Exercise for insulin resistance: what the research shows

Written by INNER G

November is Diabetes Awareness Month in Canada, and World Diabetes Day falls on November 14 (Health Canada, 2026). It's a good time to talk about the condition that usually comes first: insulin resistance.

Insulin resistance means the cells in your muscles, fat and liver don't respond well to insulin, the hormone that helps move sugar out of your blood (NIDDK, 2025). When blood sugar runs higher than normal but not high enough to be called diabetes, that's prediabetes. Most people with insulin resistance or prediabetes have no symptoms, and doctors don't usually test for insulin resistance directly. The tests most people get are blood sugar tests like A1C and fasting glucose (NIDDK, 2025).

The useful part is that exercise works on this directly. When you exercise, your working muscles pull sugar out of the blood through a pathway that doesn't depend on insulin (Kanaley et al., 2022). This post covers what the research says about exercise and insulin resistance, which types of exercise help, how much is enough, and how to start.

Please read first. This post is general information, not medical advice, and it can't tell you whether you have insulin resistance, prediabetes or diabetes. Only blood tests ordered by your health care provider can do that. If you have diabetes, take insulin or take medications that can cause low blood sugar, talk to your doctor before you change your exercise routine, since exercise can lower blood sugar and your doses or timing may need to change (Kanaley et al., 2022).

What the research says about exercise and insulin resistance

The best known study is the Diabetes Prevention Program, a randomized trial of 3,234 people in the United States whose blood sugar was above normal but not yet in the diabetes range (Knowler et al., 2002). People were randomly assigned to a placebo pill, the diabetes drug metformin, or a lifestyle program with two goals: lose at least 7% of body weight and do at least 150 minutes of physical activity a week.

  • Over an average of 2.8 years, the lifestyle program cut new cases of type 2 diabetes by 58% compared with placebo.
  • Metformin cut new cases by 31%. The lifestyle program worked better than the drug.
  • In real numbers: new cases per 100 people per year were 11.0 with placebo, 7.8 with metformin and 4.8 with the lifestyle program.

A Finnish trial of 522 people with impaired glucose tolerance, a form of prediabetes, found the same 58% drop in risk with diet and exercise counselling (Tuomilehto et al., 2001).

Exercise wasn't just riding along with weight loss. A later look at the Diabetes Prevention Program found that people who reached the activity goal but not the weight loss goal still had 44% less diabetes (Kanaley et al., 2022). The American College of Sports Medicine notes that improved insulin sensitivity after any physical activity can last from 2 to 72 hours (Kanaley et al., 2022). That's why the timing of your week matters, which we cover below.

What the big studies found

Switch views to see diabetes prevention in people with higher than normal blood sugar, or HbA1c changes in people who already have type 2 diabetes.

Which types of exercise help

Both cardio and strength training help. In type 2 diabetes, doing both seems to help most.

  • Strength training. A 2023 meta analysis of 27 studies in people with overweight or obesity who didn't have diabetes found that resistance training lowered fasting insulin and HOMA IR, a common research measure of insulin resistance (Boyer et al., 2023). The analysis pooled before and after measurements, so treat the size of the effect with some caution.
  • Cardio and conditioning. In a network meta analysis of 13 studies in people with prediabetes, aerobic exercise, resistance training and both combined all improved insulin resistance and blood sugar, with aerobic training doing best on HbA1c and HOMA IR (Huang et al., 2021). It was a small set of studies, so the ranking between types is not settled.
  • Both together. In people with type 2 diabetes, a network meta analysis of 37 trials with 2,208 people found that supervised cardio and supervised strength training each lowered HbA1c by 0.30 percentage points compared with no exercise, and that combining them lowered it further: 0.17 points more than cardio alone and 0.23 points more than strength alone (Pan et al., 2018).
  • Yoga. Yoga may improve A1C, blood fats and body composition in people with type 2 diabetes, but the American College of Sports Medicine says more studies are needed to confirm it (Kanaley et al., 2022). It's a good addition, not a replacement.

Diabetes Canada's guidelines say that both aerobic and resistance exercise are beneficial and that it's best to do both (Sigal et al., 2018). If you're trying to fit both into one week, see our post on balancing strength training with cardio.

