Evidence summary (Updated 2022)

Structured programmes incorporating aerobic, resistance or combination of exercise can reduce HBA1c by up to 0.9% [1]. Regular exercise can therefore reduce need for or dose of medications in the treatment of type 2 diabetes.
Studies have found that in people with type 2 diabetes, regular exercise can reduce dependence on glucose-lowering oral medications and insulin (2).One study suggested physical activity may be associated with better glycemic control in individuals with T2DM who are not taking Metformin compared to those taking Metformin and physical activity. [2]. It is also important to note that exercise in patients taking glucose lowering medication(s) can increase risk of hypoglycemic events.

Quality of Evidence
Grade C – Low Quality

Strength of recommendation
Grade 1 – Strong recommendation

Conclusion
Recent evidence has found that a regular structured exercise programme including aerobic and resistance exercise can reduce the dependence on glucose-lowering oral medications and the use of insulin. It is also important to note that exercise can increase the risk of hypoglycaemic events in those taking glucose-lowering medications.

References:
[1] Umpierre D, Ribeiro PA, Kramer CK, Leitão CB, Zucatti AT, Azevedo MJ, Gross JL, Ribeiro JP, Schaan BD. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011 May 4;305(17):1790-9
[2] Abdalhk D, Riddell M, Swayze S, Kuk J: Association between Metformin and physical activity with glucose control in adults with type 2 Diabetes. Endocrinology, Diabetes & Metabolism. (Oct 2020). DOI: 10.1002/edm2.206