Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement

Sheri R Colberg, Ronald J Sigal, Bo Fernhall, Judith G Regensteiner, Bryan J Blissmer, Richard R Rubin, Lisa Chasan-Taber, Ann L Albright, Barry Braun, American College of Sports Medicine, American Diabetes Association, Sheri R Colberg, Ronald J Sigal, Bo Fernhall, Judith G Regensteiner, Bryan J Blissmer, Richard R Rubin, Lisa Chasan-Taber, Ann L Albright, Barry Braun, American College of Sports Medicine, American Diabetes Association

Abstract

Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes, many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower type 2 diabetes risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes mellitus, and safe and effective practices for PA with diabetes-related complications.

References

    1. Albright A, Franz M, Hornsby G, et al. : American College of Sports Medicine. Position Stand: exercise and type 2 diabetes. Med Sci Sports Exerc 2000;32(7):1345–60
    1. Aljasem LI, Peyrot M, Wissow L, Rubin RR: The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes. Diabetes Educ 2001;27(3):393–404
    1. American Diabetes Association Physical activity/exercise and diabetes. Diabetes Care 2004;27(90001):S58–S62
    1. American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33(1 Suppl.):S62–9
    1. American Diabetes Association Standards of medical care in diabetes 2010. Diabetes Care 2010;33(Suppl. 1):S11–S61
    1. Araiza P, Hewes H, Gashetewa C, Vella CA, Burge MR: Efficacy of a pedometer-based physical activity program on parameters of diabetes control in type 2 diabetes mellitus. Metabolism 2006;55(10):1382–7
    1. Armit CM, Brown WJ, Marshall AL, et al. : Randomized trial of three strategies to promote physical activity in general practice. Prev Med 2009;48(2):156–63
    1. Bahr DB, Browning RC, Wyatt HR, Hill JO: Exploiting social networks to mitigate the obesity epidemic. Obesity 2009;17(4):723–8
    1. Bajpeyi S, Tanner CJ, Slentz CA, et al. : Effect of exercise intensity and volume on persistence of insulin sensitivity during training cessation. J Appl Physiol 2009;106(4):1079–85
    1. Balducci S, Iacobellis G, Parisi L, et al. : Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complications 2006;20(4):216–23
    1. Balducci S, Zanuso S, Nicolucci A, et al. : Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in type 2 diabetic subjects. A randomized controlled trial: The Italian Diabetes and Exercise Study (IDES). Arch Intern Med. In press
    1. Barnard RJ, Lattimore L, Holly RG, Cherny S, Pritikin N: Response of non–insulin-dependent diabetic patients to an intensive program of diet and exercise. Diabetes Care 1982;5(4):370–4
    1. Barnard RJ, Ugianskis EJ, Martin DA: The effects of an intensive diet and exercise program on patients with non-insulin-dependent diabetes mellitus. J Cardiopulm Rehabil 1992;12:194–201
    1. Baynard T, Franklin RM, Goulopoulou S, Carhart R, Jr, Kanaley JA: Effect of a single vs multiple bouts of exercise on glucose control in women with type 2 diabetes. Metabolism 2005;54(8):989–94
    1. Bergman BC, Butterfield GE, Wolfel EE, Casazza GA, Lopaschuk GD, Brooks GA: Evaluation of exercise and training on muscle lipid metabolism. Am J Physiol 1999;276(1 Pt 1):E106–E17
    1. Bernbaum M, Albert SG, Cohen JD: Exercise training in individuals with diabetic retinopathy and blindness. Arch Phys Med Rehabil 1989;70(8):605–11
    1. Bernbaum M, Albert SG, Cohen JD, Drimmer A: Cardiovascular conditioning in individuals with diabetic retinopathy. Diabetes Care 1989;12(10):740–2
    1. Black LE, Swan PD, Alvar BA: Effects of intensity and volume on insulin sensitivity during acute bouts of resistance training. J Strength Cond Res 2010;24(4):1109–16
    1. Blair SN, Kohl HW, 3rd, Barlow CE, Paffenbarger RS, Jr, Gibbons LW, Macera CA: Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA 1995;273(14):1093–8
    1. Bo S, Ciccone G, Rosato R, et al. : Renal damage in patients with type 2 diabetes: a strong predictor of mortality. Diabet Med 2005;22(3):258–65
    1. 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 2007;50(1):103–12
    1. Booth GL, Kapral MK, Fung K, Tu JV: Recent trends in cardiovascular complications among men and women with and without diabetes. Diabetes Care 2006;29(1):32–7
    1. Borghouts LB, Wagenmakers AJ, Goyens PL, Keizer HA: Substrate utilization in non-obese Type II diabetic patients at rest and during exercise. Clin Sci (Lond) 2002;103(6):559–66
    1. Boule' 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 2001;286(10):1218–27
    1. Boule' NG, Kenny GP, Haddad E, Wells GA, Sigal RJ: Meta- analysis of the effect of structured exercise training on cardiorespiratory fitness in type 2 diabetes mellitus. Diabetologia 2003;46(8):1071–81
    1. Boule' NG, Weisnagel SJ, Lakka TA, et al. : Effects of exercise training on glucose homeostasis: the HERITAGE family study. Diabetes Care 2005;28(1):108–14
    1. Braden C: Nephropathy: advanced. In The Health Professional's Guide to Diabetes and Exercise. Alexandria (VA): American Diabetes Association; 1995. p. 177–80
    1. Braun B, Sharoff C, Chipkin SR, Beaudoin F: Effects of insulin resistance on substrate utilization during exercise in overweight women. J Appl Physiol 2004;97(3):991–7
    1. Braun B, Zimmermann MB, Kretchmer N: Effects of exercise intensity on insulin sensitivity in women with non–insulin-dependent diabetes mellitus. J Appl Physiol 1995;78(1):300–6
    1. Bravata DM, Smith-Spangler C, Sundaram V, et al. : Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007;298(19):2296–304
    1. Burke LM, Hawley JA: Carbohydrate and exercise. Curr Opin Clin Nutr Metab Care 1999;2(6):515–20
    1. Bweir S, Al-Jarrah M, Almalty AM, et al. : Resistance exercise training lowers HbA1c more than aerobic training in adults with type 2 diabetes. Diabetol Metab Syndr 2009;1:27.
