Exercise and the Treatment of Type 2 Diabetes Mellitus: An Update
Abstract
Exercise has long been considered a cornerstone in the treatment regimen for patients with type 2 (non-insulin-dependent) diabetes mellitus. Aerobic endurance exercise has traditionally been advocated as the most suitable exercise mode. Several exercise studies have evaluated the effect of exercise on insulin sensitivity and glycaemic control in patients with type 2 diabetes mellitus. However, the results obtained have been highly heterogeneous regarding the effect of exercise on insulin sensitivity and glycaemic control. Only in certain subgroups (e.g. patients with type 2 diabetes mellitus under 55 years of age, those with diabetes treated through diet and those who have diabetes with fairly good metabolic control), does exercise seem to be beneficial with regard to improvement in glycaemic control. There has been little research into the effects of resistance training on glucose metabolism in patients with type 2 diabetes mellitus compared with the amount of research involving aerobic endurance exercise. The incidence of type 2 diabetes mellitus increases with increasing age, partly because of the decline in muscle mass associated with aging. This corresponds with a decline in metabolic function, supporting the usefulness of resistance training. Available studies support the usefulness of resistance training in the treatment of type 2 diabetes mellitus. Therefore, based on the published studies reviewed, this author proposes that an optimal exercise programme for individuals with type 2 diabetes mellitus should include components that improve cardiorespiratory fitness, muscular strength and endurance, i.e. a combination of aerobic endurance training and circuit-type resistance training. Programmes combining various modes of exercise positively influence patient compliance with the exercise programme. The vast majority of patients with type 2 diabetes mellitus can undertake an individualised exercise programme without significantly increased risks of complications.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Low attrition rates occur within many exercise programs and there is a high rate of repeated hypocaloric diet attempts.
“Something that has become evident in the low attrition rates within many exercise programs and the high rate of repeated hypocaloric diet attempts [13-16].”
Cites
Physical Activity and Health: A Report of the Surgeon General
(1995) · PsycEXTRA Dataset · doi:10.1037/e525162010-001 · Cited by 5,488 · see citing works
Pathogenesis of NIDDM. A balanced overview.
DeFronzo, R. A., Bonadonna, R. C., & Ferrannini, E. (1992) · Diabetes Care · doi:10.2337/diacare.15.3.318 · Cited by 2,085 · see citing works
Physical activity and reduced occurrence of non–insulin-dependent diabetes mellitus
Helmrich, S. P., Ragland, D. R., Leung, R. W., & Paffenbarger, R. S. (1991) · New England Journal of Medicine · doi:10.1056/nejm199107183250302 · Cited by 1,634 · see citing works
Physical activity and incidence of non-insulin-dependent diabetes mellitus in women
Manson, J. E., Stampfer, M. J., Colditz, G. A., Willett, W. C., Rosner, B., Hennekens, C. H., Speizer, F. E., Rimm, E. B., & Krolewski, A. S. (1991) · The Lancet · doi:10.1016/0140-6736(91)90664-b · Cited by 1,164 · see citing works
Substrate Turnover during Prolonged Exercise in Man
Ahlborg, G., Felig, P., Hagenfeldt, L., Hendler, R., & Wahren, J. (1974) · Journal of Clinical Investigation · doi:10.1172/jci107645 · Cited by 786 · see citing works
A Prospective Study of Exercise and Incidence of Diabetes Among US Male Physicians
