every 30 minutes and tailoring activity to prevent hypo- or hyperglycemia.

Physical inactivity now accounts for a substantial share of complications: recent analyses link it to roughly 10% of issues like stroke, retinopathy, and kidney disease among people with diabetes. In contrast, consistent movement enhances insulin sensitivity, lowers blood glucose directly, and cuts cardiovascular risks, with evidence showing even modest increases in activity can yield measurable benefits. This matters acutely as complication rates for kidney failure, lower-extremity amputations, heart failure, and hyperglycemic crises have risen since the early 2010s, reversing prior declines in some areas like myocardial infarction.

A non-obvious tension lies in the balance between aggressive weight-loss targets (now 5-7% of baseline body weight) and the risk of muscle loss during rapid reductions, particularly with newer obesity medications; here, resistance-focused activity becomes critical to avoid sarcopenia while pursuing metabolic gains. Another under-discussed angle is the accessibility challenge: while guidelines promote inclusive approaches, barriers like mobility issues, socioeconomic factors, or lack of enjoyable options persist, potentially widening disparities in outcomes.

The economic stakes are stark: diabetes imposes annual costs exceeding $400 billion in the U.S. alone, covering direct medical expenses and lost productivity. Inaction risks further escalation as prediabetes affects nearly 100 million adults, many of whom could delay or prevent progression through sustained lifestyle changes emphasizing enjoyable movement.