Study after study has confirmed that regular exercise, combined with modest weight loss and a healthy diet, can lower type 2 diabetes risk and improve outcomes once people have the disease. In one of the most persuasive, researchers from the Diabetes Prevention Program Research Group concluded that diet and regular exercise were more effective than one of the most widely prescribed drug treatments for preventing type 2 diabetes

Yet, only 39% of surveyed adults with diabetes engaged in regular physical activity, compared with 58% of adults who did not have the disease, according to a report in the February issue of Diabetes Care. And activity levels declined as risk factors for type 2 diabetes increased.

It's not surprising to find that those with diabetes were more sedentary than the general public, but it's particularly troubling to see so few at-risk people were physically active. It's difficult to be optimistic about addressing the twin epidemics of obesity and diabetes. The best way to prevent type 2 diabetes is to prevent obesity, but it is really hard to exercise once you are obese.