Physical Activity and Exercise for Rehabilitation of Type 2 Diabetes

Background: Along with diet and medication, exercise is the third cornerstone of type 2 diabetes treatment. However, current guidelines do not provide detailed information for designing effective exercise interventions. Objective: Based on a review of the health-enhancing effects of endurance and resistance training, recommendations for exercise interventions for persons with type 2 diabetes and different comorbidities are derived to optimize the benefits of exercise. Method: A hierarchic, systematic literature analysis was conducted. The evidence is summarized, and evidence-based recommendations are given. Results: Aerobic training, resistance training, and combined training programmes hold equal potential to reduce the HbA1c by about 0.5-0.8. Endurance training improves cardiorespiratory fitness and cardiovascular risk factors. Compared to resistance training it will lead to superior effects on hypertension and blood lipids. Combined training is generally a little superior to aerobic and resistance training showing greater improvements for body weight, HDL-cholesterol and blood pressure. Health-enhancing effects are found for a broad range of exercise types, intensities and scope. Persons with type 2 diabetes should perform at least 90 min per week of vigorous (> 65% of VO(2)max) aerobic exercise or 150 mm per week of moderate-intensity (40-65% of VO(2)max) aerobic physical activity. Performing at least 240 min of physical activity per week is associated with greater cardiovascular disease risk reductions as well as with less cardiovascular events compared with lower volumes of activity. Optimizing therapeutic benefits with different types and doses of exercise in combination with dietary and drug treatments needs further research.