    1. 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 1989;256(4 Pt 1):E494–E499
    1. Castaneda C, Layne JE, Munoz-Orians L, et al. : A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care 2002;25(12):2335–41
    1. Cauza E, Hanusch-Enserer U, Strasser B, et al. : The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus. Arch Phys Med Rehabil 2005;86(8):1527–33
    1. Ceysens G, Rouiller D, Boulvain M: Exercise for diabetic pregnant women. Cochrane Database Syst Rev. 2006;3:CD004225.
    1. Chasan-Taber L, Schmidt MD, Pekow P, et al. : Physical activity and gestational diabetes mellitus among Hispanic women. J Womens Health (Larchmt) 2008;17(6):999–1008
    1. Cheng YJ, Lauer MS, Earnest CP, et al. : Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all-cause mortality in men with diabetes. Diabetes Care 2003;26(7):2052–7
    1. Christ-Roberts CY, Pratipanawatr T, Pratipanawatr W, et al. : Exercise training increases glycogen synthase activity and GLUT4 expression but not insulin signaling in overweight non- diabetic and type 2 diabetic subjects. Metabolism 2004;53(9):1233–42
    1. Christ-Roberts CY, Pratipanawatr T, Pratipanawatr W, Berria R, Belfort R, Mandarino LJ: Increased insulin receptor signaling and glycogen synthase activity contribute to the synergistic effect of exercise on insulin action. J Appl Physiol 2003;95(6):2519–29
    1. Christakis NA, Fowler JH: The spread of obesity in a large social network over 32 years. N Engl J Med 2007;357(4):370–9
    1. Church TS, Cheng YJ, Earnest CP, et al. : Exercise capacity and body composition as predictors of mortality among men with diabetes. Diabetes Care 2004;27(1):83–8
    1. 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 2005;165(18):2114–20
    1. Clark M, Hampson SE, Avery L, Simpson R: Effects of a tailored lifestyle self-management intervention in patients with type 2 diabetes. Br J Health Psychol 2004;9(Pt 3):365–79
    1. Coccheri S: Approaches to prevention of cardiovascular complications and events in diabetes mellitus. Drugs 2007;67(7):997–1026
    1. Cohen ND, Dunstan DW, Robinson C, Vulikh E, Zimmet PZ, Shaw JE: Improved endothelial function following a 14-month resistance exercise training program in adults with type 2 diabetes. Diabetes Res Clin Pract 2008;79(3):405–11
    1. Colberg SR, Hagberg JM, McCole SD, Zmuda JM, Thompson PD, Kelley DE: Utilization of glycogen but not plasma glucose is reduced in individuals with NIDDM during mild-intensity exercise. J Appl Physiol 1996;81(5):2027–33
    1. Colberg SR, Swain DP, Vinik AI: Use of heart rate reserve and rating of perceived exertion to prescribe exercise intensity in diabetic autonomic neuropathy. Diabetes Care 2003;26(4):986–90
    1. Cornelissen VA, Fagard RH: Effect of resistance training on resting blood pressure: a meta-analysis of randomized controlled trials. J Hypertens 2005;23(2):251–9
    1. Craft LL, Perna FM: The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry 2004;6(3):104–11
    1. 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 2003;26(11):2977–82
    1. Curtis JM, Horton ES, Bahnson J, et al. : Prevalence and predictors of abnormal cardiovascular responses to exercise testing among individuals with type 2 diabetes: the Look AHEAD (Action for Health in Diabetes) study. Diabetes Care 2010;33(4):901–7
    1. de Muinck ED, Lie KI: Safety and efficacy of beta-blockers in the treatment of stable angina pectoris. J Cardiovasc Pharmacol 1990;16(Suppl. 5):S123–S128
    1. Deckert T, Feldt-Rasmussen B, Borch-Johnsen K, Jensen T, Kofoed-Enevoldsen A: Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia 1989;32(4):219–26
    1. Delahanty LM, Conroy MB, Nathan DM: Psychological predictors of physical activity in the Diabetes Prevention Program. J Am Diet Assoc 2006;106(5):698–705
    1. Delahanty LM, Nathan DM: Implications of the Diabetes Prevention Program and Look AHEAD clinical trials for lifestyle interventions. J Am Diet Assoc 2008;108(4 Suppl. 1):S66–S72
    1. Dempsey JC, Butler CL, Sorensen TK, et al. : A case-control study of maternal recreational physical activity and risk of gestational diabetes mellitus. Diabetes Res Clin Pract 2004;66(2):203–15
    1. Dempsey JC, Sorensen TK, Williams MA, et al. : Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol 2004;159(7):663–70
    1. Deshpande AD, Baker EA, Lovegreen SL, Brownson RC: Environmental correlates of physical activity among individuals with diabetes in the rural midwest. Diabetes Care 2005;28(5):1012–8
    1. Diabetes Prevention Program (DPP) Research Group The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care 2002;25(12):2165–71
    1. Dishman RK, Renner KJ, Youngstedt SD, et al. : Activity wheel running reduces escape latency and alters brain monoamine levels after footshock. Brain Res Bull 1997;42(5):399–406
    1. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK: American College of Sports Medicine Position Stand: appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009;41(2):459–71
    1. Droste SK, Gesing A, Ulbricht S, Muller MB, Linthorst AC, Reul JM: Effects of long-term voluntary exercise on the mouse hypothalamic–pituitary–adrenocortical axis. Endocrinology 2003;144(7):3012–23
    1. 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 2003;26(3):557–62
    1. Dunstan DW, Daly RM, Owen N, et al. : High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care 2002;25(10):1729–36
    1. Dunstan DW, Daly RM, Owen N, et al. : Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Diabetes Care 2005;28(1):3–9
    1. Dutton GR, Provost BC, Tan F, Smith D: A tailored print-based physical activity intervention for patients with type 2 diabetes. Preventive Medicine 2008;47(4):409–11
    1. Dutton GR, Tan F, Provost BC, Sorenson JL, Allen B, Smith D: Relationship between self-efficacy and physical activity among patients with type 2 diabetes. J Behav Med 2009;32(3):270–7
    1. Dyck R, Klomp H, Tan LK, Turnell RW, Boctor MA: A comparison of rates, risk factors, and outcomes of gestational diabetes between aboriginal and non-aboriginal women in the Saskatoon health district. Diabetes Care 2002;25(3):487–93
    1. 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 1998;57(Suppl. 1):375–8
    1. Eakin EG, Reeves MM, Lawler SP, et al. : The Logan Healthy Living Program: a cluster randomized trial of a telephone-delivered physical activity and dietary behavior intervention for primary care patients with type 2 diabetes or hypertension from a socially disadvantaged community—rationale, design and recruitment. Contemp Clin Trials 2008;29(3):439–54
    1. Eddy DM, Schlessinger L, Heikes K: The metabolic syndrome and cardiovascular risk: implications for clinical practice. Int J Obes (Lond) 2008;32(Suppl. 2):S5–S10
    1. Egede LE, Zheng D: Independent factors associated with major depressive disorder in a national sample of individuals with diabetes. Diabetes Care 2003;26(1):104–11
