Van Noorden and Isaak identified regular exercise, along with diet and insulin, as one of the three components of good therapy as early as 1927 (for references, see [
1]). From a physiological perspective, structured exercise interventions have been shown to be at least as efficacious as the pharmaceutical agents currently available for improving glycaemic control [
2,
3] and cardiovascular risk profile [
4]. Despite the growing body of evidence showing the health benefits of exercise in type 2 diabetes, a recently published large-scale US survey shows that the majority of patients with diabetes do not engage in regular physical activity [
5], and there is currently no reason to believe that this is any different across the rest of the world. Although physician advice has been shown to be a strong predictor of attempts to change lifestyle habits, health professionals may not take the time or provide enough specific information to help patients successfully change their physical activity behaviour [
6]. Apparently, most physicians and diabetes nurses around the world find it difficult to prescribe structured exercise routines for individual patients, and the high costs, lack of reimbursement, low compliance and/or absence of proper infrastructure may be responsible for this [
7]. Not so long ago, cardiac patients and their doctors experienced similar problems; however, exercise-based cardiac rehabilitation programmes have been shown to be effective and feasible if available evidence-based guidelines are supported by a motivated and knowledgeable staff and applied in a patient-tailored way [
8]. Although the long-term outcome of such an approach is currently being investigated in a large-scale prospective study on intensive lifestyle interventions, the preliminary results look promising [
9]. Thus, cardiac rehabilitation programmes could serve as a model for future ‘pre-cardiac diabetes rehabilitation’ programmes.