Abstract
Aim: Physical activity is one of the cornerstones in the prevention and management of
diabetes mellitus, but the effects of different training forms on metabolic control
still remain unclear. The aims of this review are to summarize the recommendations
of 5 selected diabetes associations and to systematically review the effects of long-term
supervised exercise interventions without calorie-restriction on glycemic control
in people with type 1 and 2 diabetes focusing on resistance, endurance and combined
training consisting of both endurance and resistance training.
Methods: Literature searches were performed using MEDLINE for articles published between January
1, 2000 and March 17, 2015. Of 76 articles retrieved, 15 randomized and controlled
studies met the inclusion criteria and allowed for examining the effect of exercise
training in type 1 and 2 diabetes.
Results: Diabetes associations recommend volume-focused exercise in their guidelines. In our
analysis, all 3 training forms have the potential to improve the glycemic control,
as assessed by HbA1c (absolute changes in HbA1c ranging from −0.1% to −1.1% (−1.1 to −12 mmol/mol) in resistance training, from −0.2%
to −1.6% (−2.2 to −17.5 mmol/mol) in endurance training and from +0.1% to −1.5% (+1.1
to −16.4 mmol/mol) in combined training, respectively).
Conclusions: There is evidence that combined exercise training may improve glycemic control to
a greater extent than single forms of exercise, especially under moderate-intensive
training conditions with equal training durations. In addition, intensity of training
appears to be an important determinant of the degree of metabolic improvement. Nonetheless,
it is still unknown to what extent exercise effects glycemic homeostasis.
Key words
resistance training - endurance training - combined training - glycemic control -
systematic review
