Combined Exercises May Be Best for Type 2 Diabetes

Aerobic and resistance training helped control blood sugar and lipids in people with type 2 diabetes

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Exercise is good for everyone, including those with diabetes. But what is the best type of exercise to help control the blood sugar of people with type 2 diabetes?

A new study suggests that a combination of both cardio and resistance training exercises may be the best mix to keep blood sugar and fat levels in check in those with type 2 diabetes, as opposed to either method alone.

"Work with a trained exercise specialist to develop a workout plan to control diabetes."

This study was led by Lukas Schwingshackl, a PhD student at the University of Vienna in Austria.

The investigators conducted a systematic review and meta-analysis of data available through MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. These researchers identified a total of 14 trials with 915 people with diabetes. All of the studies were published between 2003 and 2013 and followed people with type 2 diabetes for at least eight weeks. All the participants exercised under direct or partial supervision.

The study authors looked at the kinds of exercise the participants engaged in and their levels of blood fat (lipids), blood glucose (sugar) and blood pressure.

The participants either took part in aerobic exercise (exercise that works the heart, such as jogging), resistance training (also known as strength training, such as weight lifting) or a combination of the two.

The authors found that the participants who did combined exercises had a lower level of hemoglobin A1C (average blood sugar levels for the past two to three months) than those who did either exercise alone. The A1C of those who did combined exercise was 0.17 percent lower than the A1C of those who did aerobic exercise alone and 0.62 percent lower than that of people who did only resistance training.

The American Diabetes Association and the American College of Sports Medicine have stated that a combination of resistance training and aerobic exercise training at moderately intense levels for at least 150 minutes per week may be more effective than either type of exercise alone at improving blood sugar control in people with diabetes. However, this recommendation was not based on research.

While the researchers found neither type of exercise seemed to influence diastolic (lower number) blood pressure, aerobic exercise seemed better than resistance training at lowering blood sugar levels.

However, a combination of the two types of exercises — aerobic plus resistance — was determined to be the best at lowering all blood measurements (sugar and fat).

The authors acknowledged some problems with their study, such as that most people are not likely to do exercise under supervision, and that the studies included were of low to moderate quality.

In a press release, the authors stated, "Further high quality with long-term exercise interventions are needed to develop definitive recommendations. In the meantime, combined aerobic and resistance training can be recommended as part of a lifestyle programme in the management of type 2 diabetes wherever possible.”

James Crowell, head trainer at Integrated Fitness in Pittsburgh, PA, told dailyRx, "I am a huge believer in combining aerobic and anaerobic training for my clients. When somebody is building lean muscle with weight training they boost metabolism and the ability to burn fat. When they combine shorter and longer duration aerobic training with weight training they burn fat and build that lean and strong body that so many people are looking for. I have had wonderful results when combining the two."

This study was published in the July issue of Diabetologia, the journal of the European Association for the Study of Diabetes.

The authors declared no conflicts of interest.

Review Date: 
July 2, 2014
Last Updated:
July 3, 2014