Clinical guidelines on physical activity and exercise therapy for Chinese adults with type 2 diabetes: A clinical practice guideline from the Chinese Society of Endocrinology

Professor Nanwei Tong, corresponding author of the guideline from West China Hospital of Sichuan University, emphasized: "Physical inactivity and sedentary behavior are strongly linked to the onset and progression of T2D. Conversely, increasing physical activity not only reduces the risk of developing the condition but also helps mitigate target-organ damage and mortality while improving overall health outcomes." The clinical guideline was published online on January 12, 2026 in the Journal of Sport and Health Science.

Given that health status in T2D patients varies significantly based on factors such as age, disease duration, complications, and comorbidities, the guideline emphasizes personalized care. It recommends pre-exercise cardiovascular risk assessment and foot screening, alongside individualized exercise prescriptions based on the principles of frequency, intensity, type, and time/duration. Supervision by qualified professionals and the use of wearable devices are encouraged to enhance safety and effectiveness.

All adults with T2D are advised to engage in a minimum of 150–300 minutes of moderate-intensity aerobic exercise per week, or at least 75–150 minutes of vigorous-intensity exercise, or an equivalent combination, totaling at least 450 metabolic equivalent-minutes weekly. For those capable, exceeding these recommendations with moderate-to-high levels of activity and incorporating a variety of exercise forms—including aerobic, resistance, flexibility, and balance training—is encouraged.

The guideline also provides tailored recommendations for specific subgroups, such as older adults, individuals with obesity or pre-obesity, and those with comorbidities like cardiovascular disease, hypertension, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease, and diabetic foot. Personalized, progressive multimodal exercise programs are deemed essential for these populations to optimize health benefits.

As diabetes remains a leading global chronic disease and physical inactivity a major risk factor, this guideline offers a scientific framework for clinicians to develop individualized exercise plans, aiming to improve disease prognosis and quality of life for patients with T2D.

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Reference
DOI: 10.1016/j.jshs.2026.101124