Last Updated:February 09, 2026, 14:28 IST

‘Eat less, exercise more’ sounds logical but it often fails people with Type 2 diabetes. Dr Gagandeep Singh explains why insulin resistance requires smarter strategies for reversal

Type 2 diabetes, can be reversed in many patients but only when we stop offering motivational clichés and start offering science-backed, biologically aligned solutions.

Every doctor has said it. Every patient has heard it: “Eat less, exercise more.” It sounds logical, almost unchallengeable. But after years of treating patients with Type 2 diabetes, Dr Gagandeep Singh, MBBS, Founder, Redial Clinic | Specialist in Reversing Diabetes, Hypertension, Obesity & PCOS without Medication is unequivocal, “It is one of the most well-intentioned yet harmful pieces of advice in modern medicine.”

Not because diet and exercise don’t matter they absolutely do but because this oversimplified prescription ignores the metabolic reality of what is actually happening inside a diabetic patient’s body.

The Problem Isn’t Laziness It’s Biology

Type 2 diabetes is not a discipline problem. As Dr Singh explains, it is a complex metabolic dysfunction involving insulin resistance, fatty liver infiltration, and impaired beta-cell function. “When you tell a patient with significant insulin resistance to simply eat less,” he says, “you’re asking their body to run on less fuel while their cells are already starving for glucose they can’t absorb efficiently.”

The predictable outcome is compensatory hunger, fatigue, and eventual relapse. Calorie restriction without metabolic context, Dr Singh notes, is like asking someone to drive farther with a leaking fuel tank. “You haven’t fixed the leak, you’ve only reduced the supply.”

Why Generic Exercise Advice Backfires

“Exercise more” is equally incomplete advice. According to Dr Singh, a patient who starts walking for 30 minutes a day is certainly doing something positive but walking alone rarely changes insulin sensitivity in a meaningful way. “Muscle is metabolically active tissue,” he explains. “It acts as a glucose sink, pulling sugar out of the bloodstream even at rest.”

Yet most patients are never guided to prioritise resistance training. Instead, they are told to “be more active,” which often translates to moderate cardio that barely moves the metabolic needle. Worse still, crash diets combined with excessive cardio can lead to the loss of lean muscle mass, the very tissue required to reverse insulin resistance.

“The scale may go down,” Dr. Singh cautions, “but metabolic health often worsens underneath.”

What Actually Works

After more than twelve years of practising intermittent fasting himself and implementing structured metabolic protocols with hundreds of patients, Dr. Singh has found that success does not come from simpler advice, but from smarter systems.

“Body recomposition matters far more than weight loss,” he explains. Losing visceral fat while preserving or building lean muscle leads to far more durable metabolic improvement than chasing a number on the scale. Time-restricted eating typically 14 to 16-hour fasting windows combined with adequate protein intake of 25 to 30 grams per meal, improves insulin sensitivity far more reliably than calorie counting ever does.

Most importantly, reversal requires coordination. As Dr Singh emphasises, effective outcomes come from a system where a physician adjusts medications in real time, a nutritionist customises meal plans around the patient’s lifestyle, and a fitness professional builds progressive resistance training habits. “This is the model that succeeds,” he says, “where ‘eat less, exercise more’ fails every time.”

The Real Failure

The failure, Dr Singh stresses, is not the patient’s. It is the medical system’s reliance on oversimplified slogans for a deeply complex metabolic disease. “Patients aren’t lacking willpower,” he says. “They’re lacking a protocol that respects the biology of their condition.”

Type 2 diabetes, Dr Singh concludes, can be reversed in many patients but only when we stop offering motivational clichés and start offering science-backed, biologically aligned solutions.

NHS guidelines encourage adults aged 19-64 to complete two-and-a-half hours of exercise per week, or a bit less if it’s more intense, alongside a couple of “strengthening activities”. But exercising at 19 tends to feel very different to exercising at 64.

Not only do your social, work and family commitments mount up as you advance through life, but your ability to recover from intense exercise also reduces. Yet the benefits of exercise, and strength training in particular, become more valuable the older you get for injury prevention, freedom of movement, and heart health.

Patrick James, head coach at Marchon Victoria gym, understands this better than most. Despite more than a decade of experience working as a coach, he counts persuading his mum to lift weights as one of his top achievements to date.

“She’s 67, and always felt that if she walked regularly and did the gardening, she didn’t need to do it,” he says. “But if you want to walk up the stairs and get out of a chair in 10 years’ time, you need to strengthen your legs.”