Manson, J. E. (1992) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1992.03490010065031 · Cited by 778 · see citing works
Physical Activity, Fitness, and Health
(2012) · doi:10.5040/9781718209107.part-001 · Cited by 742 · see citing works
International Textbook of Diabetes Mellitus
(2003) · Wiley eBooks · doi:10.1002/0470862092 · Cited by 741 · see citing works
Perseghin, G., Price, T. B., Petersen, K. F., Roden, M., Cline, G. W., Gerow, K., Rothman, D. L., & Shulman, G. I. (1996) · New England Journal of Medicine · doi:10.1056/nejm199610313351804 · Cited by 699 · see citing works
Glucose metabolism during leg exercise in man
Wahren, J., Felig, P., Ahlborg, G., & Jorfeldt, L. (1971) · Journal of Clinical Investigation · doi:10.1172/jci106772 · Cited by 598 · see citing works
Effect of muscle mass decrease on age-related BMR changes
Tzankoff, S. P., & Norris, A. H. (1977) · Journal of Applied Physiology · doi:10.1152/jappl.1977.43.6.1001 · Cited by 402 · see citing works
Mourier, A., Gautier, J.-F., Kerviler, E. D., Bigard, A. X., Villette, J.-M., Garnier, J.-P., Duvallet, A., Guezennec, C. Y., & Cathelineau, G. (1997) · Diabetes Care · doi:10.2337/diacare.20.3.385 · Cited by 361 · see citing works
Pratley, R., Nicklas, B., Rubin, M., Miller, J., Smith, A., Smith, M., Hurley, B., & Goldberg, A. (1994) · Journal of Applied Physiology · doi:10.1152/jappl.1994.76.1.133 · Cited by 299 · see citing works
Strength training increases insulin action in healthy 50- to 65-yr-old men
Miller, J. P., Pratley, R. E., Goldberg, A. P., Gordon, P., Rubin, M., Treuth, M. S., Ryan, A. S., & Hurley, B. F. (1994) · Journal of Applied Physiology · doi:10.1152/jappl.1994.77.3.1122 · Cited by 282 · see citing works
Physical training and insulin sensitivity
Koivisto, V. A., Yki‐Järvinen, H., & DeFronzo, R. A. (1986) · Diabetes/Metabolism Reviews · doi:10.1002/dmr.5610010407 · Cited by 257 · see citing works
Exercise and the metabolic syndrome
Koivisto, V. A., Eriksson, J. G., & TAIMELA, S. P. (1997) · Diabetologia · doi:10.1007/s001250050653 · Cited by 248 · see citing works
Self-citationGlucose tolerance in young and older athletes and sedentary men
Seals, D. R., Hagberg, J. M., Allen, W. K., Hurley, B. F., Dalsky, G. P., Ehsani, A. A., & Holloszy, J. O. (1984) · Journal of Applied Physiology · doi:10.1152/jappl.1984.56.6.1521 · Cited by 228 · see citing works
Effects of Exercise on Glucose Tolerance and Insulin Resistance
Holloszy, J. O., Schultz, J., KUSNIERKIEWICZ, J., Hagberg, J. M., & Ehsani, A. A. (1986) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1986.tb08932.x · Cited by 226 · see citing works
Hurley, B. F., Hagberg, J. M., Goldberg, A. P., Seals, D. R., Ehsani, A. A., Brennan, R., & Holloszy, J. O. (1988) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198820020-00008 · Cited by 205 · see citing works
Resistance training improves the metabolic profile in individuals with type 2 diabetes
Honkola, A., Forsén, T. J., & Eriksson, J. G. (1997) · Acta Diabetologica · doi:10.1007/s005920050082 · Cited by 203 · see citing works
Self-citationImprovement in Glucose Tolerance After 1 Wk of Exercise in Patients With Mild NIDDM
Rogers, M. A., Yamamoto, C., King, D. S., Hagberg, J. M., Ehsani, A. A., & Holloszy, J. O. (1988) · Diabetes Care · doi:10.2337/diacare.11.8.613 · Cited by 201 · see citing works
Effect of exercise on insulin action, glucose tolerance, and insulin secretion in aging
Kahn, S. E., Larson, V., Beard, J. C., Cain, K. C., Fellingham, G. W., Schwartz, R. S., Veith, R. C., Stratton, J. R., Cerqueira, M., & Abrass, I. B. (1990) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1990.258.6.e937 · Cited by 198 · see citing works
