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You are here: Home / Diabetes and Exercise / EveryDay Exercise / New Guidelines for Exercise in Type 2 Diabetes

New Guidelines for Exercise in Type 2 Diabetes

January 31, 2011 By Toby Smithson

New guidelines stress the crucial role that physical activity plays in the management of Type 2 diabetes: physicians should prescribe exercise….

Developed by a panel of 9 experts, the new guidelines are published concurrently in the December issue of Medicine & Science in Sports & Exercise and Diabetes Care.

“High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently,” the expert panel writes, “but it is now well established that participation in regular physical activity improves blood glucose control and can prevent or delay Type 2 diabetes mellitus, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life.”

Most of the benefits of exercise are realized through acute and long-term improvements in insulin action, accomplished with both aerobic and resistance training, the experts write.

For people who already have Type 2 diabetes, the new guidelines recommend at least 150 minutes per week of moderate to vigorous aerobic exercise spread out at least 3 days during the week, with no more than 2 consecutive days between bouts of aerobic activity. These recommendations take into account the needs of those whose diabetes may limit vigorous exercise.

Sheri R. Colberg, PhD, writing chair, professor of exercise science at Old Dominion University, adjunct professor of internal medicine at Eastern Virginia Medical School, Norfolk, Virginia, and regular Diabetes In Control contributor, stated that, “Most people with Type 2 diabetes do not have sufficient aerobic capacity to undertake sustained vigorous activity for that weekly duration, and they may have orthopedic or other health limitations.” “For this reason, the ADA [American Diabetes Association] and ACSM [American College of Sports Medicine] call for a regimen of moderate-to-vigorous activity and make no recommendation for a lesser amount of vigorous activity.”

The panel specifically recommends that such moderate exercise correspond to approximately 40% to 60% of maximal aerobic capacity and states that for most people with Type 2 diabetes, brisk walking is a moderate-intensity exercise.

The expert panel also recommends that resistance training be part of the exercise regimen. This should be done at least twice a week — ideally 3 times a week — on nonconsecutive days. The panel also recommends that people just beginning to do weight training be supervised by a qualified exercise trainer “to ensure optimal benefits to blood glucose control, blood pressure, lipids, and cardiovascular risk and to minimize injury risk.”

Regular use of a pedometer is also encouraged. In a meta-analysis of 8 randomized controlled trials and 18 observational studies, people who used pedometers increased their physical activity by 27% over baseline. Having a goal, such as taking 10,000 steps per day, was an important predictor of increased physical activity, according to the expert panel.

Finally, the new guidelines emphasize that exercise must be done regularly to have continued benefits and should include regular training of varying types.

Physicians should prescribe exercise, Dr. Colberg said in a statement. “Many physicians appear unwilling or cautious about prescribing exercise to individuals with Type 2 diabetes for a variety of reasons, such as excessive body weight or the presence of health-related complications. However, the majority of people with Type 2 diabetes can exercise safely, as long as certain precautions are taken. The presence of diabetes complications should not be used as an excuse to avoid participation in physical activity.”New guidelines stress the crucial role that physical activity plays in the management of Type 2 diabetes: physicians should prescribe exercise….

Developed by a panel of 9 experts, the new guidelines are published concurrently in the December issue of Medicine & Science in Sports & Exercise and Diabetes Care.

“High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently,” the expert panel writes, “but it is now well established that participation in regular physical activity improves blood glucose control and can prevent or delay Type 2 diabetes mellitus, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life.”

Most of the benefits of exercise are realized through acute and long-term improvements in insulin action, accomplished with both aerobic and resistance training, the experts write.

For people who already have Type 2 diabetes, the new guidelines recommend at least 150 minutes per week of moderate to vigorous aerobic exercise spread out at least 3 days during the week, with no more than 2 consecutive days between bouts of aerobic activity. These recommendations take into account the needs of those whose diabetes may limit vigorous exercise.

