Oral Presentation Annual Meetings of the Endocrine Society of Australia and Society for Reproductive Biology and Australia and New Zealand Bone and Mineral Society 2016

Exercise for Type 2 Diabetes: What kind? How much? How intense? (#217)

Robin Daly 1
  1. Deakin University, Burwood, VIC, Australia

Exercise is recommended as a key strategy in the management of type 2 diabetes (T2D), but not all forms are equally effective. Current guidelines recommend 150 min/week of moderate-vigorous aerobic training (AT) and at least two sessions of progressive resistance training (PRT) to optimise glycaemic control and improve fitness, strength, lean mass and cardiometabolic health. While there is some evidence that the combination of AT+PRT has additive benefits, and that the effects of exercise are independent of weight loss, questions still remain about the optimal type and dose (frequency, intensity, duration) that should be prescribed. Supervised structured programs are more effective than physical activity advice even with dietary co-intervention, and high-intensity training appears to result in greater benefits for glycaemic control. However, if weight loss is the goal a greater training volume (≥ 250 min/week) is recommended, but PRT should be prescribed to prevent muscle loss. An alternative time-efficient option is low volume high-intensity interval training (HITT), which involves short bouts of intense activity with rest breaks. Emerging data indicates this mode of AT may be more effective at improving HbA1c (and other cardiometabolic outcomes) compared to low-intensity training in people with T2D. However, the characteristics of the optimal HITT session (interval number, length, and intensity) and issues around long-term adherence and safety remain to be determined. Accumulating research also suggests that prolonged periods of sedentary behaviour (sitting) can adversely affect glycaemic measures, independently of physical activity time and adiposity. Whether reducing sitting time is an effective treatment for T2D is not known, but there is some evidence that interrupting prolonged sitting with brief bouts of light-intensity walking or simple strengthening exercise can improve post-prandial cardiometabolic risk factors in adults with T2D. This presentation will provide an overview of the current evidence related to the optimal type, intensity, duration and frequency of exercise for the management of T2D, along with precautions and limitations for those with co-morbidities, and whether dietary co-interventions can enhance the health benefits.