    1. Eriksson J, Lindstrom J, Valle T, et al. : 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 1999;42(7):793–801
    1. Evans EM, Racette SB, Peterson LR, Villareal DT, Greiwe JS, Holloszy JO: Aerobic power and insulin action improve in response to endurance exercise training in healthy 77–87 yr olds. J Appl Physiol 2005;98(1):40–5
    1. Ewing DJ, Clarke BF: Diabetic autonomic neuropathy: present insights and future prospects. Diabetes Care 1986;9(6):648–65
    1. Featherstone JF, Holly RG, Amsterdam EA: Physiologic responses to weight lifting in coronary artery disease. Am J Cardiol 1993;71(4):287–92
    1. Figueroa A, Baynard T, Fernhall B, Carhart R, Kanaley JA: Endurance training improves post-exercise cardiac autonomic modulation in obese women with and without type 2 diabetes. Eur J Appl Physiol 2007;100(4):437–44
    1. Fowler-Brown A, Pignone M, Pletcher M, Tice JA, Sutton SF, Lohr KN: Exercise tolerance testing to screen for coronary heart disease: a systematic review for the technical support for the U.S. Preventive Services Task Force. Ann Intern Med 2004;140(7):W9–W24
    1. Fox CS, Pencina MJ, Wilson PW, Paynter NP, Vasan RS, D'Agostino RB, Sr: Lifetime risk of cardiovascular disease among individuals with and without diabetes stratified by obesity status in the Framingham heart study. Diabetes Care 2008;31(8):1582–4
    1. Fredrickson SK, Ferro TJ, Schutrumpf AC: Disappearance of microalbuminuria in a patient with type 2 diabetes and the metabolic syndrome in the setting of an intense exercise and dietary program with sustained weight reduction. Diabetes Care 2004;27(7):1754–5
    1. Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O: Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 2003;348(5):383–93
    1. 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 2007;32(3):567–75
    1. Ganda O: Patients on various drug therapies. In Ruderman N DJ, Schenider SH, Kriska A: Eds. Handbook of Exercise in Diabetes. Alexandria (VA): American Diabetes Association; 2002. p. 587–99
    1. Garcia-Roves PM, Han DH, Song Z, Jones TE, Hucker KA, Holloszy JO: Prevention of glycogen supercompensation pro- longs the increase in muscle GLUT4 after exercise. Am J Physiol Endocrinol Metab 2003;285(4):E729–E736
    1. Garetto LP, Richter EA, Goodman MN, Ruderman NB: Enhanced muscle glucose metabolism after exercise in the rat: the two phases. Am J Physiol 1984;246(6 Pt 1):E471–E475
    1. Ghanassia E, Brun JF, Fedou C, Raynaud E, Mercier J: Substrate oxidation during exercise: type 2 diabetes is associated with a decrease in lipid oxidation and an earlier shift towards carbohydrate utilization. Diabetes Metab 2006;32(6):604–10
    1. Ghilarducci LE, Holly RG, Amsterdam EA: Effects of high resistance training in coronary artery disease. Am J Cardiol 1989;64(14):866–70
    1. Ghosh S, Khazaei M, Moien-Afshari F, et al. : Moderate exercise attenuates caspase-3 activity, oxidative stress, and inhibits progression of diabetic renal disease in db/db mice. Am J Physiol Renal Physiol 2009;296(4):F700–F708
    1. Gillison FB, Skevington SM, Sato A, Standage M, Evangelidou S: The effects of exercise interventions on quality of life in clinical and healthy populations; a meta-analysis. Soc Sci Med 2009;68(9):1700–10
    1. Gimeno Orna JA, Boned Juliani B, Lou Arnal LM, Castro Alonso FJ: Microalbuminuria and clinical proteinuria as the main predictive factors of cardiovascular morbidity and mortality in patients with type 2 diabetes [in Spanish]. Rev Clin Esp 2003;203(11):526–31
    1. Glasgow RE, Nutting PA, King DK, et al. : Randomized effectiveness trial of a computer-assisted intervention to improve diabetes care. Diabetes Care 2005;28(1):33–9
    1. Gleeson-Kreig J: Social support and physical activity in type 2 diabetes: a social-ecologic approach. Diabetes Educ 2008;34(6):1037–44
    1. Goldsmith JR, Lidtke RH, Shott S: The effects of range-of-motion therapy on the plantar pressures of patients with diabetes mellitus. J Am Podiatr Med Assoc 2002;92(9):483–90
    1. Goodpaster BH, Katsiaras A, Kelley DE: Enhanced fat oxidation through physical activity is associated with improvements in insulin sensitivity in obesity. Diabetes 2003;52(9):2191–7
    1. Goodyear LJ, Kahn BB: Exercise, glucose transport, and insulin sensitivity. Annu Rev Med 1998;49:235–61
    1. Gordon BA, Benson AC, Bird SR, Fraser SF: Resistance training improves metabolic health in type 2 diabetes: a systematic review. Diabetes Res Clin Pract 2009;83(2):157–75
    1. Gordon LA, Morrison EY, McGrowder DA, et al. : Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes. BMC Complement Altern Med 2008;8:21.
    1. Gorin AA, Wing RR, Fava JL, et al. : Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect. Int J Obes 2008;32(11):1678–84
    1. Goulet ED, Melancon MO, Aubertin-Leheudre M, Dionne IJ: Aerobic training improves insulin sensitivity 72–120 h after the last exercise session in younger but not in older women. Eur J Appl Physiol 2005;95(2–3):146–52
    1. Goulet ED, Melancon MO, Dionne IJ, Aubertin-Leheudre M: No sustained effect of aerobic or resistance training on insulin sensitivity in nonobese, healthy older women. J Aging Phys Act 2005;13(3):314–26
    1. Graham C, Lasko-McCarthey P: Exercise options for persons with diabetic complications. Diabetes Educ 1990;16(3):212–20
    1. Grossman E, Messerli FH, Goldbourt U: High blood pressure and diabetes mellitus: are all antihypertensive drugs created equal? Arch Intern Med 2000;160(16):2447–52
    1. Hamman RF, Wing RR, Edelstein SL, et al. : Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 2006;29(9):2102–7
    1. Haskell WL, Lee IM, Pate RR, et al. : 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 2007;39(8):1423–34
    1. Healy GN, Dunstan DW, Salmon J, et al. : Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care 2008;31(4):661–6
    1. Healy GN, Wijndaele K, Dunstan DW, et al. : Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) Diabetes Care 2008;31(2):369–71
    1. Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS, Jr: Physical activity and reduced occurrence of non–insulin-dependent diabetes mellitus. N Engl J Med 1991;325(3):147–52
    1. 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 2004;27(12):2988–9
    1. Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F: Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes 2004;53(2):294–305
    1. Houmard JA, Tanner CJ, Slentz CA, Duscha BD, McCartney JS, Kraus WE: Effect of the volume and intensity of exercise training on insulin sensitivity. J Appl Physiol 2004;96(1):101–6
    1. Howorka K, Pumprla J, Haber P, Koller-Strametz J, Mondrzyk J, Schabmann A: Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy. Cardiovasc Res 1997;34(1):206–14
    1. Hu FB, Sigal RJ, Rich-Edwards JW, et al. : Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999;282(15):1433–9
