Background Intensive lifestyle intervention involving weight reduction and moderate physical activity has been shown to help regulate, and even prevent, type 2 diabetes. Aim This study sought to explore factors affecting uptake of an education and physical activity programme for those diagnosed with type 2 diabetes. Method Focus group discussions were conducted with individuals who completed the programme and semi-structured interviews were conducted with those who declined the invitation to attend. Data were analysed using a thematic framework approach and key similarities and differences between the groups were identified. Results The 11 programme participants studied appeared to have received clearer messages about the severity of unmanaged diabetes, whereas the 10 non-attenders studied felt that co-morbidities posed greater risks to their health. There were major concerns among both groups about undertaking exercise, and strategies for diabetes management focused heavily on dietary modification. Conclusion The findings of this study suggest that fears and lack of understanding about both diabetes and exercise can act as barriers to engaging in physical activity. These findings are supported by the literature and highlight the need for more tailored programmes of lifestyle intervention for those with type 2 diabetes.