• Enhanced insulin sensitivity, which follows an acute bout of exercise, can lower insulin needs for a period of hours to days afterward and may increase the risk of hypoglycemia.
• Physical activity improves insulin action, lowers blood glucose levels, improves BMI, and reduces multiple risk factors for cardiovascular disease in diabetes.
REFERENCES
American College of Sports Medicine: American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc 41:687–708, 2009
American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care 36 (Suppl.1):S67–S74, 2013a
American Diabetes Association: Standards of medical care in diabetes—2013. Diabetes Care 36 (Suppl. 1):S11–S66, 2013b
Boon H, Blaak EE, Saris WH, Keizer HA, Wagenmakers AJ, van Loon LJ: Substrate source utilisation in long-term diagnosed type 2 diabetes patients at rest, and during exercise and subsequent recovery. Diabetologia 50:103–112, 2007
Boulé 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 286:1218–1227, 2001
Bray GA, Smith SR, DeJonge L, de Souza R, Rood J, Champagne CM, Laranjo N, Carey V, Obarzanek E, Loria CM, Anton SD, Ryan DH, Greenway FL, Williamson D, Sacks FM: Effect of diet composition on energy expenditure during weight loss: the POUNDS LOST study. Int J Obes (Lond) 36:448–455, 2012
Cartee GD, Young DA, Sleeper MD, Zierath J, Wallberg-Henriksson H, Holloszy JO: Prolonged increase in insulin-stimulated glucose transport in muscle after exercise. Am J Physiol 256:E494–E499, 1989
Caspersen CJ, Powell KE, Christenson GM: Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports 100:126–131, 1985
Cheung BM, Ong KL, Cherny SS, Sham PC, Tso AW, Lam KS: Diabetes prevalence and therapeutic target achievement in the United States, 1999 to 2006. Am J Med 122:443–453, 2009
Chokkalingam K, Tsintzas K, Norton L, Jewell K, Macdonald IA, Mansell PI: Exercise under hyperinsulinaemic conditions increases whole-body glucose disposal without affecting muscle glycogen utilisation in type 1 diabetes. Diabetologia 50:414–421, 2007a
Chokkalingam K, Tsintzas K, Snaar JE, Norton L, Solanky B, Leverton E, Morris P, Mansell P, Macdonald IA: Hyperinsulinaemia during exercise does not suppress hepatic glycogen concentrations in patients with type 1 diabetes: a magnetic resonance spectroscopy study. Diabetologia 50:1921–1929, 2007b
Chomentowski P, Dubé JJ, Amati F, Stefanovic-Racic M, Zhu S, Toledo FG, Goodpaster BH: Moderate exercise attenuates the loss of skeletal muscle mass that occurs with intentional caloric restriction-induced weight loss in older, overweight to obese adults. J Gerontol A Biol Sci Med Sci 64:575–580, 2009
Church TS, LaMonte MJ, Barlow CE, Blair SN: Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes. Arch Intern Med 165:2114–2120, 2005
Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B, American College of Sports Medicine, American Diabetes Association: Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 33:e147–e167, 2010
Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ: Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care 26:2977–2982, 2003
Davenport MH, Mottola MF, McManus R, Gratton R: A walking intervention improves capillary glucose control in women with gestational diabetes mellitus: a pilot study. Appl Physiol Nutr Metab 33:511–517, 2008
de Souza RJ, Bray GA, Carey VJ, Hall KD, LeBoff MS, Loria CM, Laranjo NM, Sacks FM, Smith SR: Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial. Am J Clin Nutr 95:614–625, 2012
Diabetes Prevention Program (DPP) Research Group: The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care 25:2165–2171, 2002
Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW: Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care 26:557–562, 2003
Dyck RF, Sheppard MS, Cassidy H, Chad K, Tan L, Van Vliet SH: Preventing NIDDM among aboriginal people: is exercise the answer? Description of a pilot project using exercise to prevent gestational diabetes. Int J Circumpolar Health 57 (Suppl. 1):S375–S378, 1998
Eriksson J, Lindstrom J, Valle T, Aunola S, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Lauhkonen M, Lehto P, Lehtonen A, Louheranta A, Mannelin M, Martikkala V, Rastas M, Sundvall J, Turpeinen A, Viljanen T, Uusitupa M, Tuomilehto J: Prevention of type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland. Study design and 1-year interim report on the feasibility of the lifestyle intervention programme. Diabetologia 42:793–801, 1999
Galbo H, Tobin L, van Loon LJ: Responses to acute exercise in type 2 diabetes, with an emphasis on metabolism and interaction with oral hypoglycemic agents and food intake. Appl Physiol Nutr Metab 32:567–575, 2007
Gallen IW, Hume C, Lumb A: Fueling the athlete with type 1 diabetes. Diabetes Obes Metab 13:130–136, 2011
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP, American College of Sports Medicine: American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43:1334–1359, 2011
Goodpaster BH, Katsiaras A, Kelley DE: Enhanced fat oxidation through physical activity is associated with improvements in insulin sensitivity in obesity. Diabetes 52:2191–2197, 2003
Gorman E, Chudyk AM, Madden KM, Ashe MC: Bone health and type 2 diabetes mellitus: a systematic review. Physiother Can 63:8–20, 2012
Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, Hoskin M, Kriska AM, Mayer-Davis EJ, Pi-Sunyer X, Regensteiner J, Venditti B, Wylie-Rosett J: Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 29:2102–2107, 2006
Hapo Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA: Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002, 2008
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1423–1434, 2007
Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr: Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 325:147–152, 1991
Herriott MT, Colberg SR, Parson HK, Nunnold T, Vinik AI: Effects of 8 weeks of flexibility and resistance training in older adults with type 2 diabetes. Diabetes Care 27:2988–2989, 2004
Hordern MD, Cooney LM, Beller EM, Prins JB, Marwick TH, Coombes JS: Determinants of changes in blood glucose response to short-term exercise training in patients with type 2 diabetes. Clin Sci (Lond) 115:273–281, 2008
Hu FB, Stampfer MJ, Solomon C, Liu S, Colditz GA, Speizer FE, Willett WC, Manson JE: Physical activity and risk for cardiovascular events