The American College of Sports Medicine and the American Diabetes Association released a joint report identifying the beneficial impacts exercise with diabetes reviewing academic studies (Colberg, Sigal, Fernhall, & Regensteiner, 2010). Key statements are categorised A to E, A being the strongest and E the weakest defined as ‘Expert consensus or clinical experience’.

Key statements include:

• PA causes increased glucose update into active muscles balanced by hepatic glucose production, with a greater reliance on carbohydrate to fuel muscular activity as intensity increases (cat A)
• ‘Insulin-stimulated BG uptake into skeletal muscle predominates at rest and is impaired in type 2 diabetes, while muscular contractions stimulate BG transport via a separate additive mechanism not impaired by insulin resistance or type 2 diabetes.’
• Risks of acute hypoglycaemia are minimal without the use of exogenous insulin or insulin secretagogues (cat C)
• Transient hypoglycaemia can follow intense PA (cat C)
• Resistance exercises result in lower fasting BG levels for at least 24 hours post exercise in individuals with IFG (cat C).
• A combination of aerobic and resistance exercise training may be more effective in improving BG control than either alone, however more studies are needed to determine whether total caloric expenditure, exercise duration or exercise mode is responsible (Cat B).
• Milder forms of exercise (e.g. tai chi and yoga) have shown mixed results (cat C).
• PA can result in acute improvements in systemic insulin action lasting from 2 to 72 hours (cat A).
• Aerobic and resistance training improve insulin action, BG control and fat oxidation and storage in muscle (cat B)
• At least 2.5 hours per week of moderate to vigorous PA should be undertaken as part of lifestyle changes to prevent type 2 diabetes onset in high risk adults (cat A).
• Moderate exercise may lower glucose levels in GDM (cat B). Adults with type 2 diabetes should undertake at least 150 minutes of moderate to vigorous activity per week (cat B)