Movement as Medicine for People Actively Managing Diabetes
by Dr Paula Diab, PhD, CDCES Diabetologist & Weight Management Specialist
In conversations about diabetes and weight management, exercise is often introduced with a sigh. It can feel like another instruction, another expectation, another thing we are “supposed” to do — often framed around weight loss, calorie burn, or achieving a number on a scale.
The latest obesity guidelines invite us to shift this narrative. They emphasise lifestyle behaviours as the foundation of weight management, not as a punishment or prerequisite, but as a support for long-term health. Importantly, they encourage us to focus on health outcomes rather than chasing a BMI value. This reframing matters — because movement is not only about weight. It is about living well in the body we have today.
If you are able to move, then move — not because you must, but because movement is one of the most powerful tools we have to support physical, mental, and emotional wellbeing.
Movement as medicine — beyond the scale
For people living with diabetes, the physical benefits of regular movement are well established. Exercise improves insulin sensitivity, reduces glycaemic variability, supports cardiovascular health, preserves muscle mass, and helps maintain functional independence as we age. These benefits occur regardless of whether weight changes.
This point is critical. Too often, people abandon exercise because the scale does not respond as expected. But metabolic health can improve dramatically even when body weight remains stable. Blood glucose trends, blood pressure, lipid profiles, energy levels, sleep quality, and physical capacity often improve long before any visible changes occur.
The guidelines remind us that health is not a number. Strength, endurance, balance, mobility, and confidence in one’s body are meaningful outcomes in their own right.
Exercise and weight management — reframing the role
Exercise alone is not a magic solution for weight loss, and presenting it as such sets people up for disappointment. However, when combined with other lifestyle behaviours, movement plays a powerful role in weight maintenance, metabolic regulation, and long-term sustainability.
Regular physical activity helps:
- Preserve lean muscle mass during weight loss
- Prevent weight regain after weight loss
- Improve appetite regulation and body awareness
- Reduce inflammation and cardiometabolic risk
Perhaps most importantly, exercise supports identity change. People begin to see themselves as someone who moves, who is capable, who invests in their health. This shift often has more lasting impact than any number on a chart.
The overlooked benefit: mental health
While the physical benefits of exercise are widely discussed, the mental health effects are just as profound — and often more immediately felt.
Regular movement has been shown to reduce symptoms of anxiety and depression, improve mood, enhance cognitive function, and support better sleep. But beyond the biochemistry, there is something deeply human about movement.
Setting a small goal — walking around the block, attending a class, completing a short strength session — and achieving it builds self-trust. For many people living with chronic conditions, that sense of agency can be transformative.
Exercise also creates space. Space away from screens, from noise, from constant input. It can become a daily pause — a time to breathe, to reflect, to be present in one’s body rather than at war with it.
Movement as contemplation
Many people experience exercise as a time of quiet contemplation. Walking outdoors, swimming, cycling, or even rhythmic indoor movement can create a sense of grounding. It allows us to notice our breath, our surroundings, our capacity.
There is something profoundly healing about gratitude for a body that can move, even imperfectly. For those living with diabetes or obesity, joint pain, neuropathy, or fatigue, movement may look different — slower, gentler, adapted — but it remains meaningful.
Exercise becomes less about control and more about connection: to the body, to the present moment, and to life beyond illness.
What counts as exercise?
One of the biggest barriers to movement is the belief that it must look a certain way. Gym memberships, intense workouts, or structured programmes can feel intimidating or inaccessible.
In reality, movement counts if it moves you. Perhaps a 10-minute walk after meals, doing some work in the garden or playing with your children or grandchildren. Why not dance to some music in the kitchen whilst the kettle boils or try some gentle stretching or chair based exercise before you even start your day?
Consistency matters far more than intensity. The goal is not perfection, but regular engagement.
A challenge
The school my daughter attends, Thomas More College in Durban, South Africa, hosts an annual Long Walk where children of all ages are encouraged to set a personal goal and walk it. The event traces its origins back to an unexpected place. In 1962, President John F. Kennedy came across a forgotten executive order from Theodore Roosevelt stating that U.S. Marine officers should be able to walk 50 miles in 20 hours. Kennedy was struck not by the military aspect, but by the idea of physical readiness as a reflection of national and personal wellbeing. At a time when modern life was becoming increasingly sedentary (and how more sedentary has it become since then?!), he challenged Americans to test their own physical capacity — not to compete, but to rediscover what their bodies were capable of.
Last year, my daughter decided she wanted to do the 35 mile walk. She set her goal and achieved it. She is not a competitive athlete. She doesn’t define herself by sport. But it was a goal she wanted to achieve. Not to prove anything to anyone else, but to herself. It took a great deal of practical, physical and emotional support but she did it. Crossing that finish line was not about endurance alone. It was about discovering that her body, when respected and supported, could do far more than she had imagined. The sense of achievement stayed with her long after the soreness faded.
This year she has set her sights on the full 50 miles.
That, to me, captures the essence of movement as medicine. Not perfection. Not athleticism. Not chasing an ideal body. But the quiet confidence that comes from setting a meaningful goal, showing up, and moving forward — even when it feels hard.
Final thoughts
“If you are able to move, then move” is not a command. It’s not about distance or speed or even competition. It is an invitation to choose to engage with the body you have, supported by those around you, and discover strength you may not yet know is there.
An invitation to honour the body you have today. An invitation to support your physical health without reducing it to numbers. An invitation to experience movement as nourishment — for the body, the mind, and the inner life that often goes unnamed.
Movement does not have to be dramatic to be meaningful. It simply has to be chosen, again and again, with kindness.
And sometimes, the most powerful step is the next one.
6 Simple, practical tips
- Start where you are
The best exercise is the one you will do. Begin with what feels manageable, even if it feels “too easy.” - Attach movement to routine
Walk after meals, stretch while the kettle boils, stand up during phone calls. Habits grow when they fit into real life. - Aim for progress, not comparison
Your movement does not need to resemble anyone else’s. Your body, history, and circumstances are unique. - Include strength, if possible
Muscle is metabolically protective. Even two short strength sessions per week can make a meaningful difference. - Listen to your body, not fear
Some discomfort is normal. Pain is not. Learning the difference builds confidence and trust. - Celebrate non-scale wins
Better glucose trends, improved mood, more energy, better sleep — these are real outcomes.