    1. Hu FB, Stampfer MJ, Solomon C, et al. : Physical activity and risk for cardiovascular events in diabetic women. Ann Intern Med 2001;134(2):96–105
    1. Ibanez J, Gorostiaga EM, Alonso AM, et al. : Lower muscle strength gains in older men with type 2 diabetes after resistance training. J Diabetes Complications 2008;22(2):112–8
    1. Ibanez J, Izquierdo M, Arguelles I, et al. : Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes. Diabetes Care 2005;28(3):662–7
    1. Innes KE, Vincent HK: The influence of yoga-based programs on risk profiles in adults with type 2 diabetes mellitus: a systematic review. Evid Based Complement Alternat Med 2007;4(4):469–86
    1. Ishii T, Yamakita T, Sato T, Tanaka S, Fujii S: Resistance training improves insulin sensitivity in NIDDM subjects without altering maximal oxygen uptake. Diabetes Care 1998;21(8):1353–5
    1. Ivy JL, Holloszy JO: Persistent increase in glucose uptake by rat skeletal muscle following exercise. Am J Physiol 1981;241(5):C200–C203
    1. Jackson R, Asimakopoulou K, Scammell A: Assessment of the transtheoretical model as used by dietitians in promoting physical activity in people with type 2 diabetes. J Hum Nutr Diet 2007;20(1):27–36
    1. Jacobs-van der Bruggen MA, Bos G, Bemelmans WJ, Hoogenveen RT, Vijgen SM, Baan CA: Lifestyle interventions are cost-effective in people with different levels of diabetes risk: results from a modeling study. Diabetes Care 2007;30(1):128–34
    1. Jacobs-van der Bruggen MA, van Baal PH, Hoogenveen RT, et al. : Cost-effectiveness of lifestyle modification in diabetes patients. Diabetes Care 2009;32(8):1453–8
    1. Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W: Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA 2003;290(10):1323–30
    1. Jeffery RW, Wing RR, Sherwood NE, Tate DF: Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr 2003;78(4):684–9
    1. Jeon CY, Lokken RP, Hu FB, van Dam RM: Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care 2007;30(3):744–52
    1. Johansen KL: Exercise and chronic kidney disease: current recommendations. Sports Med 2005;35(6):485–99
    1. John L, Rao PS, Kanagasabapathy AS: Rate of progression of albuminuria in type II diabetes. Five-year prospective study from south India. Diabetes Care 1994;17(8):888–90
    1. Johnson NA, Sachinwalla T, Walton DW, et al. : Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology 2009;50(4):1105–12
    1. Juutilainen A, Lehto S, Ronnemaa T, Pyorala K, Laakso M: Retinopathy predicts cardiovascular mortality in type 2 diabetic men and women. Diabetes Care 2007;30(2):292–9
    1. Kadoglou NP, Iliadis F, Angelopoulou N, et al. : The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus. Eur J Cardiovasc Prev Rehabil 2007;14(6):837–43
    1. Kahn JK, Zola B, Juni JE, Vinik AI: Decreased exercise heart rate and blood pressure response in diabetic subjects with cardiac autonomic neuropathy. Diabetes Care 1986;9(4):389–94
    1. Kang J, Kelley DE, Robertson RJ, et al. : Substrate utilization and glucose turnover during exercise of varying intensities in individuals with NIDDM. Med Sci Sports Exerc 1999;31(1):82–9
    1. Kang J, Robertson RJ, Hagberg JM, et al. : Effect of exercise intensity on glucose and insulin metabolism in obese individuals and obese NIDDM patients. Diabetes Care 1996;19(4):341–9
    1. Kelley GA, Kelley KA, Tran ZV: Aerobic exercise and resting blood pressure: a meta-analytic review of randomized, controlled trials. Prev Cardiol 2001;4(2):73–80
    1. Kelley GA, Kelley KS: Progressive resistance exercise and resting blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2000;35(3):838–43
    1. Kelley GA, Kelley KS: Effects of aerobic exercise on lipids and lipoproteins in adults with type 2 diabetes: a meta-analysis of randomized-controlled trials. Public Health 2007;121(9):643–55
    1. Kelley GA, Sharpe Kelley K: Aerobic exercise and resting blood pressure in older adults: a meta-analytic review of randomized controlled trials. J Gerontol A Biol Sci Med Sci 2001;56(5):M298–M303
    1. Kennedy JW, Hirshman MF, Gervino EV, et al. : Acute exercise induces GLUT4 translocation in skeletal muscle of normal human subjects and subjects with type 2 diabetes. Diabetes 1999;48(5):1192–7
    1. Keyserling TC, Samuel-Hodge CD, Ammerman AS, et al. : A randomized trial of an intervention to improve self-care behaviors of African-American women with type 2 diabetes: impact on physical activity. Diabetes Care 2002;25(9):1576–83
    1. Kim SH, Lee SJ, Kang ES, et al. : Effects of lifestyle modification on metabolic parameters and carotid intima-media thickness in patients with type 2 diabetes mellitus. Metabolism 2006;55(8):1053–9
    1. King DS, Baldus PJ, Sharp RL, Kesl LD, Feltmeyer TL, Riddle MS: Time course for exercise-induced alterations in insulin action and glucose tolerance in middle-aged people. J Appl Physiol 1995;78(1):17–22
    1. Kinmonth AL, Wareham NJ, Hardeman W, et al. : Efficacy of a theory-based behavioural intervention to increase physical activity in an at-risk group in primary care (ProActive UK): a randomised trial. Lancet 2008;371(9606):41–8
    1. Kirk A, Barnett J, Leese G, Mutrie N: A randomized trial investigating the 12-month changes in physical activity and health outcomes following a physical activity consultation delivered by a person or in written form in type 2 diabetes: Time2Act. Diabet Med 2009;26(3):293–301
    1. Kirk A, Mutrie N, MacIntyre P, Fisher M: Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with type 2 diabetes. Diabetologia 2004;47(5):821–32
    1. Kirk AF, Mutrie N, Macintyre PD, Fisher MB: Promoting and maintaining physical activity in people with type 2 diabetes. Am J Prev Med 2004;27(4):289–96
    1. Kirwan JP, Solomon TP, Wojta DM, Staten MA, Holloszy JO: Effects of 7 days of exercise training on insulin sensitivity and responsiveness in type 2 diabetes mellitus. Am J Physiol Endocrinol Metab 2009;297(1):E151–E156
    1. Klein R, Klein BE, Moss SE: Epidemiology of proliferative diabetic retinopathy. Diabetes Care 1992;15(12):1875–91
    1. Klein R, Klein BE, Moss SE: Prevalence of microalbuminuria in older-onset diabetes. Diabetes Care 1993;16(10):1325–30
    1. Knowler WC, Barrett-Connor E, Fowler SE, et al. : Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393–403
    1. Knudtson MD, Klein R, Klein BE: Physical activity and the 15-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye study. Br J Ophthalmol 2006;90(12):1461–3
    1. Koh KP, Fassett RG, Sharman JE, Coombes JS, Williams AD: Effect of intradialytic versus home-based aerobic exercise training on physical function and vascular parameters in hemodialysis patients: a randomized pilot study. Am J Kidney Dis 2010;55(1):88–99
    1. Koivisto V, Defronzo R: Exercise in the treatment of type II diabetes. Acta Endocrinol (Copenh) 1984;262(Suppl.):107–16
