According to Gram Research analysis, a 2026 randomized trial found that mild cold exposure (15°C water) reduced 24-hour average blood sugar by 0.6 mmol/L in people with type 2 diabetes, helping them spend 8.8% more time in healthy blood sugar ranges. However, the same cold exposure did not help people with prediabetes, suggesting benefits depend on having established type 2 diabetes rather than just elevated blood sugar levels.
A new study from the Netherlands found that brief exposure to mild cold water that makes you shiver can help people with type 2 diabetes lower their blood sugar levels within 24 hours. Researchers had 12 people with type 2 diabetes and 12 with prediabetes sit in cold water suits at different temperatures. The mild cold exposure reduced average blood sugar by about 11% and helped people spend more time in the healthy blood sugar range. However, the same cold exposure didn’t help people with prediabetes, suggesting the benefit depends on how severe someone’s blood sugar problem already is.
Key Statistics
A 2026 randomized controlled trial of 24 adults published in Diabetologia found that mild cold exposure (15°C) reduced 24-hour average blood sugar levels by 0.6 mmol/L in people with type 2 diabetes, representing approximately an 11% reduction.
In the same 2026 study, people with type 2 diabetes spent 8.8% more time in the healthy blood sugar range and 10.9% less time in dangerously high blood sugar after mild cold exposure, but moderate cold (4°C) produced no significant glucose improvements.
The 2026 trial found that mild cold exposure increased metabolic rate by 1.57 times normal in people with type 2 diabetes, but this increase in energy expenditure did not explain the blood sugar improvements, suggesting a different biological mechanism.
Prediabetes participants in the 2026 study showed no improvement in blood sugar levels from either mild or moderate cold exposure, indicating that cold exposure benefits only appear in people with established type 2 diabetes.
The Quick Take
- What they studied: Whether sitting in cold water that makes you shiver can help control blood sugar levels in people with type 2 diabetes and prediabetes
- Who participated: 24 adults aged 40-75 years old (12 with type 2 diabetes and 12 with prediabetes) from the Netherlands who were overweight, non-smokers, and not very active
- Key finding: After mild cold exposure (15°C water), people with type 2 diabetes had blood sugar levels drop by about 0.6 mmol/L and spent 8.8% more time in the healthy blood sugar range, but the same cold didn’t help people with prediabetes
- What it means for you: Cold exposure might become a helpful tool for managing type 2 diabetes, but it’s not a replacement for medication or lifestyle changes. The effect was only seen with mild cold, not intense cold, and only in people with established diabetes, not prediabetes. More research is needed before doctors recommend this as a treatment.
The Research Details
This was a randomized crossover trial, which means each person participated in two different cold exposure sessions in random order, and they didn’t know which temperature they were experiencing. Researchers used water-perfused suits (special suits with water flowing through them) to expose participants to two different cold temperatures: mild cold at 15°C (about 59°F) and moderate cold at 4°C (about 39°F). Each session was designed to increase how much energy the body burns at rest by either 1.5 times (mild) or 2.5 times (moderate). The researchers confirmed that participants were actually shivering using special equipment that measures heat production and muscle activity. Blood sugar was continuously monitored for 24 hours before and after each cold session using glucose monitors worn on the skin, while participants ate the same meals and stayed relatively inactive to keep other factors constant.
This research approach is important because it tests whether a single, short cold exposure can immediately improve blood sugar control in people with diabetes. By using continuous glucose monitoring instead of just checking blood sugar once or twice, researchers could see the full picture of how blood sugar changed throughout the entire day. The crossover design (where each person serves as their own control) is powerful because it reduces the effect of individual differences between people. By measuring actual shivering with scientific equipment, researchers confirmed that the cold really did trigger the expected biological response.
This study has several strengths: it was randomized (reducing bias), participants were masked to which temperature they received (reducing placebo effects), and measurements were objective (using continuous glucose monitors and equipment to measure shivering). However, the sample size was small (only 24 people total), which limits how much we can generalize the findings. The study was conducted in one region of the Netherlands with specific types of participants (overweight, sedentary, aged 40-75), so results might differ in other populations. This was also a short-term study looking at just one exposure session, so we don’t know if repeated cold exposure would have lasting benefits.
What the Results Show
In people with type 2 diabetes, mild cold exposure (15°C) significantly reduced 24-hour average blood sugar levels by 0.6 mmol/L (about 11% reduction). This is a meaningful change because it moved people closer to normal blood sugar ranges. After the mild cold exposure, people with type 2 diabetes also spent 8.8% more time with blood sugar in the healthy range and 10.9% less time with dangerously high blood sugar. Fasting blood sugar (measured first thing in the morning) also dropped by 0.6 mmol/L after mild cold exposure. Interestingly, moderate cold (4°C) did not produce these beneficial effects, suggesting that the intensity of cold matters—too much cold might not be as helpful as mild cold. In contrast, people with prediabetes showed no improvement in blood sugar levels from either mild or moderate cold exposure, indicating that the benefit depends on already having type 2 diabetes rather than just having slightly elevated blood sugar.
The study found that both mild and moderate cold exposure successfully increased how much energy the body burned at rest, confirming that the cold exposure was working as intended. In the final hour of mild cold, metabolic rate increased by 1.57 times normal, and in moderate cold it increased by 2.09 times normal. However, this increase in energy expenditure alone didn’t explain the blood sugar improvements, suggesting the benefit works through a different mechanism than simply burning more calories. The researchers identified that people with higher starting blood sugar levels, younger age, and better liver health (lower ALT enzyme levels) showed the greatest blood sugar improvements, suggesting these factors predict who will benefit most from cold exposure.
