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Exercise prescription for patients with type 2 diabetes and pre-diabetes: A position statement from Exercise and Sport Science Australia

  • Matthew D. Hordern
    Affiliations
    School of Medicine, The University of Queensland, Australia

    Centre of Clinical Research Excellence in Cardiovascular Disease and Metabolic Disorders, The University of Queensland, Princess Alexandra Hospital, Australia

    School of Human Movement Studies, The University of Queensland, Australia
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  • David W. Dunstan
    Affiliations
    Baker IDI Heart and Diabetes Institute, Australia
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  • Johannes B. Prins
    Affiliations
    School of Medicine, The University of Queensland, Australia

    Centre of Clinical Research Excellence in Cardiovascular Disease and Metabolic Disorders, The University of Queensland, Princess Alexandra Hospital, Australia
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  • Michael K. Baker
    Affiliations
    School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Australia

    Exercise, Health & Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia

    Boden Institute of Obesity, Nutrition and Exercise, University of Sydney, Australia
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  • Maria A. Fiatarone Singh
    Affiliations
    Exercise, Health & Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia

    Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA

    Boden Institute of Obesity, Nutrition and Exercise, University of Sydney, Australia
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  • Jeff S. Coombes
    Correspondence
    Corresponding author.
    Affiliations
    Centre of Clinical Research Excellence in Cardiovascular Disease and Metabolic Disorders, The University of Queensland, Princess Alexandra Hospital, Australia

    School of Human Movement Studies, The University of Queensland, Australia
    Search for articles by this author

      Abstract

      Type 2 diabetes mellitus (T2DM) and pre-diabetic conditions such as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are rapidly increasing in prevalence. There is compelling evidence that T2DM is more likely to develop in individuals who are insufficiently active. Exercise training, often in combination with other lifestyle strategies, has beneficial effects on preventing the onset of T2DM and improving glycaemic control in those with pre-diabetes. In addition, exercise training improves cardiovascular risk profile, body composition and cardiorespiratory fitness, all strongly related to better health outcomes. Based on the evidence, it is recommended that patients with T2DM or pre-diabetes accumulate a minimum of 210 min per week of moderate-intensity exercise or 125 min per week of vigorous intensity exercise with no more than two consecutive days without training. Vigorous intensity exercise is more time efficient and may also result in greater benefits in appropriate individuals with consideration of complications and contraindications. It is further recommended that two or more resistance training sessions per week (2–4 sets of 8–10 repetitions) should be included in the total 210 or 125 min of moderate or vigorous exercise, respectively. It is also recommended that, due to the high prevalence and incidence of comorbid conditions in patients with T2DM, exercise training programs should be written and delivered by individuals with appropriate qualifications and experience to recognise and accommodate comorbidities and complications.

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