Improves glycaemic control
The beneficial effect of physical activity in people with type 2 diabetes is well documented. There is international consensus that physical activity comprises one of the three cornerstones of treatment together with dietary modification and medication (Boule et al., 2001; Thomas et al., 2006; Wing, 2010; Umpierre et al., 2011).
Structured programmes, lasting a minimum 12 weeks, of 150 minutes moderate intensity exercise per week have been shown to be associated with a greater benefit (reduction in HBA1c of 0.9%) than exercise for less than 150 minutes per week (reduction in HBA1c of 0.4%). Those with higher baseline HBA1c stand to gain the most from exercising, with greatest HBA1c reductions shown with exercise (Umpierre et al., 2011).
Both structured, supervised exercise programmes and less structured, unsupervised physical activity programmes (of variable activity type and mode of delivery) are effective for improving glycaemic control in people with type 2 diabetes (Thomas et al., 2006; Sigal et al., 2007; Umpierre et al., 2011).
Both aerobic and resistance training improve glycaemic control and have positive metabolic effects, however combined exercise programs give the greatest improvement in HBA1c levels (Thomas et al., 2006; Sigal et al., 2007; Umpierre et al., 2011). High Intensity Interval Training (often referred to as HIIT) improves glycaemic control compared to control but not compared to aerobic training (Jelleyman et al., 2015).
Quality of evidence
Strength of recommendation
Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA 2001: 286: 1218–1227.
Jelleyman C, Yates T, O’Donovan G, Gray LJ, King JA, Khunti K, Davies MJ. The effects of high-intensity interval training on glucose regulation and insulin resistance: a meta-analysis. Obes Rev. 2015 Nov;16(11):942-61.
Sigal, R.J., Kenny, G.P., Boulé, N.G., Wells, G.A., Prud’homme, D., Fortier, M., Reid, R.D., Tulloch, H. (2007) Effects of aerobic training, resistance training, or both on glycaemic control in Type 2 diabetes: a randomised trial. Annals of Internal Medicine; 147(6): 357-369251
Thomas D, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2006, Issue 3.
Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010 Sep 27;170(17):1566-75.
Umpierre D, Ribeiro PA, Kramer CK, Leitão CB, Zucatti AT, Azevedo MJ, Gross JL, Ribeiro JP, Schaan BD. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011 May 4;305(17):1790-9.