Schneider, S. H., Khachadurian, A. K., Amorosa, L. F., Clemow, L., & Ruderman, N. B. (1992) · Diabetes Care · doi:10.2337/diacare.15.11.1800 · Cited by 195 · see citing works
Segal, K. R., Edaño, A., Abalos, A. M., Albu, J., Blando, L., Tomas, M. B., & Pi‐Sunyer, F. X. (1991) · Journal of Applied Physiology · doi:10.1152/jappl.1991.71.6.2402 · Cited by 186 · see citing works
Effect of Physical Training on Insulin Action in Obesity
DeFronzo, R. A., Sherwin, R. S., & Kraemer, N. (1987) · Diabetes · doi:10.2337/diab.36.12.1379 · Cited by 182 · see citing works
Physiological response to circuit weight training in borderline hypertensive subjects
HARRIS, K. A., & Holly, R. G. (1987) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198706000-00011 · Cited by 181 · see citing works
Effects of high-intensity strength training on cardiovascular function
Hurley, B. F., Seals, D. R., Ehsani, A. A., CARTIER, L. J., Dalsky, G. P., Hagberg, J. M., & Holloszy, J. O. (1984) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198410000-00011 · Cited by 174 · see citing works
Trovati, M., Carta, Q., Cavalot, F. L., Vitali, S., Banaudi, C., Lucchina, P. G., Fiocchi, F., Emanuelli, G., & Lenti, G. (1984) · Diabetes Care · doi:10.2337/diacare.7.5.416 · Cited by 173 · see citing works
Burstein, R., Polychronakos, C., Toews, C. J., MacDougall, J. D., Guyda, H. J., & Posner, B. I. (1985) · Diabetes · doi:10.2337/diab.34.8.756 · Cited by 171 · see citing works
Increased Insulin Receptors after Exercise in Patients with Insulin-Dependent Diabetes Mellitus
Pedersen, O. B., Beck‐Nielsen, H., & Hedïng, L. G. (1980) · New England Journal of Medicine · doi:10.1056/nejm198004173021603 · Cited by 166 · see citing works
Cardiovascular adaptations to resistance training
Fleck, S. J. (1988) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198810001-00010 · Cited by 154 · see citing works
Vanninen, E. J., Uusitupa, M. I. J., Siitonen, O., Laitinen, J. H., & L�nsimies, E. (1992) · Diabetologia · doi:10.1007/bf00401201 · Cited by 150 · see citing works
Eriksson, J. G., Tuominen, J. A., Valle, T. T., Sundberg, S., Sovijärvi, A. R., Lindholm, H. J., Tuomilehto, J., & Koivisto, V. A. (1998) · Hormone and Metabolic Research · doi:10.1055/s-2007-978828 · Cited by 150 · see citing works
Self-citationResistance Training in the Treatment of Non-Insulin-Dependent Diabetes Mellitus
Eriksson, J. G., TAIMELA, S. P., Eriksson, K., Parviainen, S., Peltonen, J. T. K., & Kujala, U. M. (1997) · International Journal of Sports Medicine · doi:10.1055/s-2007-972627 · Cited by 148 · see citing works
Self-citationEffects of exercise and lack of exercise on insulin sensitivity and responsiveness
King, D. S., Dalsky, G. P., Clutter, W. E., Young, D. A., Staten, M. A., Cryer, P. E., & Holloszy, J. O. (1988) · Journal of Applied Physiology · doi:10.1152/jappl.1988.64.5.1942 · Cited by 148 · see citing works
Diet and exercise in the treatment of NIDDM. The need for early emphasis
Barnard, R. J., Jung, T., & Inkeles, S. B. (1994) · Diabetes Care · doi:10.2337/diacare.17.12.1469 · Cited by 144 · see citing works
Diminished insulin response in highly trained athletes
Lohmann, D., Liebold, F., Heilmann, W., Senger, H., & Pohl, A. K. (1978) · Metabolism · doi:10.1016/0026-0495(78)90017-3 · Cited by 138 · see citing works
Dunstan, D. W., Mori, T. A., Puddey, I. B., Beilin, L. J., Burke, V., Morton, A. R., & Stanton, K. G. (1997) · Diabetes Care · doi:10.2337/diacare.20.6.913 · Cited by 128 · see citing works
Huang, C. H., & Wu, J.-Y. (1994) · Journal of Applied Physics · doi:10.1063/1.357118 · Cited by 126 · see citing works
