ACSM Updates Guidance for Exercise in Type 2 Diabetes

The authors note that for adults with type 2 diabetes, regular aerobic exercise training improves glycemic management, with less daily time in hyperglycemia and reductions in overall glycemia. In terms of overall glucose management and attenuation of insulin levels, high-intensity resistance exercise training has greater beneficial effects than low- to moderate-intensity resistance training. Postprandial glucose and insulin levels are modestly attenuated with small “doses” of physical activity throughout the day to break up sitting, especially for individuals with insulin resistance and higher body mass index. For beneficial effects on hemoglobin A1c, blood lipids, and blood pressure, weight loss of >5 percent seems to be necessary. A moderately high volume of exercise (~500 kcal) done four to five times per week is needed for reductions in visceral fat for individuals with type 2 diabetes. Youth and adolescents with type 2 diabetes are recommended to meet the same physical activity goals set for youth in the general population, despite limited data.

“Exercise can play an important role in managing type 2 diabetes, and workouts can be modified to fit the abilities of most people,” Kanaley said in a statement. “Those with type 2 diabetes who want to lose weight should consider workouts of moderately high volume for four to five days per week.”

One author disclosed financial ties to the pharmaceutical and medical device industries.