    1. Kokkinos P, Myers J, Nylen E, et al. : Exercise capacity and all-cause mortality in African American and Caucasian men with type 2 diabetes. Diabetes Care 2009;32(4):623–8
    1. Kosaka K, Noda M, Kuzuya T: Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males. Diabetes Res Clin Pract 2005;67(2):152–62
    1. Kothari V, Stevens RJ, Adler AI, et al. : UKPDS 60: risk of stroke in type 2 diabetes estimated by the UK Prospective Diabetes Study risk engine. Stroke 2002;33(7):1776–81
    1. Kreisman SH, Halter JB, Vranic M, Marliss EB: Combined infusion of epinephrine and norepinephrine during moderate exercise reproduces the glucoregulatory response of intense exercise. Diabetes 2003;52(6):1347–54
    1. Kwon HR, Han KA, Ku YH, et al. : The effects of resistance training on muscle and body fat mass and muscle strength in type 2 diabetic women. Korean Diabetes J 2010;34(2):101–10
    1. Laaksonen DE, Lindstrom J, Lakka TA, et al. : Physical activity in the prevention of type 2 diabetes: the Finnish Diabetes Prevention Study. Diabetes 2005;54(1):158–65
    1. Lam P, Dennis SM, Diamond TH, Zwar N: Improving glycaemic and BP control in type 2 diabetes. The effectiveness of tai chi. Aust Fam Physician 2008;37(10):884–7
    1. Larsen JJ, Dela F, Madsbad S, Galbo H: The effect of intense exercise on postprandial glucose homeostasis in type II diabetic patients. Diabetologia 1999;42(11):1282–92
    1. Larsen JJ, Dela F, Madsbad S, Vibe-Petersen J, Galbo H: Interaction of sulfonylureas and exercise on glucose homeostasis in type 2 diabetic patients. Diabetes Care 1999;22(10):1647–54
    1. Lazarevic G, Antic S, Vlahovic P, Djordjevic V, Zvezdanovic L, Stefanovic V: Effects of aerobic exercise on microalbuminuria and enzymuria in type 2 diabetic patients. Ren Fail 2007;29(2):199–205
    1. Lee DC, Sui X, Church TS, Lee IM, Blair SN: Associations of cardiorespiratory fitness and obesity with risks of impaired fasting glucose and type 2 diabetes in men. Diabetes Care 2009;32(2):257–62
    1. Lee IM, Skerrett PJ: Physical activity and all-cause mortality: what is the dose–response relation? Med Sci Sports Exerc 2001;33(Suppl. 6):S459–S471; discussion S93–S94
    1. Legato MJ, Gelzer A, Goland R, et al. : Gender-specific care of the patient with diabetes: review and recommendations. Gend Med 2006;3(2):131–58
    1. Lemaster JW, Mueller MJ, Reiber GE, Mehr DR, Madsen RW, Conn VS: Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: feet first randomized controlled trial. Phys Ther 2008;88(11):1385–98
    1. Lemaster JW, Reiber GE, Smith DG, Heagerty PJ, Wallace C: Daily weight-bearing activity does not increase the risk of diabetic foot ulcers. Med Sci Sports Exerc 2003;35(7):1093–9
    1. Levine JA, Lanningham-Foster LM, McCrady SK, et al. : Interindividual variation in posture allocation: possible role in human obesity. Science 2005;307(5709):584–6
    1. Levine JA, McCrady SK, Lanningham-Foster LM, Kane PH, Foster RC, Manohar CU: The role of free-living daily walking in human weight gain and obesity. Diabetes 2008;57(3):548–54
    1. Li G, Zhang P, Wang J, et al. : The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet 2008;371(9626):1783–9
    1. Liebreich T, Plotnikoff RC, Courneya KS, Boule N: Diabetes NetPLAY: a physical activity website and linked email counselling randomized intervention for individuals with type 2 diabetes. Int J Behav Nutr Phys Act 2009;6:18.
    1. Lind E, Ekkekakis P, Vazou S: The affective impact of exercise intensity that slightly exceeds the preferred level: pain for no additional gain. J Health Psychol 2008;13(4):464–8
    1. Lindstrom J, Ilanne-Parikka P, Peltonen M, et al. : Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 2006;368(9548):1673–9
    1. Liu J, Laditka JN, Mayer-Davis EJ, Pate RR: Does physical activity during pregnancy reduce the risk of gestational diabetes among previously inactive women? Birth 2008;35(3):188–95
    1. Loimaala A, Groundstroem K, Rinne M, et al. : Effect of long-term endurance and strength training on metabolic control and arterial elasticity in patients with type 2 diabetes mellitus. Am J Cardiol 2009;103(7):972–7
    1. Loimaala A, Huikuri HV, Koobi T, Rinne M, Nenonen A, Vuori I: Exercise training improves baroreflex sensitivity in type 2 diabetes. Diabetes 2003;52(7):1837–42
    1. Low PA, Walsh JC, Huang CY, McLeod JG: The sympathetic nervous system in diabetic neuropathy. A clinical and pathological study. Brain 1975;98(3):341–56
    1. Maiorana A, O'Driscoll G, Goodman C, Taylor R, Green D: Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes Res Clin Pract 2002;56(2):115–23
    1. Malpass A, Andrews R, Turner KM: Patients with type 2 diabetes experiences of making multiple lifestyle changes: a qualitative study. Patient Educ Couns 2009;74(2):258–63
    1. Mamcarz A, Chmielewski M, Braksator W, et al. : Factors influencing cardiac complications in patients with type-2 diabetes mellitus and silent myocardial ischaemia: five-year follow-up [in Polish]. Pol Arch Med Wewn 2004;112(6):1433–43
    1. Manetta J, Brun JF, Perez-Martin A, Callis A, Prefaut C, Mercier J: Fuel oxidation during exercise in middle-aged men: role of training and glucose disposal. Med Sci Sports Exerc 2002;34(3):423–9
    1. Manson JE, Rimm EB, Stampfer MJ, et al. : Physical activity and incidence of non–insulin-dependent diabetes mellitus in women. Lancet 1991;338(8770):774–8
    1. Marcus RL, Smith S, Morrell G, et al. : Comparison of combined aerobic and high-force eccentric resistance exercise with aerobic exercise only for people with type 2 diabetes mellitus. Phys Ther 2008;88(11):1345–54
    1. Marliss EB, Vranic M: Intense exercise has unique effects on both insulin release and its roles in glucoregulation: implications for diabetes. Diabetes 2002;51(Suppl. 1):S271–S283
    1. McAuley E, Blissmer B: Self-efficacy determinants and con- sequences of physical activity. Exerc Sport Sci Rev 2000;28(2):85–8
    1. McAuley PA, Myers JN, Abella JP, Tan SY, Froelicher VF: Exercise capacity and body mass as predictors of mortality among male veterans with type 2 diabetes. Diabetes Care 2007;30(6):1539–43
    1. McDermott MM, Ades P, Guralnik JM, et al. : Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA 2009;301(2):165–74
    1. McGavock J, Sellers E, Dean H: Physical activity for the prevention and management of youth-onset type 2 diabetes mellitus: focus on cardiovascular complications. Diab Vasc Dis Res 2007;4(4):305–10
    1. McKay HG, King D, Eakin EG, Seeley JR, Glasgow RE: The diabetes network Internet-based physical activity intervention: a randomized pilot study. Diabetes Care 2001;24(8):1328–34
    1. Mier N, Medina AA, Ory MG: Mexican Americans with type 2 diabetes: perspectives on definitions, motivators, and programs of physical activity. Prev Chronic Dis 2007;4(2):A24.
