[Physical activity and exercise for rehabilitation of type 2 diabetes]

Along with diet and medication, exercise is the third cornerstone of type 2 diabetes treatment. However, current guidelines do not provide detailed information for designing effective exercise interventions.

Based on a review of the health-enhancing effects of endurance and resistance training, recommendations for exercise interventions for persons with type 2 diabetes and different comorbidities are derived to optimize the benefits of exercise.

A hierarchic, systematic literature analysis was conducted. The evidence is summarized, and evidence-based recommendations are given.

Aerobic training, resistance training, and combined training programmes hold equal potential to reduce the HbA1c by about 0.5-0.8. Endurance training improves cardiorespiratory fitness and cardiovascular risk factors. Compared to resistance training it will lead to superior effects on hypertension and blood lipids. Combined training is generally a little superior to aerobic and resistance training showing greater improvements for body weight, HDL-cholesterol and blood pressure. Health-enhancing effects are found for a broad range of exercise types, intensities and scope. Persons with type 2 diabetes should perform at least 90 min per week of vigorous (> 65% of VO (2)max) aerobic exercise or 150 min per week of moderate-intensity (40-65% of VO (2)max) aerobic physical activity. Performing at least 240 min of physical activity per week is associated with greater cardiovascular disease risk reductions as well as with less cardioÂ-vascular events compared with lower volumes of activity. Optimizing therapeutic benefits with different types and doses of exercise in combination with dietary and drug treatments needs further research.