Improvement of Glucose Homeostasis After Exercise Training in Non-insulin-dependent Diabetes
Reitman, J. S., Vasquez, B., Klimeś, I., & NAGULESPARAN, M. (1984) · Diabetes Care · doi:10.2337/diacare.7.5.434 · Cited by 120 · see citing works
Effects of Exercise Training Modality on Glucose Tolerance in Men with Abnormal Glucose Regulation
SMUTOK, M. A., Reece, C., Kokkinos, P. F., Farmer, C., Dawson, P., Vane, J. D., Patterson, J., Goldberg, A. P., & Hurley, B. F. (1994) · International Journal of Sports Medicine · doi:10.1055/s-2007-1021061 · Cited by 117 · see citing works
Effects of resistance exercise on glucose tolerance in normal and glucose-intolerant subjects
Fluckey, J. D., Hickey, M. S., Brambrink, J. K., Hart, K. K., Alexander, K., & Craig, B. W. (1994) · Journal of Applied Physiology · doi:10.1152/jappl.1994.77.3.1087 · Cited by 117 · see citing works
Lehmann, R., Vokac, A., Niedermann, K., Agosti, K., & Spinas, G. A. (1995) · Diabetologia · doi:10.1007/bf00401764 · Cited by 116 · see citing works
Effects of Exercise on Insulin Sensitivity in Humans
Devlin, J. T. (1992) · Diabetes Care · doi:10.2337/diacare.15.11.1690 · Cited by 113 · see citing works
Effects of high resistance training in coronary artery disease
Ghilarducci, L. E. C., Holly, R. G., & Amsterdam, E. A. (1989) · The American Journal of Cardiology · doi:10.1016/0002-9149(89)90833-3 · Cited by 109 · see citing works
Effects of Physical Training on Metabolic Control in Elderly Type 2 Diabetes Mellitus Patients
Ligtenberg, P. C., Hoekstra, J. B. L., Bol, E., Zonderland, M. L., & Erkelens, D. W. (1997) · Clinical Science · doi:10.1042/cs0930127 · Cited by 103 · see citing works
A Study of Anyon Statistics by Breit Hamiltonian FormalismPreprint
Huang, G. L., & Lee, C. R. (1993) · arXiv (Cornell University) · doi:10.48550/arxiv.hep-th/9305161 · Cited by 98 · see citing works
Rönnemaa, T., Mattila, K. S., Lehtonen, A., & Kallio, V. (1986) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1986.tb02754.x · Cited by 91 · see citing works
Impaired Glucose Tolerance and NIDDM: Does a Lifestyle Intervention Program Have an Effect?
Bourn, D. M., Mann, J. I., McSkimming, B. J., Waldron, M., & Wishart, J. D. (1994) · Diabetes Care · doi:10.2337/diacare.17.11.1311 · Cited by 87 · see citing works
Effect of 10 days of physical inactivity on glucose tolerance in master athletes
Rogers, M. A., King, D. S., Hagberg, J. M., Ehsani, A. A., & Holloszy, J. O. (1990) · Journal of Applied Physiology · doi:10.1152/jappl.1990.68.5.1833 · Cited by 81 · see citing works
Primary Prevention of Non-insulin-dependent Diabetes Mellitus
Manson, J. E., & Spelsberg, A. (1994) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(18)30615-9 · Cited by 69 · see citing works
Heath, G., Wilson, R., Smith, J. A., et al. (1991) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/53.6.1642s · Cited by 68 · see citing works
The health professional's guide to diabetes and exercise
Ruderman, N. B., & Devlin, J. T. (1995) · American Diabetes Association eBooks · Cited by 51 · see citing works
Exercise Prescription for Individuals with Metabolic Disorders
Young, J. C. (1995) · Sports Medicine · doi:10.2165/00007256-199519010-00004 · Cited by 46 · see citing works
Effects of resistive training on left ventricular function
Effron, M. B. (1989) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198912000-00013 · Cited by 46 · see citing works
The Etiology and Pathogenesis of Non-insulin-dependent Diabetes
Groop, L., & Eriksson, J. G. (1992) · Annals of Medicine · doi:10.3109/07853899209167000 · Cited by 36 · see citing works