Does coaching make a difference?

It seems to. In a JAMA meta analysis of 47 trials with 8,538 people with type 2 diabetes, structured exercise training lowered HbA1c by 0.67 percentage points compared with control groups. Advice to be more active lowered HbA1c only when it came with diet advice, and activity advice alone was not linked to a change (Umpierre et al., 2011). In the 2018 network meta analysis, supervised cardio lowered HbA1c 0.60 points more than unsupervised cardio (Pan et al., 2018). Diabetes Canada also notes that supervised programs have been especially effective for people with type 2 diabetes (Sigal et al., 2018).

How much exercise is enough?

Diabetes Canada recommends (Sigal et al., 2018):

  1. At least 150 minutes a week of moderate to vigorous aerobic exercise, spread over at least 3 days, with no more than 2 days in a row without exercise.
  2. Resistance exercise at least twice a week, and preferably 3 times, on top of the aerobic work.
  3. Getting up briefly every 20 to 30 minutes when you've been sitting a long time.

The minutes seem to matter. In the JAMA meta analysis, structured exercise of more than 150 minutes a week was linked to an HbA1c drop of 0.89 percentage points, compared with 0.36 points for 150 minutes or less (Umpierre et al., 2011). Smaller amounts still help, just less (Sigal et al., 2018).

The American College of Sports Medicine adds that strength training works well with 8 to 10 exercises for the major muscle groups, 1 to 3 sets of 10 to 15 reps, 2 to 3 days a week but not on back to back days (Kanaley et al., 2022). Because the effect of each session fades within a few days, the "no more than 2 days off in a row" rule is there for a reason.

Plan a week and check it against the guidelines

Tap a day to switch it between rest, cardio or conditioning, strength, or both. Then set how long your cardio sessions are.

Green = cardio or conditioning · Red = strength · Split = both · White = rest

Targets from Diabetes Canada: at least 150 minutes a week of moderate to vigorous aerobic exercise over at least 3 days, no more than 2 days in a row without exercise, and resistance exercise at least twice a week, preferably 3 (Sigal et al., 2018). Strength days not back to back, from the American College of Sports Medicine (Kanaley et al., 2022). The week is treated as repeating, so Sunday runs into Monday. General information, not medical advice.

Break up your sitting

What you do between workouts counts too. A 2022 meta analysis of 7 one day trials found that breaking up long periods of sitting with short, light walks lowered blood sugar and insulin after meals compared with sitting the whole time. Walking breaks worked better than standing breaks (Buffey et al., 2022). The people studied mostly had overweight or obesity, and each trial lasted one day, so we don't yet know the long term effect.

The American College of Sports Medicine also reports that light walking or simple bodyweight exercises for 3 minutes every 30 minutes lowered blood sugar and insulin after meals in people with type 2 diabetes, and that most studies show activity after meals helps blunt blood sugar spikes (Kanaley et al., 2022). A few practical ways to do it:

  • Set a timer to get up every 20 to 30 minutes at your desk.
  • Take a short walk after dinner instead of going straight to the couch.
  • Do a few sit to stands or calf raises during a TV break or a phone call.

Food, sleep and weight

Exercise works best alongside the basics. The Diabetes Prevention Program paired activity with a weight loss goal of at least 7% (Knowler et al., 2002), and NIDDK lists healthy food and drinks, physical activity, managing your weight and getting enough sleep as ways to help prevent or reverse insulin resistance and prediabetes (NIDDK, 2025). Our posts on how much protein to eat, intermittent fasting and sleep and recovery go deeper, and our nutrition coaching can help you build eating habits that fit your week.

How to start safely

  1. Get tested if you're unsure. Ask your doctor whether a blood sugar test makes sense for you. Exercise is worth doing either way, but knowing your numbers helps you track progress.
  2. Talk to your doctor first if you have diabetes, take insulin or medications that can cause low blood sugar, or have heart disease or diabetes complications affecting your eyes, kidneys or nerves.
  3. Start with what you can do this week. A few 10 to 15 minute walks and two short strength sessions is a fine first step. Build toward 150 minutes and 2 to 3 strength days.
  4. Don't take more than 2 days off in a row. Spread your sessions out so the effect of each one carries into the next.
  5. Lift something. Bodyweight, bands, dumbbells or machines all count. Get instruction when you start, which Diabetes Canada also recommends.
  6. Move after meals and break up sitting. Short walks add up.
  7. Keep going. The two big prevention trials followed people for about 3 years, not a few weeks.