It started with a simple twice-weekly bodyweight circuit; kneeling press-ups off the sofa, squatting to a chair, rows with a weight in the garden and single-leg hip thrusts. Now she is the proud owner of three different kettlebells and completes four or more home workouts each week.

“She can feel the benefits of it now – that rush of endorphins, feeling healthier and feeling stronger,” James says.

Those aged 50 and up can experience similar results sans gym, with just a couple of weekly workouts, he adds. This approach maximises the juice-to-squeeze ratio of your exercise efforts.

Here are his tips on how to maximise your workout.

Tip 1: Consider your exercise choice

“In your younger years, you can afford to train poorly and get away with it,” James says. “As you get older, moving towards your 50s, 60s and 70s, you can’t. Whether through hormones or your body’s ability to synthesise protein, the rate at which your body can adapt and recover from exercise slows down.”

But this doesn’t mean you should stop exercising – quite the opposite. James’s solution is to box smart.

“I can’t train my 65-year-old client the same way a bodybuilder in their 20s trains,” he explains. “He might have played rugby back in the day and now he has very little cartilage in his knees, so it hurts to do a heavy back squat, so I have to find an exercise or variation that allows him to train the same muscles without it being painful.”

For example, instead of heavy barbell squats, James might prescribe goblet squats to a box, reducing the range of motion to one that is comfortable for the client.

Tip 2: Lift lighter weights for more repetitions

Lowering the weight you’re lifting and the number of repetitions you’re lifting it for can reduce pressure on certain joints and minimise discomfort during strength training workouts.

“Heavier strength training – lifting a heavy weight for five repetitions or less – will put a bit more pressure through the joints,” James says. “You can get a similar stimulus for building muscle and maintaining strength from lifting lighter weights for 10-20 reps.”

For example, you might substitute the five sets of five heavy barbell squats mentioned above for three sets of 10-20 goblet squats to a box.

“The intensity will be a little bit lower, but you’ll still get a great stimulus to develop muscle and build a stronger body,” says James. “And for most people, the joints will feel better through doing some strength training, if they build it up gradually.”

The key is to start with lighter weights and exercises with smaller ranges of motion, then progress over time.

Tip 3: Challenge yourself

There does have to be an element of challenge in a strength training exercise to ensure it’s effective for building strength and muscle, James says.

“We don’t need to be training to failure [the point where your muscles are too tired to complete another repetition] on every set, as someone in our 50s or 60s,” he explains. “We just want to make sure the sets we do are somewhat challenging so we can create a good stimulus for muscle growth. If we can do that consistently, then, over time, we are going to get stronger.”

Take a “little and often” approach and aim to hit major muscle groups in the legs, glutes, back, chest and shoulders twice a week.

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Tip 4: Embrace the full-body workout to maximise efficiency

Rather than focusing on a single muscle each session, James recommends doing full-body workouts two or three times per week.

“For building muscle, we know that one set done three times per week is better than three sets done once per week,” he explains, adding that the more you work a certain muscle and movement pattern on any given day, the more it will take out of you. The quality of the exercise will also decrease as you tire, leading to diminishing returns.

By spreading each muscle’s workload through the week, you can keep your body feeling fairly fresh and ready for the rigours of daily life – as well as your next workout.

Tip 5: Get your priorities straight

Six to 10 sets per week for each major muscle group should be sufficient to build muscle for most people, James says. If you want to focus on developing a certain area, you might add a couple of extra weekly sets or exercises that target those muscles.

“You want to prioritise the big muscles in your sessions – these are usually working in the compound or multi-muscle exercises you can lift more weight with,” he says. “In the lower body, aim to hit the quads, glutes and hamstrings. In the upper body, there are the pecs in the chest, the lats in the back and the delts of the shoulder.”

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Tip 6: Progressive overload is essential for continued results

The body adapts to get better at the things we consistently ask it to do, so strength training can be seen as a conversation with our muscles.

Every time we lift weights, we are telling our body that we want to become stronger. If we make a strong enough case, doing sufficiently challenging exercises, then over time it will adapt by bolstering our bones, tendons, ligaments and muscles.

This is why we have to apply progressive overload: the process of gradually increasing the difficulty of our workouts over time, in line with our increasing strength and fitness levels. You need to increase the weight, up the number of sets and repetitions, or switch to a more challenging exercise variation, relative to your rising strength level, to send the body a clear message that you want to continue to grow stronger, rather than just maintain what you have or lose muscle.