Sheri R. Colberg, PhD, writing chair, professor of exercise science at Old Dominion University, adjunct professor of internal medicine at Eastern Virginia Medical School, Norfolk, Virginia, and regular Diabetes In Control contributor, stated that, “Most people with Type 2 diabetes do not have sufficient aerobic capacity to undertake sustained vigorous activity for that weekly duration, and they may have orthopedic or other health limitations.” “For this reason, the ADA [American Diabetes Association] and ACSM [American College of Sports Medicine] call for a regimen of moderate-to-vigorous activity and make no recommendation for a lesser amount of vigorous activity.”

The panel specifically recommends that such moderate exercise correspond to approximately 40% to 60% of maximal aerobic capacity and states that for most people with Type 2 diabetes, brisk walking is a moderate-intensity exercise.

The expert panel also recommends that resistance training be part of the exercise regimen. This should be done at least twice a week — ideally 3 times a week — on nonconsecutive days. The panel also recommends that people just beginning to do weight training be supervised by a qualified exercise trainer “to ensure optimal benefits to blood glucose control, blood pressure, lipids, and cardiovascular risk and to minimize injury risk.”

Regular use of a pedometer is also encouraged. In a meta-analysis of 8 randomized controlled trials and 18 observational studies, people who used pedometers increased their physical activity by 27% over baseline. Having a goal, such as taking 10,000 steps per day, was an important predictor of increased physical activity, according to the expert panel.

Finally, the new guidelines emphasize that exercise must be done regularly to have continued benefits and should include regular training of varying types.

Physicians should prescribe exercise, Dr. Colberg said in a statement. “Many physicians appear unwilling or cautious about prescribing exercise to individuals with Type 2 diabetes for a variety of reasons, such as excessive body weight or the presence of health-related complications. However, the majority of people with Type 2 diabetes can exercise safely, as long as certain precautions are taken. The presence of diabetes complications should not be used as an excuse to avoid participation in physical activity.”

Filed Under: EveryDay Exercise, New in the News

Toby Smithson Diabetes Everyday

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Toby Smithson dynamically combines her knowledge as a certified diabetes educator and registered dietitian nutritionist with her life experiences successfully managing type 1 diabetes for more than five decades.

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Feb 3

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Are you wearing red? Today is the day we raise awareness about woman and heart disease by wearing red and offering ways to reduce the risk of heart disease. 

Cardiovascular disease is the number 1 killer of women AND people with diabetes are at a 2-4 times higher risk. Yikes!
Let’s do what we can to lower our risk:
❤️Choose foods low in saturated fat, trans fat and sodium.
❤️Add higher fiber foods like fruits, vegetables, beans, nuts seeds, and whole grains
❤️Choose fish, poultry without the skin and lower fat dairy while limiting meats. If you do choose meat, choose the leanest cuts.
❤️Place 150 minutes of moderate activity or 75 minutes of aerobic activity on your schedule each week. 
 All of these suggestions are both heart healthy and diabetes friendly. 

#gored #goredforwomen #diabetes #hearthealth #type1diabetes #type2diabetes @american_heart #reducediabetescomplications

Are you wearing red? Today is the day we raise awareness about woman and heart disease by wearing red and offering ways to reduce the risk of heart disease.

Cardiovascular disease is the number 1 killer of women AND people with diabetes are at a 2-4 times higher risk. Yikes!
Let’s do what we can to lower our risk:
❤️Choose foods low in saturated fat, trans fat and sodium.
❤️Add higher fiber foods like fruits, vegetables, beans, nuts seeds, and whole grains
❤️Choose fish, poultry without the skin and lower fat dairy while limiting meats. If you do choose meat, choose the leanest cuts.
❤️Place 150 minutes of moderate activity or 75 minutes of aerobic activity on your schedule each week.
All of these suggestions are both heart healthy and diabetes friendly.

#gored #goredforwomen #diabetes #hearthealth #type1diabetes #type2diabetes @american_heart #reducediabetescomplications
...

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Feb 1

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It’s national sweetpotato month! I’ll be sharing a lot of information throughout the month about this nutrition powerhouse food that can be included with your meals all year long. Please follow along.  Link to video is in my bio ( click on linktr.ee/TobySmithson) and look under YouTube. 