    1. Minuk HL, Vranic M, Hanna AK, Albisser AM, Zinman B: Glucoregulatory and metabolic response to exercise in obese non-insulin-dependent diabetes. Am J Physiol 1981;240:E458–E464
    1. Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW: Are health care professionals advising patients with diabetes or at risk for developing diabetes to exercise more? Diabetes Care 2006;29(3):543–8
    1. Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW: Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care 2007;30(2):203–9
    1. Morrison S, Colberg SR, Mariano M, Parson HK, Vinik AI: Balance training reduces falls risk in older individuals with type 2 diabetes. Diabetes Care 33(4):748–50
    1. Mourad JJ, Le Jeune S: Blood pressure control, risk factors and cardiovascular prognosis in patients with diabetes: 30 years of progress. J Hypertens Suppl 2008;26(3):S7–S13
    1. Mourier A, Gautier JF, De Kerviler E, et al. : Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM. Effects of branched-chain amino acid supplements. Diabetes Care 1997;20(3):385–91
    1. Muller-Riemenschneider F, Reinhold T, Nocon M, Willich SN: Long-term effectiveness of interventions promoting physical activity: a systematic review. Prev Med 2008;47(4):354–68
    1. Musi N, Fujii N, Hirshman MF, et al. : AMP-activated protein kinase (AMPK) is activated in muscle of subjects with type 2 diabetes during exercise. Diabetes 2001;50(5):921–7
    1. Narayan KM, Boyle JP, Geiss LS, Saaddine JB, Thompson TJ: Impact of recent increase in incidence on future diabetes burden: U.S., 2005–2050. Diabetes Care 2006;29(9):2114–6
    1. Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF: Lifetime risk for diabetes mellitus in the United States. JAMA 2003;290(14):1884–90
    1. National High Blood Pressure Education Program Working Group National High Blood Pressure Education Program Working Group report on hypertension in diabetes. Hypertension 1994;23(2):145–58; discussion 59–60
    1. Nelson ME, Rejeski WJ, Blair SN, et al. : Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007;39(8):1435–45
    1. Nichols GA, Koro CE: Does statin therapy initiation increase the risk for myopathy? An observational study of 32,225 diabetic and nondiabetic patients. Clin Ther 2007;29(8):1761–70
    1. O'Gorman DJ, Karlsson HK, McQuaid S, et al. : Exercise training increases insulin-stimulated glucose disposal and GLUT4 (SLC2A4) protein content in patients with type 2 diabetes. Diabetologia 2006;49(12):2983–92
    1. Ogilvie D, Foster CE, Rothnie H, et al. : Interventions to promote walking: systematic review [see comment]. BMJ 2007;334(7605):1204.
    1. Oken E, Ning Y, Rifas-Shiman SL, Radesky JS, Rich-Edwards JW, Gillman MW: Associations of physical activity and inactivity before and during pregnancy with glucose tolerance. Obstet Gynecol 2006;108(5):1200–7
    1. Paffenbarger RS, Jr, Hyde RT, Wing AL, Lee IM, Jung DL, Kampert JB: The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993;328(8):538–45
    1. Pagkalos M, Koutlianos N, Kouidi E, Pagkalos E, Mandroukas K, Deligiannis A: Heart rate variability modifications following exercise training in type 2 diabetic patients with definite cardiac autonomic neuropathy. Br J Sports Med 2008;42(1):47–54
    1. Painter P, Carlson L, Carey S, Paul SM, Myll J: Low-functioning hemodialysis patients improve with exercise training. Am J Kidney Dis 2000;36(3):600–8
    1. Painter P, Carlson L, Carey S, Paul SM, Myll J: Physical functioning and health-related quality-of-life changes with exercise training in hemodialysis patients. Am J Kidney Dis 2000;35(3):482–92
    1. Pan XR, Li GW, Hu YH, et al. : Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997;20(4):537–44
    1. Pavlou KN, Krey S, Steffee WP: Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr 1989;49(Suppl. 5):1115–23
    1. Peek ME, Tang H, Alexander GC, Chin MH: National prevalence of lifestyle counseling or referral among African-Americans and whites with diabetes. J Gen Intern Med 2008;23(11):1858–64
    1. Pena KE, Stopka CB, Barak S, Gertner HR, Jr, Carmeli E: Effects of low-intensity exercise on patients with peripheral artery disease. Phys Sportsmed 2009;37(1):106–10
    1. Penn L, Moffatt SM, White M: Participants' perspective on maintaining behaviour change: a qualitative study within the European Diabetes Prevention Study. BMC Public Health 2008;8:235.
