Does strength training actually help prediabetes, and is lifting weights a better bet than just walking more? The honest answer is that it depends what you’re trying to improve, but yes, resistance training has real, recent evidence behind it, more than most of the generic “move more” advice floating around. A 2024 review of 24 trials and nearly 2,000 adults with prediabetes found it was the single best exercise type for one of the main markers doctors track, though not for all of them.
I’m Charlie Johns, a personal trainer based in Cork. A good number of the people I coach are desk workers in their 30s, 40s and 50s who’ve been told by a GP that their blood sugar is “a bit high” and left to work out what that means on their own. I’m a trainer, not a doctor, so where this calls for your GP rather than me, I’ll say so plainly.
The short answer
- ✓ Resistance training helps. A 2024 network meta-analysis found low- to moderate-load strength training produced the largest improvement in fasting blood glucose of any single exercise type studied.
- ✓ No one exercise wins on everything. A combination of resistance training and moderate aerobic work came out ahead for HbA1c specifically, the marker most GPs actually use to diagnose and track prediabetes.
- ✓ Prediabetes is more common in Ireland than most people think, and the number of cases is projected to keep rising without a national prevention programme.
- ✓ Weight loss matters alongside training. The HSE says losing 5 to 7% of body weight can significantly help prevent progression to type 2 diabetes.
- ✓ Check with your GP first if you already have a diagnosis, an existing heart condition, or haven't exercised in years.
What prediabetes actually is, and why it’s worth taking seriously
Prediabetes means your blood glucose is higher than normal but not yet high enough to be classed as type 2 diabetes. The HSE diagnoses it with a simple HbA1c blood test: below 42 mmol/mol is normal, 42 to 47 is prediabetes, and 48 or above is type 2 diabetes. Most people with it have no symptoms at all. Blood glucose creeps up gradually, which is exactly why it tends to be picked up on a routine blood test rather than something you’d notice yourself.
It’s worth taking seriously because it rarely stays still. An HSE-commissioned study projected that the number of adults over 40 with prediabetes in Ireland would rise from around 192,000 in 2020 to roughly 303,000 by 2036, with type 2 diabetes cases in the same group projected to roughly double, from 216,000 to 414,000, over the same period. Ireland doesn’t currently have a national prevention programme targeting prediabetes, though a pilot linked to the new GP contract is planned. Left alone, the condition tends to get worse with time rather than resolve itself, which is the opposite of what most people assume about a borderline result.
The HSE’s main risk factors are worth knowing: being over 45, having a close relative with diabetes, carrying excess weight, a history of gestational diabetes, doing less than 30 minutes of activity on 5 days a week, high blood pressure or cholesterol, and a handful of other conditions including PCOS. None of those are something you did wrong. Most are also things training and lifestyle changes can genuinely move.
Why muscle is where blood sugar control starts
Here’s the mechanism most “eat less sugar” advice skips entirely. Skeletal muscle is where your body clears the majority of glucose from your bloodstream once insulin signals it to do so. More muscle, and muscle that’s more responsive to insulin, means more glucose gets taken up and used rather than left circulating. Resistance training improves exactly that: it makes muscle tissue more sensitive to insulin and better at pulling glucose out of the blood, particularly when the training targets large muscle groups like the glutes and quads, the same muscles that do the most work in a basic strength session for your bones.
This is the same underlying mechanism that shows up in other conditions I write about, including the insulin resistance that drives a lot of PCOS symptoms. The details differ by condition, but the principle holds: muscle isn’t just about how you look. It’s one of the biggest levers you have over how your body handles blood sugar day to day.
What the evidence actually shows
I’d rather give you the honest, slightly messier picture than a tidy “lift weights and you’re sorted” headline. A 2024 network meta-analysis published in Frontiers in Endocrinology, covering 24 randomised trials and 1,946 adults with prediabetes across seven different exercise approaches, found no single winner across every measure.
For fasting blood glucose, low- to moderate-load resistance training came out clearly on top, lowering it by an average of 0.48 mmol/L more than no exercise. For HbA1c, the marker most GPs actually use, a combination of moderate-intensity aerobic exercise and low- to moderate-load resistance training ranked highest, lowering it by 0.30%. For blood glucose two hours after a meal, vigorous aerobic exercise ranked best. The reviewers rated the overall evidence quality as moderate and recommend interpreting the numbers conservatively, and HIIT wasn’t analysed as its own category. Their conclusion, and mine: resistance training and moderate aerobic work both help, and doing both beats picking one and hoping.