Where should you start?

Two quick questions to point you to a starting place.

What sounds most like you right now?
How do you like to train?

This is a training suggestion, not a test for insulin resistance, prediabetes or diabetes. Only blood tests from your health care provider can tell you that. If you have diabetes or take medication that can lower blood sugar, talk to your doctor before changing your exercise.

How we can help

The research keeps pointing to structured, supervised exercise that combines cardio and strength. That's how we run things.

At Inner G, a fitness studio in Concord, our coaches run small group classes in strength, conditioning, mobility, yoga and breathwork, capped at 16 people, so a coach can teach you the lifts, watch your form and scale the work to where you are today. If you'd rather start one on one, a coach can set up a plan designed around your schedule, your experience and any advice from your doctor, and progress it as you get stronger. Our nutrition coaching covers the food side.

We're coaches, not doctors or dietitians, and we don't diagnose or treat insulin resistance or diabetes. We're happy to work alongside your health care team.

Questions? Call (289) 536-8066 or email g-squad@innerg.ca.

References

Boyer W, Toth L, Brenton M, Augé R, Churilla J, Fitzhugh E. (2023). The role of resistance training in influencing insulin resistance among adults living with obesity/overweight without diabetes: a systematic review and meta-analysis. Obesity Research & Clinical Practice, 17(4):279-287. doi:10.1016/j.orcp.2023.06.002. PubMed

Buffey AJ, Herring MP, Langley CK, Donnelly AE, Carson BP. (2022). The acute effects of interrupting prolonged sitting time in adults with standing and light-intensity walking on biomarkers of cardiometabolic health in adults: a systematic review and meta-analysis. Sports Medicine, 52(8):1765-1787. doi:10.1007/s40279-022-01649-4. PubMed · PMC

Health Canada. (2026). Calendar of health promotion days: November, Diabetes Awareness Month and World Diabetes Day. Government of Canada. Canada.ca

Huang L, Fang Y, Tang L. (2021). Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: a network meta-analysis. BMC Endocrine Disorders, 21(1):181. doi:10.1186/s12902-021-00846-y. PubMed · PMC

Kanaley JA, Colberg SR, Corcoran MH, Malin SK, Rodriguez NR, Crespo CJ, Kirwan JP, Zierath JR. (2022). Exercise/physical activity in individuals with type 2 diabetes: a consensus statement from the American College of Sports Medicine. Medicine & Science in Sports & Exercise, 54(2):353-368. doi:10.1249/MSS.0000000000002800. PubMed · PMC

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6):393-403. doi:10.1056/NEJMoa012512. PubMed · PMC

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2025, March). Insulin resistance & prediabetes. National Institutes of Health. niddk.nih.gov

Pan B, Ge L, Xun YQ, Chen YJ, Gao CY, Han X, Zuo LQ, Shan HQ, Yang KH, Ding GW, Tian JH. (2018). Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 15(1):72. doi:10.1186/s12966-018-0703-3. PubMed · PMC

Sigal RJ, Armstrong MJ, Bacon SL, Boulé NG, Dasgupta K, Kenny GP, Riddell MC; Diabetes Canada Clinical Practice Guidelines Expert Committee. (2018). Physical activity and diabetes. Canadian Journal of Diabetes, 42(Suppl 1):S54-S63. doi:10.1016/j.jcjd.2017.10.008. PubMed · Guideline chapter: Diabetes Canada

Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M; Finnish Diabetes Prevention Study Group. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, 344(18):1343-1350. doi:10.1056/NEJM200105033441801. PubMed

Umpierre D, Ribeiro PA, Kramer CK, Leitão CB, Zucatti AT, Azevedo MJ, Gross JL, Ribeiro JP, Schaan BD. (2011). Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA, 305(17):1790-1799. doi:10.1001/jama.2011.576. PubMed

Want a coach to do this with you? See personal training in Vaughan or small group fitness classes.

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