    1. Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A: Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care 2000;23(5):606–11
    1. Physical Activity Guidelines Advisory Committee Physical Activity Guidelines Advisory Committee Report, 2008. Washington (DC); U.S. Department of Health and Human Services; 2008. p 683
    1. Pi-Sunyer X, Blackburn G, Brancati FL, et al. : Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care 2007;30(6):1374–83
    1. Plockinger U, Topuz M, Riese B, Reuter T: Risk of exercise-induced hypoglycaemia in patients with type 2 diabetes on intensive insulin therapy: comparison of insulin glargine with NPH insulin as basal insulin supplement. Diabetes Res Clin Pract 2008;81(3):290–5
    1. Ploug T, Galbo H, Richter EA: Increased muscle glucose uptake during contractions: no need for insulin. Am J Physiol 1984;247(6 Pt 1):E726–E731
    1. Poirier P, Mawhinney S, Grondin L, et al. : Prior meal enhances the plasma glucose lowering effect of exercise in type 2 diabetes. Med Sci Sports Exerc 2001;33(8):1259–64
    1. Practice ACO: ACOG Committee opinion. Number 267, January 2002: exercise during pregnancy and the postpartum period. Obstet Gynecol 2002;99(1):171–3
    1. Pruchnic R, Katsiaras A, He J, Kelley DE, Winters C, Goodpaster BH: Exercise training increases intramyocellular lipid and oxidative capacity in older adults. Am J Physiol Endocrinol Metab 2004;287(5):E857–E862
    1. Ramachandran A, Snehalatha C, Mary S, et al. : The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 2006;49(2):289–97
    1. Rhodes RE, Warburton DE, Murray H: Characteristics of physical activity guidelines and their effect on adherence: a review of randomized trials. Sports Med 2009;39(5):355–75
    1. Richter EA, Garetto LP, Goodman MN, Ruderman NB: Muscle glucose metabolism following exercise in the rat: increased sensitivity to insulin. J Clin Invest 1982;69(4):785–93
    1. Richter EA, Ploug T, Galbo H: Increased muscle glucose uptake after exercise. No need for insulin during exercise. Diabetes 1985;34(10):1041–8
    1. Rimbert V, Boirie Y, Bedu M, Hocquette JF, Ritz P, Morio B: Muscle fat oxidative capacity is not impaired by age but by physical inactivity: association with insulin sensitivity. FASEB J 2004;18(6):737–9
    1. Ronnemaa T, Marniemi J, Puukka P, Kuusi T: Effects of long-term physical exercise on serum lipids, lipoproteins and lipid metabolizing enzymes in type 2 (non–insulin-dependent) diabetic patients. Diabetes Res 1988;7(2):79–84
    1. Rosenstock J, Hassman DR, Madder RD, et al. : Repaglinide versus nateglinide monotherapy: a randomized, multicenter study. Diabetes Care 2004;27(6):1265–70
    1. Ross R, Dagnone D, Jones PJ, et al. : Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000;133(2):92–103
    1. Ross R, Janssen I, Dawson J, et al. : Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res 2004;12(5):789–98
    1. Sacco WP, Malone JI, Morrison AD, Friedman A, Wells K: Effect of a brief, regular telephone intervention by paraprofessionals for type 2 diabetes. J Behav Med 2009;32(4):349–59
    1. Saris WH, Blair SN, van Baak MA, et al. : How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obes Rev 2003;4(2):101–14
    1. Schoeller DA, Shay K, Kushner RF: How much physical activity is needed to minimize weight gain in previously obese women? Am J Clin Nutr 1997;66(3):551–6
    1. Sharples L, Hughes V, Crean A, et al. : Cost-effectiveness of functional cardiac testing in the diagnosis and management of coronary artery disease: a randomised controlled trial. The CECaT trial. Health Technol Assess 2007;11(49):iii–iv, ix–115
    1. Shrier I: Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clin J Sport Med 1999;9(4):221–7
    1. Sigal RJ, Kenny GP, Boule' NG, et al. : Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med 2007;147:357–69
    1. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C: Physical activity/exercise and type 2 diabetes. Diabetes Care 2004;27(10):2518–39
    1. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD: Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care 2006;29(6):1433–8
    1. Sigal RJ, Purdon C, Bilinski D, Vranic M, Halter JB, Marliss EB: Glucoregulation during and after intense exercise: effects of beta-blockade. J Clin Endocrinol Metab 1994;78(2):359–66
    1. Singleton JR, Smith AG, Russell JW, Feldman EL: Microvascular complications of impaired glucose tolerance. Diabetes 2003;52(12):2867–73
    1. Sjosten N, Kivela SL: The effects of physical exercise on depressive symptoms among the aged: a systematic review. Int J Geriatr Psychiatry 2006;21(5):410–8
    1. Smith AG, Singleton JR: Impaired glucose tolerance and neuropathy. Neurologist 2008;14(1):23–9
    1. Smith SC, Jr, Allen J, Blair SN, et al. : AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation 2006;113(19):2363–72
    1. Snowling NJ, Hopkins WG: Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care 2006;29(11):2518–27
    1. Stellingwerff T, Boon H, Gijsen AP, Stegen JH, Kuipers H, van Loon LJ: Carbohydrate supplementation during pro- longed cycling exercise spares muscle glycogen but does not affect intramyocellular lipid use. Pflugers Arch 2007;454(4):635–47
    1. Stevens RJ, Kothari V, Adler AI, Stratton IM: The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56). Clin Sci (Lond) 2001;101(6):671–9
    1. Stewart KJ: Role of exercise training on cardiovascular disease in persons who have type 2 diabetes and hypertension. Cardiol Clin 2004;22(4):569–86
    1. Suh SH, Paik IY, Jacobs K: Regulation of blood glucose homeostasis during prolonged exercise. Mol Cells 2007;23(3):272–9
    1. Sui X, Hooker SP, Lee IM, et al. : A prospective study of cardiorespiratory fitness and risk of type 2 diabetes in women. Diabetes Care 2008;31(3):550–5
    1. Szewieczek J, Dulawa J, Strzalkowska D, Batko-Szwaczka A, Hornik B: Normal insulin response to short-term intense exercise is abolished in type 2 diabetic patients treated with gliclazide. J Diabetes Complications 2009;23(6):380–6
    1. Szewieczek J, Dulawa J, Strzalkowska D, Hornik B, Kawecki G: Impact of the short-term, intense exercise on postprandial glycemia in type 2 diabetic patients treated with gliclazide. J Diabetes Complications 2007;21(2):101–7
    1. The Today Study Group, Zeitler P, Epstein L, et al. : Treatment options for type 2 diabetes in adolescents and youth: a study of the comparative efficacy of metformin alone or in combination with rosiglitazone or lifestyle intervention in adolescents with type 2 diabetes. Pediatr Diabetes 2007;8(2):74–87