Tip 7: Find low-impact ways to raise your heart rate

If you are new to exercise, James advises opting for a lower-impact form of cardio – for example, using exercise machines such as exercise bikes, rowing machines and ellipticals, which make it easy to get your heart rate up with a low risk of injury.

Using these machines once or twice a week to get a bit out of breath can deliver plenty of health benefits, including improved heart health and reduced risk of several major illnesses.

These more intense activities should also be underlined by a healthy dose of daily movement – “Aerobic activities such as longer walks.”

Tip 9: Put enjoyment first

Enjoyment is the most important, and most overlooked, tenet of a successful exercise plan. You could have a scientifically-optimised training plan for building muscle, but if you don’t follow it because you don’t enjoy it, it’s going to be redundant, James says.

“It’s about finding a plan that someone can adhere to, enjoy and be consistent with,” he says. “And if you’re consistent, you’ll most likely see results.”

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The four-move workout

This is a beginner workout with minimal equipment, which works the main muscle groups of your upper and lower body and should take no more than 30 minutes. Do three sets of 10-20 repetitions of each exercise, and repeat two to four times per week.

The aim is to perform at least 10 repetitions in every set, while using a weight challenging enough that you cannot easily lift it for 20 repetitions.

“As you start to adapt to the training and become familiar with the movements, try to either increase the weight or number of reps.”

If you don’t own any weights, a filled water bottle or rucksack can be used instead, but James recommends investing in a couple of dumbbells or kettlebells to broaden your exercise horizons if you’re training at home.

“You can get a set of kettlebells for around 20 quid,” he says. “Start with a 5kg and 10kg weight, and as you get stronger, you can buy heavier options.”

Exercise 1: Squat to chair or sofa

How to perform a goblet squat to box

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Sets: 3 Reps: 10-20 Rest: 90 seconds

Coach’s notes:

Exercise 2: Romanian deadlift

How to perform a kettlebell Romanian deadlift

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Sets: 3 Reps: 10-20 Rest: 90 seconds

Coach’s notes:

Exercise 3: Press-up to chair or sofa

How to perform a hands-elevated press-up

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Sets: 3 Reps: 10-20 Rest: 90 seconds

Coach’s notes:

Exercise 4: Single-arm row

How to perform a single-arm row

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Sets: 3 Reps: 10-20 Rest: 90 seconds

Coach’s notes:

What is the difference between a fitness watch and a smartwatch?

Fitness watches are designed primarily for tracking health and activity, with features like workout modes, heart rate monitoring, GPS and sleep insights, often paired with longer battery life. They’re a good choice if you train regularly or are looking to build healthier habits.

Smartwatches, on the other hand, focus more on lifestyle features like notifications, calls, apps and contactless payments, with fitness tracking as an extra. If you want something that fits seamlessly into everyday life as well as workouts, a smartwatch may be the better option. Some devices sit in the middle, offering a balance of both.

Our round-up includes a mix of dedicated fitness trackers and lifestyle watches, so you’re bound to find one that suits your needs.

What is the best fitness tracker for sleep?

Sleep tracking capabilities vary between devices. Some just total up the number of hours you’re getting, while others break this down into heavy, light and rapid eye movement (REM) sleep. Some also provide a score for the quality of your sleep and offer tips on how to improve it.

All of the watches featured in this round-up offer a solid level of sleep tracking, but if sleep is your main focus, it’s worth considering a dedicated device such as the Oura Ring 4 smart ring or the Garmin Index Sleep Monitor, a lightweight armband designed to be worn overnight – both of which we’ve tested and rated by the Good Housekeeping Institute.

Are fitness trackers waterproof?

All fitness trackers are sweat-proof and many are also waterproof, meaning they can be worn when you’re in the shower or when swimming. If you swim several regularly, look out for a fitness tracker that will monitor your pool sessions, including the number of lengths you swim, as well as the time you’re active and the calories you burn.

Can fitness trackers measure blood pressure?

No, most fitness trackers can’t measure blood pressure directly. However, the Huawei Watch D2, which we’ve tested, does offer on-wrist blood pressure monitoring using an inflatable cuff built into the strap.

If monitoring your blood pressure is a priority, it’s worth investing in a dedicated, clinically validated blood pressure monitor. See our best blood pressure monitors round-up for more information.