[Lifestyle: physical activity and training in the prevention and treatment of type 2 diabetes mellitus (Update 2026)].

Lifestyle, particularly regular physical activity, is known to be an important component in the prevention and treatment of type 2 diabetes mellitus and should be an integral component of the care of people with diabetes. There is broad consensus that an efficient prevention and treatment of diabetes in most cases must also be accompanied by a modification of the lifestyle. The aims of promoting physical activity are initially the training of the cardiovascular system, strengthening the musculature, increasing the energy turnover and the reduction of inactivity. To gain substantial health benefits a minimum of 150 min of moderate or 75 min of vigorous intense aerobic physical activity and additionally muscle strengthening activities per week are necessary. The extent of the positive effect of activity is directly proportional to the degree of cardiorespiratory fitness achieved and can only be maintained by appropriate training. Physical training is effective in all age groups and for both sexes. By reducing the insulin resistance and functional improvement of insulin secretion, physical training has a positive influence on glycemia and the cardiovascular risk is also reduced. Additionally, inactivity per se should be recognized as a risk factor, independent of the construct of the physical activity. In particular, prolonged episodes of sitting should be avoided.