Exercise professionals can make a major difference in helping clients prevent or manage diabetes. Colberg et al. (2010) stress that combining aerobic exercise with resistance training is the best way to enhance blood glucose control. Use these training recommendations to start working with diabetic clients today.

Resistance Training Recommendations

Frequency. At least twice weekly on nonconsecutive days (Colberg et al. 2010); ideally at least three times a week. Colberg and colleagues propose that resistance training should be coordinated with other regular aerobic activities.

Intensity. For optimal gains in strength and insulin action, resistance training should be performed at moderate intensity (50% of 1-repetition maximum) or vigorous intensity (75%–80% 1-Rm) (Colberg et al. 2010).

Duration. Five to 10 exercises performed for the major muscles of the upper/lower body and core with at least 10–15 repetitions performed to near fatigue (Colberg et al. 2010). in time, resistance load should increase so the client can attain momentary muscular fatigue with 8–10 reps. a minimum of 1 set to near fatigue is encouraged, but 3–4 sets are recommended for optimal strength gains (Colberg et al. 2010).

Mode. Resistance machines and/or free weights are appropriate for gains in strength and mass (Colberg et al. 2010). For optimal blood glucose regulation, heavier weights or resistance may be required as strength increases (Colberg et al. 2010).

Progression. The rate should be slow, to prevent injury. once the target number of repetitions can consistently be exceeded, resistance can begin to increase (Colberg et al. 2010).

Is High-Intensity Training Appropriate for Type 2 Diabetes?

Not having enough time for long-duration training sessions prevents a lot of people from sticking with an exercise regimen. in their research review, Bird, S.R., & Hawley, J.A. (2012) propose that preliminary research indicates that high-intensity interval training is more time efficient than longer-duration aerobic exercise and can produce similar insulin-sensitivity improvements in untrained adults.

For example, Little et al. (2011) had eight type 2 diabetes subjects (63 ± 8 years of age) perform six sessions of HIIT training over 2 weeks. The HIIT protocol included 60 seconds of cycling at about 90% of maximal heart rate followed by
60 seconds of rest (subjects self-selected to pedal at a very light intensity or to rest passively). Participants completed 10 intervals, and the workout included a 3-minute cycle warm-up and a 2-minute cycle cool-down for a total workout time of
25 minutes. Findings showed that this 2-week HIIT program enhanced glucose control and induced skeletal-muscle adaptations that are linked to metabolic-health improvements in patients with type 2 diabetes.

These encouraging results warrant further long-term research with large-scale clinical trials to determine the most appropriate and effective HIIT training guidelines for type 2 diabetes clients.

Aerobic Training Recommendations

Frequency. At least 3 days a week with no more than 2 consecutive rest days (because of the transient nature of exercise-induced improvements in blood glucose uptake). Colberg et al. (2010) say current guidelines recommend five sessions of moderate activity per week.

Intensity. At least moderate, approximately 40%–60% of maximal aerobic capacity (Colberg et al. 2010). Brisk walking and other “somewhat hard” exercises usually qualify as moderately intense for most people with type 2 diabetes (Colberg et al. 2010). Gradual increases in intensity yield more health benefits. Training intensity is a better predictor of improved blood glucose control than training volume, so clients should increase intensity before increasing volume (Colberg et al. 2010).

Duration. At least 150 minutes per week at moderate intensity or higher. Aerobic activities should last at least 10 minutes and be spread throughout the week. Around 150 minutes per week of moderate-intensity exercise is associated with reduced morbidity and mortality in all populations, though further benefits are likely for those who go beyond the recommended durations (Colberg et al. 2010).

Mode. Aerobic exercises that innervate large muscle groups and cause sustained increases in heart rate are likely to be beneficial. engagement in a variety of aerobic exercise modes should be encouraged.

To view the full article which ran in the the September 2014 issue of the IDEA Fitness Journal click here.


Bird, S.R., & Hawley, J.A. 2012. Exercise and type 2 diabetes: New prescription for an old problem. Maturitas, 72 (4), 311-16.

Colberg, S.R., et al. 2010. Exercise and type 2 diabetes. Diabetes Care, 33 (12), e147-67.

Little, J.P., et al. 2011. Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. Journal of Applied Physiology, 111 (6), 1554-60.

Matthew J. Aguilera

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