Self-citationExercise in the treatment of type II diabetes
Koivisto, V. A., & DeFronzo, R. A. (1983) · Acta Endocrinologica · doi:10.1530/acta.0.104s107 · Cited by 35 · see citing works
Abnormal glucoregulation during exercise in type II (non-insulin-dependent) diabetes
Schneider, S. H., Khachadurian, A. K., Amorosa, L. F., Gavras, H. P., Fineberg, S. E., & Ruderman, N. B. (1987) · Metabolism · doi:10.1016/0026-0495(87)90243-5 · Cited by 34 · see citing works
Lampman, R. M., SCHTEINGART, D. E., Santinga, J. T., Savage, P. J., Hydrick, C. R., Bassett, D. R., & Block, W. D. (1987) · Diabetologia · doi:10.1007/bf00292538 · Cited by 33 · see citing works
A Review of the Effects of Resistance Training for Individuals with Diabetes Mellitus
Soukup, J. T., & Kovaleski, J. E. (1993) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572179301900410 · Cited by 26 · see citing works
Physical activity, fitness, and non-insulin-dependent (type II) diabetes mellitus.
Gudat, U., Berger, M. E., Lefèbvre, P. J., et al. (1994) · Cited by 25 · see citing works
Overview of diabetes mellitus and exercise.
Jm, E. (1989) · PubMed · Cited by 19 · see citing works
Exercise in the Clinical Management of Diabetes
Campaigne, B. N., & Lampnian, R. M. (1995) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199509000-00018 · Cited by 18 · see citing works
Di, G. X., Wp, T., Zhang, J., et al. (1993) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Effects of exercise and diet on chronic disease
Roberts, C. K., & Barnard, R. J. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00852.2004 · Cited by 556 · see citing works
Physical activity and risk for cardiovascular events in diabetic women
Hu, F. B., Stampfer, M. J., Solomon, C., Liu, S., Colditz, G. A., Speizer, F. E., Willett, W. C., & Manson, J. E. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-2-200101160-00009 · Cited by 424 · see citing works
Exercise as a therapeutic intervention for the prevention and treatment of insulin resistance
Hawley, J. A. (2004) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.505 · Cited by 344 · see citing works
Tambalis, K., Panagiotakos, D. B., Kavouras, S. A., & Sidossis, L. S. (2009) · Angiology · doi:10.1177/0003319708324927 · Cited by 224 · see citing works
Clark, J. E. (2015) · Journal of Diabetes & Metabolic Disorders · doi:10.1186/s40200-015-0154-1 · Cited by 158 · see citing works
Chipkin, S. R., Klugh, S. A., & Chasan-Taber, L. (2001) · Cardiology Clinics · doi:10.1016/s0733-8651(05)70231-9 · Cited by 123 · see citing works
Clark, J. (2016) · Biology of Sport · doi:10.5604/20831862.1212974 · Cited by 50 · see citing works
Clark, J. E. (2012) · Journal of Diabetes & Metabolic Disorders · doi:10.1186/2251-6581-11-19 · Cited by 19 · see citing works
- Authors
- Eriksson, J. G.
- Corresponding author
- Eriksson, Johan G.
- ORCID
- Eriksson, Johan G.
- Venue
- Sports Medicine
- Published
- 1999
- Volume
- 27
- Issue
- 6
- Pages
- 381-391
- ISSN
- 0112-1642 (ISSN-L)
- OpenAlex
- W1972969924
- Cited by
- 113
- References
- 64
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 6 · 2014: 4 · 2013: 5 · 2012: 7
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, exercise therapy, resistance training, insulin sensitivity, glycemic control, glucose metabolism, exercise adherence, exercise safety, cardiorespiratory fitness, muscle strength and endurance, circuit training
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 2, Exercise Therapy, Humans, Insulin Resistance, Patient Compliance, Physical Endurance, Physical Fitness, Sports Medicine, Weight Lifting, Exercise, Prescriptions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
