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Editorial |

New Evidence for the Value of Supervised Exercise Training in Type 2 Diabetes Mellitus

Ronald J. Sigal, MD, MPH; Glen P. Kenny, PhD
Arch Intern Med. 2010;170(20):1790-1791. doi:10.1001/archinternmed.2010.376.
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Exercise has been considered an important component of diabetes management for decades,1 although solid evidence of its effectiveness has been published mainly in the past 10 years. In the Aerobics Centre Longitudinal Study,2 12-year cardiovascular and overall mortality were approximately 60% lower in diabetic individuals with moderate to high cardiorespiratory (aerobic) fitness at baseline compared with those with low baseline fitness (42% of the men). The standard recommendation for people with diabetes has historically been to perform aerobic exercise such as brisk walking, swimming, or jogging, rather than resistance exercise such as weight lifting or exercise with weight machines. Indeed, the official position of the American Diabetes Association through 2004 was that “high-resistance exercise using weights may be acceptable for young individuals with diabetes, but not for older individuals or those with long-standing diabetes.”3(pS60) This position was never evidence based. High-intensity resistance exercise has been found to be safe and beneficial for glycemic control in elderly people with diabetes.4,5 A 2006 meta-analysis6 found that aerobic exercise, resistance exercise, and combined aerobic and resistance exercise each improved glycemic control in type 2 diabetes mellitus (T2DM), and a 2009 systematic review7 confirmed that resistance training had beneficial effects on glycemic control, insulin sensitivity, and, in some studies, lipid levels and body composition, with no serious adverse effects.

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