    1. Thomas DE, Elliott EJ, Naughton GA: Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev 2006;3:CD002968.
    1. Tomas E, Sevilla L, Palacin M, Zorzano A: The insulin-sensitive GLUT4 storage compartment is a postendocytic and heterogeneous population recruited by acute exercise. Biochem Biophys Res Commun 2001;284(2):490–5
    1. Tsang T, Orr R, Lam P, Comino E, Singh MF: Effects of tai chi on glucose homeostasis and insulin sensitivity in older adults with type 2 diabetes: a randomised double-blind sham-exercise- controlled trial. Age Ageing 2008;37(1):64–71
    1. Tudor-Locke C, Bell RC, Myers AM, et al. : Controlled outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type II diabetes. Int J Obes Relat Metab Disord 2004;28(1):113–9
    1. Tufescu A, Kanazawa M, Ishida A, et al. : Combination of exercise and losartan enhances renoprotective and peripheral effects in spontaneously type 2 diabetes mellitus rats with nephropathy. J Hypertens 2008;26(2):312–21
    1. Tuomilehto J, Lindstrom J, Eriksson JG, et al. : Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344(18):1343–50
    1. U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2007. Atlanta (GA): U.S. Department of Health and Human Services Centers for Disease Control and Prevention; 2008
    1. U.S. Preventive Services Task Force Screening for coronary heart disease: recommendation statement. Ann Intern Med 2004;140(7):569–72
    1. Vincent KR, Braith RW, Feldman RA, et al. : Resistance exercise and physical performance in adults aged 60 to 83. J Am Geriatr Soc 2002;50(6):1100–7
    1. Vinik AI: Neuropathy. In The Health Professional's Guide to Diabetes and Exercise. Alexandria (VA): American Diabetes Association; 1995. p. 183–97
    1. Vinik AI, Ziegler D: Diabetic cardiovascular autonomic neuropathy. Circulation 2007;115(3):387–97
    1. Wadden TA, West DS, Delahanty L, et al. : The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it. Obesity 2006;14(5):737–52
    1. Wagner H, Degerblad M, Thorell A, et al. : Combined treatment with exercise training and acarbose improves metabolic control and cardiovascular risk factor profile in subjects with mild type 2 diabetes. Diabetes Care 2006;29(7):1471–7
    1. Wahren J, Ekberg K: Splanchnic regulation of glucose production. Annu Rev Nutr 2007;27:329–45
    1. Wang JH: Effects of tai chi exercise on patients with type 2 diabetes. Med Sport Sci 2008;52:230–8
    1. Wang Y, Simar D, Fiatarone Singh MA: Adaptations to exercise training within skeletal muscle in adults with type 2 diabetes or impaired glucose tolerance: a systematic review. Diabetes Metab Res Rev 2009;25(1):13–40
    1. Watt MJ, Heigenhauser GJ, Dyck DJ, Spriet LL: Intramuscular triacylglycerol, glycogen and acetyl group metabolism during 4 h of moderate exercise in man. J Physiol 2002;541(Pt 3):969–78
    1. Wei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN: Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med 2000;132(8):605–11
    1. Wei M, Gibbons LW, Mitchell TL, Kampert JB, Lee CD, Blair SN: The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men. Ann Intern Med 1999;130(2):89–96
    1. Weinsier RL, Hunter GR, Desmond RA, Byrne NM, Zuckerman PA, Darnell BE: Free-living activity energy expenditure in women successful and unsuccessful at maintaining a normal body weight. Am J Clin Nutr 2002;75(3):499–504
    1. Wenger NK, Froelicher ES, Smith LK, et al. : Cardiac rehabilitation as secondary prevention. Agency for Health Care Policy and Research and National Heart, Lung, and Blood Institute. Clin Pract Guidel Quick Ref Guide Clin 1995;17:1–23
    1. Willey KA, Singh MA: Battling insulin resistance in elderly obese people with type 2 diabetes: bring on the heavy weights. Diabetes Care 2003;26(5):1580–8
    1. Williams DM: Exercise, affect, and adherence: an integrated model and a case for self-paced exercise. J Sport Exerc Psychol 2008;30(5):471–96
    1. Williams DM, Dunsiger S, Ciccolo JT, Lewis BA, Albrecht AE, Marcus BH: Acute affective response to a moderate-intensity exercise stimulus predicts physical activity participation 6 and 12 months later. Psychol Sport Exerc 2008;9(3):231–45
    1. Williams K, Prevost AT, Griffin S, et al. : The ProActive trial protocol—a randomised controlled trial of the efficacy of a family-based, domiciliary intervention programme to increase physical activity among individuals at high risk of diabetes [ISRCTN61323766]. BMC Public Health 2004;4:48.
    1. Williamson DA, Rejeski J, Lang W, et al. : Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Arch Intern Med 2009;169(2):163–71
    1. Wing RR: Exercise and weight control. In Ruderman N, Devlin JT, Schneider SH, Kriska A: Eds. Handbook of Exercise in Diabetes. Alexandria (VA): American Diabetes Association; 2002. p. 355–64
    1. Winnick JJ, Sherman WM, Habash DL, et al. : Short-term aerobic exercise training in obese humans with type 2 diabetes mellitus improves whole-body insulin sensitivity through gains in peripheral, not hepatic insulin sensitivity. J Clin Endocrinol Metab 2008;93(3):771–8
    1. Wycherley TP, Brinkworth GD, Noakes M, Buckley JD, Clifton PM: Effect of caloric restriction with and without exercise training on oxidative stress and endothelial function in obese subjects with type 2 diabetes. Diabetes Obes Metab 2008;10(11):1062–73
    1. Yates T, Davies M, Gorely T, Bull F, Khunti K: Rationale, design and baseline data from the Pre-diabetes Risk Education and Physical Activity Recommendation and Encouragement (PRE-PARE) programme study: a randomized controlled trial. Patient Educ Couns 2008;73(2):264–71
    1. Yates T, Khunti K, Bull F, Gorely T, Davies MJ: The role of physical activity in the management of impaired glucose tolerance: a systematic review. Diabetologia 2007;50(6):1116–26
    1. Yeh SH, Chuang H, Lin LW, Hsiao CY, Wang PW, Yang KD: Tai chi chuan exercise decreases A1C levels along with increase of regulatory T-cells and decrease of cytotoxic T-cell population in type 2 diabetic patients. Diabetes Care 2007;30(3):716–8
    1. Yeung EW, Yeung SS: Interventions for preventing lower limb soft-tissue injuries in runners. Cochrane Database Syst Rev 2001;3:CD001256.
    1. Young LH, Wackers FJ, Chyun DA, et al. : Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: the DIAD study: a randomized controlled trial. JAMA 2009;301(15):1547–55
    1. Zee RY, Romero JR, Gould JL, Ricupero DA, Ridker PM: Polymorphisms in the advanced glycosylation end product-specific receptor gene and risk of incident myocardial infarction or ischemic stroke. Stroke 2006;37(7):1686–90
    1. Zhang C, Solomon CG, Manson JE, Hu FB: A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Arch Intern Med 2006;166(5):543–8
    1. Zhang Y, Fu FH: Effects of 14-week tai ji quan exercise on metabolic control in women with type 2 diabetes. Am J Chin Med 2008;36(4):647–54
    1. Ziegler D, Gries FA, Spuler M, Lessmann F: The epidemiology of diabetic neuropathy. Diabetic Cardiovascular Autonomic Neuropathy Multicenter Study Group. J Diabetes Complications 1992;6(1):49–57
    1. Zierath JR, He L, Guma A, Odegoard Wahlstrom E, Klip A, Wallberg-Henriksson H: Insulin action on glucose transport and plasma membrane GLUT4 content in skeletal muscle from patients with NIDDM. Diabetologia 1996;39(10):1180–9
    1. Zoppini G, Targher G, Zamboni C, et al. : Effects of moderate-intensity exercise training on plasma biomarkers of inflammation and endothelial dysfunction in older patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2006;16(8):543–9
    1. Zwierska I, Walker RD, Choksy SA, Male JS, Pockley AG, Saxton JM: Upper- vs lower-limb aerobic exercise rehabilitation in patients with symptomatic peripheral arterial disease: a randomized controlled trial. J Vasc Surg 2005;42(6):1122–30

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