Physical Activity/Exercise and Type 2 Diabetes

Sigal, Ronald J.; Kenny, Glen P.; Wasserman, David H.; Castaneda-Sceppa, Carmen; White, Russell D.

doi:10.2337/dc06-9910

Cited by 949Physical Activity and HealthCardiovascular and exercise physiologyDiabetes, Cardiovascular Risks, and Lipoproteins

Physical Activity/Exercise and Type 2 Diabetes

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Sigal, Ronald J., Kenny, Glen P., Wasserman, David H., Castaneda-Sceppa, Carmen, White, Russell D.·2006·Diabetes Care

DOI 10.2337/dc06-9910

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Abstract

DIABETES -Boule ´et al.(6) undertook a systematic review and meta-analysis on the effects of structured exercise interventions in clinical trials of Ն8 weeks duration on HbA 1c (A1C) and body mass in people with type 2 diabetes.Postintervention A1C was significantly lower in exercise than control groups (7.65 vs. 8.31%, weighted mean difference Ϫ0.66%; P Ͻ 0.001).In contrast, postintervention body weight did not differ between the exercise and control groups.Meta-regression confirmed that the beneficial effect of exercise on A1C was independent of any effect on body weight.Therefore, structured exercise programs had a statistically and clinically significant beneficial effect on glycemic control, and this effect was not primarily mediated by weight loss.A subsequent meta-analysis by the same authors (7) showed that exercise intensity predicted postintervention weighted mean difference in A1C (r ϭ Ϫ0.91, P ϭ 0.002) to a larger extent than exercise volume (r ϭ Ϫ0.46, P ϭ 0.26).These results provide support for encouraging type 2 diabetic individuals who are already exercising at moderate intensity to consider increasing the intensity of their exercise in order to obtain additional benefits in both aerobic fitness and glycemic control. PHYSICAL ACTIVITY, AEROBIC FITNESS, AND RISK OF CARDIOVASCULAR AND OVERALL MORTALITY-Large cohort studies have found that higher levels of habitual aerobic fitness and/or physical activity are associated with significantly lower subsequent cardiovascular and overall mortality (8 -10), to a much greater extent than could be explained by glucose lowering alone.For example, Church et al. (8) found that men in the lowest, second, and third quartiles of cardiorespiratory fitness had 4.5-, 2.8-, and 1.6-fold greater risk for overall mortality than men in the highest quartile of cardiorespiratory fitness, even after adjustment for age, examination year, baseline cardiovascular disease (CVD), hypercholesterolemia, hypertriglyceridemia, BMI, hypertension, parental CVD, smoking, and baseline fasting glucose levels.Essentially all of the association between higher BMI and higher mortality was explained by confounding with cardiorespiratory fitness; there was no difference in mortality among normal-weight, overweight, and obese men after adjustment for cardiorespiratory fitness.In the same cohort, it was shown that among moderately fit subjects (21st-60th percentile for age) whose only exercise was walking, the mean time spent per week on exercise was 130 min for men and 148 min for women (11).These times are consistent with recommendations from the U.S. Surgeon General (12) and other respected bodies (13-15) stating that 150 min/week of moderate-intensity exercise should be accumulated.Moderately fit subjects whose only exercise was jogging or running reported a mean of 90 min/week for men and 92 min/week for women.These times are consistent with

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Lifestyle interventions, particularly those promoting sustained engagement in physical activity, are fundamental to improving metabolic outcomes and preventing complications in type 2 diabetes.
“lifestyle interventions, particularly those promoting sustained engagement in physical activity, are fundamental to improving metabolic outcomes and preventing complications.”
From Effectiveness of wearable technologies in supporting physical activity and metabolic health in adults with type 2 diabetes: a systematic-narrative hybrid review (2025) · cites this paper as [2]

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Authors: Sigal, R. J., Kenny, G. P., Wasserman, D. H., Castaneda-Sceppa, C., & White, R. D.
Affiliations: University of Ottawa (CA)
Vanderbilt University (US)
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
Truman Medical Center (US)
ORCID: Sigal, Ronald J.
Kenny, Glen P.
Wasserman, David H.
White, Russell D.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2006-06-01
Volume: 29
Issue: 6
Pages: 1433-1438
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc06-9910
OpenAlex: W2167398654
Cited by: 949
References: 71
Citations by year: 2026: 9 · 2025: 21 · 2024: 21 · 2023: 21 · 2022: 25 · 2021: 37 · 2020: 37 · 2019: 36 · 2018: 62 · 2017: 58 · 2016: 60 · 2015: 53 · 2014: 71 · 2013: 57 · 2012: 71
FWCI: 35.13
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (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, structured exercise, glycemic control, HbA1c, exercise intensity, cardiorespiratory fitness, cardiovascular mortality, all-cause mortality, body mass, weight loss
MeSH terms: Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, Humans, Physical Fitness, Safety, Societies, Medical, United States, Exercise

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