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Diabetes T2 – Reduces risk of diabetic complications

Reduces risk of diabetic complications

Evidence summary

Few studies, and no RCTS, have examined the effect of exercise alone on microvascular complication risk, however given that exercise improves HBA1c and blood pressure, which are two important risk factors for microvascular complication in type 2 diabetes, regular exercise is likely to reduce risk. Cohort studies have shown that greater levels of physical activity and higher cardiorespiratory fitness levels in people with type 2 diabetes are associated with reduced development and progression of retinopathy and nephropathy (Estacio et al., 1998; Holt et al., 2017; Lazarevic et al., 2007; Stratton et al., 2001; John et al., 1994).

Quality of evidence

High quality

Strength of recommendation



Estacio RO, Jeffers BW, Gifford N, Schrier RW. Effect of blood pressure control on diabetic microvascular complications in patients with hypertension and type 2 diabetes.  Diabetes Care. 2000 Apr;23 Suppl 2:B54- 64.

Holt RIG, Cockram C, Flyvbjerg A, Goldstein BJ, Chen MZ, Andrews RC.  Textbook of Diabetes, 5th Edition, Wiley-Blackwell, Chapter 26; 351-371 (2017). ISBN: 978-1-118-91202-7

John L, Rao PS, Kanagasabapathy AS. Rate of progression of albuminuria in type II diabetes. Five-year prospective study from south India.  Diabetes Care. 1994 Aug;17(8):888-90.

Lazarevic G, Antic S, Vlahovic P, Djordjevic V, Zvezdanovic L, Stefanovic V. Effects of aerobic exercise on microalbuminuria and enzymuria in type 2 diabetic patients. Ren Fail. 2007;29(2):199-205.

Stratton IM, Kohner EM, Aldington SJ, Turner RC, Holman RR, Manley SE, Matthews DR. UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia. 2001 Feb;44(2):156-63.