A sensible starting plan
You don’t need a complicated split to put this into practice. A full-body strength session two or three times a week, built around the large muscle groups, covers the resistance training side well, and pairing it with regular walking or another moderate aerobic activity covers the rest.
| Exercise | Sets x reps | Coaching note |
|---|---|---|
| Goblet squat | 3 x 8 to 10 | Targets the quads and glutes, two of the biggest glucose-using muscle groups in the body. |
| Seated or band row | 3 x 10 to 12 | Squeeze your shoulder blades together at the end of each pull. |
| Romanian deadlift | 3 x 8 to 10 | Push your hips back with soft knees. Worth learning the hip hinge properly before adding weight. |
| Dumbbell shoulder press | 3 x 8 to 10 | Seated or standing. Brace your stomach rather than leaning back. |
| Brisk walk | 20 to 30 minutes | On your non-lifting days. Counts toward the HSE's activity guidance and supports the aerobic side of blood sugar control. |
If weight is part of what’s driving your numbers, it’s worth knowing that losing 5 to 7% of body weight is what the HSE flags as significant for preventing progression to type 2 diabetes. Structured fat loss and strength training aren’t separate projects, they work together, which is part of why I built the Office Worker’s 5kg Guarantee around exactly this combination for desk-based clients.
How heavy, how often
For the strength sessions, pick a weight where the last couple of reps of each set feel genuinely hard while your technique stays clean. That’s the same advice I’d give anyone starting out, whether you’re managing prediabetes or just getting back into training after a long break, and my guide to overcoming gym anxiety as a beginner covers the nerves that come with starting from scratch.
Two to three strength sessions a week is a realistic, well-supported starting point. If you’re unsure how that fits around a working week, how often you should go to the gym breaks frequency down by experience level. Progress with blood markers tends to be steady rather than dramatic, usually measured in months rather than weeks, and my guide to how long it takes to see results from personal training sets out fair expectations rather than overnight promises.
When to see your GP first
The plan above suits most people starting out with a prediabetes diagnosis or known risk factors. Speak to your GP first if any of these apply to you.
None of this rules training out. It usually just means starting with your GP’s input and building a plan around what they tell you, rather than skipping that step.
The bigger picture
Prediabetes gets treated as a footnote on a blood test result, a number to glance at and forget. It’s more useful to treat it as the point where lifestyle changes do the most good, before anything progresses further. The evidence doesn’t point to one miracle exercise, it points to resistance training and moderate aerobic activity working together, built around a plan you can actually stick to for months rather than weeks.
If you’d like help building that plan, I’m a personal trainer based in Cork, coaching at Phenom Gym in Ballintemple and Resolution Fitness in Douglas. Most clients in this position do well on a PT membership, which pairs coached strength sessions with programming that adapts as your numbers improve, or the Office Worker’s 5kg Guarantee if weight loss is the bigger part of the picture for you. If you’re outside Cork, online coaching follows the same approach remotely. My guides on what a personal trainer costs in Cork and how to choose one will help if you’re still comparing options.
When you’re ready, book your free 60-minute personal training session and consultation. We’ll talk through what your GP has said, what your week actually looks like, and build a plan around both the training and the numbers you’re trying to move. No pressure, no sales pitch.
Frequently asked questions
Does strength training help prediabetes?
Yes. A 2024 network meta-analysis of 24 trials and 1,946 adults with prediabetes found low- to moderate-load resistance training produced the biggest improvement in fasting blood glucose of any single exercise type studied. It wasn't the best option for every marker, HbA1c responded best to a combination of resistance training and moderate aerobic work, but strength training is clearly part of a well-supported answer, not a guess.
What's the best exercise for prediabetes, cardio or weights?
A combination, based on the current evidence. The 2024 Frontiers in Endocrinology review found low- to moderate-load resistance training ranked highest for fasting glucose on its own, while a mix of moderate aerobic exercise and resistance training ranked highest for HbA1c, and vigorous aerobic work ranked highest for post-meal glucose. No single modality won on every measure, which is why the review's authors recommend combining resistance and aerobic training rather than picking one.
Can prediabetes be reversed through exercise alone?
For many people, yes, especially when exercise is paired with the other changes the HSE recommends: losing 5 to 7% of body weight if you're carrying excess, eating more fibre, and reducing long periods of sitting. Results vary by individual, and some people will need their GP's input alongside lifestyle changes, particularly if other health conditions are involved. Regular monitoring with your GP is the HSE's standard advice either way.
How common is prediabetes in Ireland?
More common than most people realise, and rising. An HSE-commissioned study projected the number of adults over 40 with pre-diabetes would grow from around 192,000 in 2020 to roughly 303,000 by 2036 without a national prevention programme, and Ireland doesn't yet have one, though a pilot linked to the new GP contract is planned. Type 2 diabetes cases in the same age group are projected to roughly double over the same period.
How often should I strength train if I have prediabetes?
Two to three sessions a week targeting the large muscle groups, such as the legs and glutes, is a sensible starting point, alongside the HSE's general activity guidance of building up toward regular movement most days and cutting down on long stretches of sitting. Consistency over months matters more than training hard for a week or two and stopping.
When should I see a GP about prediabetes?
See your GP for a check if you have risk factors such as being over 45, carrying excess weight, a close relative with diabetes, or very low activity levels, since a simple HbA1c blood test confirms it either way. If you already have a prediabetes diagnosis, the HSE recommends annual monitoring, and you should also check with your GP before starting a new exercise routine if you have an existing heart condition or haven't been active in years.