Previous research suggested that repeated cold exposure over weeks or months might improve metabolism and glucose control, but this is one of the first studies to look at whether a single acute cold exposure can immediately help. The finding that mild cold works better than moderate cold is somewhat surprising and contradicts the assumption that more intense cold would produce better results. The difference between type 2 diabetes and prediabetes is important—it suggests that cold exposure may only help when blood sugar regulation is already significantly impaired, not in earlier stages of metabolic dysfunction. This aligns with some research showing that different interventions work better at different stages of metabolic disease.
The biggest limitation is the small sample size of only 24 people, which means results might not apply to larger, more diverse populations. The study only looked at one cold exposure session, so we don’t know if repeated cold exposure would have lasting benefits or if the effect would wear off over time. Participants were specifically selected to be overweight, sedentary, and aged 40-75, so results might differ in younger people, very active people, or people with normal weight. The study was conducted in one region of the Netherlands, and results might differ in other climates or populations. We also don’t fully understand why mild cold worked better than moderate cold, or exactly how cold exposure improves blood sugar—the mechanism isn’t completely clear. Finally, this study cannot tell us whether cold exposure would work as well as existing diabetes medications or whether it could replace them.
The Bottom Line
Based on this research, cold exposure cannot yet be recommended as a standard treatment for type 2 diabetes. However, it shows promise as a potential additional tool that might help alongside medication and lifestyle changes. If someone with type 2 diabetes is interested in trying cold exposure, mild cold (around 15°C or 59°F) appears more beneficial than intense cold, and it should only be considered under medical supervision. People with prediabetes should not expect benefits from cold exposure based on this research. Anyone with heart disease, high blood pressure, or other health conditions should consult their doctor before attempting cold exposure, as sudden cold can stress the cardiovascular system.
People with type 2 diabetes who are looking for additional ways to manage their blood sugar should be aware of this research, though it’s too early to make it a primary treatment strategy. Healthcare providers treating type 2 diabetes may find this interesting as a potential complementary approach. People with prediabetes should not expect benefits based on this study. People with heart conditions, uncontrolled high blood pressure, or cold sensitivity should avoid cold exposure without medical clearance.
In this study, the blood sugar improvements were seen within 24 hours of a single cold exposure session. However, this doesn’t mean the benefits would last long-term or that repeated exposure would produce cumulative benefits. More research is needed to understand whether regular cold exposure would maintain these benefits or if the body would adapt and stop responding. Realistic expectations should be that any benefits would likely be temporary unless cold exposure was repeated regularly, and even then, the long-term effects are unknown.
Frequently Asked Questions
Can cold showers help lower blood sugar if I have type 2 diabetes?
Research shows mild cold exposure (around 15°C) reduced blood sugar by about 11% in people with type 2 diabetes within 24 hours. However, this was a single exposure in a controlled study, and more research is needed before doctors recommend it as a treatment. It should not replace medication or lifestyle changes.
Does cold exposure work for prediabetes?
No. A 2026 study found that cold exposure did not improve blood sugar levels in people with prediabetes, only in those with established type 2 diabetes. This suggests the benefit depends on having more severe blood sugar problems.
Is intense cold better than mild cold for blood sugar control?
Surprisingly, no. The study found that mild cold (15°C) improved blood sugar in type 2 diabetes, but moderate cold (4°C) did not. This suggests that very intense cold may not be as beneficial as mild cold exposure.
How long does the blood sugar improvement last after cold exposure?
This study only measured blood sugar for 24 hours after a single cold exposure. We don’t know if benefits last longer or if repeated cold exposure would maintain improvements. More research is needed on long-term effects.
Is cold exposure safe for people with heart problems?
Cold exposure can stress the heart and blood vessels. Anyone with heart disease, high blood pressure, or other cardiovascular conditions should consult their doctor before attempting cold exposure, as it may not be safe for them.
Want to Apply This Research?
- Track fasting blood glucose levels (first measurement of the day) and average daily glucose readings for 3-5 days before and after mild cold exposure sessions. Record the water temperature used, duration of exposure, and intensity of shivering to identify the optimal conditions for your body.
- If using a diabetes management app, log cold exposure sessions as a non-pharmacological intervention. Record the time of day, temperature, duration, and any subjective feelings during and after exposure. Compare your glucose patterns on days with and without cold exposure to see if you notice personal benefits.
- Over 4-6 weeks, alternate between weeks with mild cold exposure (2-3 times per week) and weeks without, while keeping diet and activity constant. Track average daily glucose, time in range, and fasting glucose. Note any patterns in how your body responds. Share this data with your healthcare provider to determine if cold exposure is helping your individual diabetes management.
This research is preliminary and should not be used as a substitute for medical advice, diagnosis, or treatment from a qualified healthcare provider. Cold exposure can pose risks for people with heart disease, high blood pressure, or other health conditions. Anyone with type 2 diabetes considering cold exposure should consult their doctor first. This study involved only 24 people in a single session, so results may not apply to all populations. Cold exposure should never replace prescribed diabetes medications or established lifestyle modifications. Always work with your healthcare team before trying new interventions for diabetes management.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.