@ncsweetpotatoes #ncsweetpotatoes #makeitNCsweet #sweetpotatoisONEword #sponsored #diabetes #diabetesawareness #type1diabetes #type2diabetes #typeonediabetes #diabetesfriendly

It’s national sweetpotato month! I’ll be sharing a lot of information throughout the month about this nutrition powerhouse food that can be included with your meals all year long. Please follow along. Link to video is in my bio ( click on linktr.ee/TobySmithson) and look under YouTube.

@ncsweetpotatoes #ncsweetpotatoes #makeitNCsweet #sweetpotatoisONEword #sponsored #diabetes #diabetesawareness #type1diabetes #type2diabetes #typeonediabetes #diabetesfriendly
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Jan 31

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Which are the best eating plans for people with diabetes??? Read all about it ➡️ 
#bestdiets #diabetes #diabetesdiet #diabetesdietitian #diabetesdietplan @usnews #type1diabetes #type2diabetes 

https://health.usnews.com/health-news/blogs/eat-run/articles/best-eating-plans-for-people-with-diabetes

Which are the best eating plans for people with diabetes??? Read all about it ➡️
#bestdiets #diabetes #diabetesdiet #diabetesdietitian #diabetesdietplan @usnews #type1diabetes #type2diabetes

https://health.usnews.com/health-news/blogs/eat-run/articles/best-eating-plans-for-people-with-diabetes
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Jan 27

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6 month old Clark, just finished eating his dinner and clanking around his food bowl used as a toy. He found me and posed for this photo. What would the caption be?
#englishspringerspaniel #englishspringerspanielpuppy @springerrescueamerica #mealtime

6 month old Clark, just finished eating his dinner and clanking around his food bowl used as a toy. He found me and posed for this photo. What would the caption be?
#englishspringerspaniel #englishspringerspanielpuppy @springerrescueamerica #mealtime
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Jan 27

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Are you wondering which eating plan is best for diabetes? I feel honored to be on the expert panel for rating best diets for US News. Here’s the link to my deeper dive into what we are looking for with a best eating plan for people with diabetes. @usnews #diabetes #eatingplan #bestdiet #bestdietplan #type1diabetes #type2diabetes #type1 #type2 #dash #dashdiet #mediterraneandiet #flexitariandiet #flexitarian 

https://health.usnews.com/health-news/blogs/eat-run/articles/best-eating-plans-for-people-with-diabetes

Are you wondering which eating plan is best for diabetes? I feel honored to be on the expert panel for rating best diets for US News. Here’s the link to my deeper dive into what we are looking for with a best eating plan for people with diabetes. @usnews #diabetes #eatingplan #bestdiet #bestdietplan #type1diabetes #type2diabetes #type1 #type2 #dash #dashdiet #mediterraneandiet #flexitariandiet #flexitarian

https://health.usnews.com/health-news/blogs/eat-run/articles/best-eating-plans-for-people-with-diabetes
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Jan 26

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A different type of crime was committed on the last episode of Will Trent. Crime… misinformation about diabetes. 
It was revealed on this episode that one of the detectives had diabetes. She had been fainting and kept quiet why she felt that way. Then… as she was feeling faint again, she opened up to Will Trent ( well he also “detected” she must have diabetes). BUT… when you are at the point of feeling faint, you can’t just sit down and have an in depth convo and you certainly are not supposed to take an injection of insulin. Feeling faint is associated with hypoglycemia, low blood sugar. And what about that injection that Will Trent “wanted to help the detective out with”??? No thank you. Please don’t jab me or anyone else with insulin- it’s supposed to be given subcutaneously… no need to jab. 
Did anyone else see this episode? 
@willtrentabc #diabetesawareness #diabetesmisinformation #diabetes #diabetesfacts #diabeteseducator

A different type of crime was committed on the last episode of Will Trent. Crime… misinformation about diabetes.
It was revealed on this episode that one of the detectives had diabetes. She had been fainting and kept quiet why she felt that way. Then… as she was feeling faint again, she opened up to Will Trent ( well he also “detected” she must have diabetes). BUT… when you are at the point of feeling faint, you can’t just sit down and have an in depth convo and you certainly are not supposed to take an injection of insulin. Feeling faint is associated with hypoglycemia, low blood sugar. And what about that injection that Will Trent “wanted to help the detective out with”??? No thank you. Please don’t jab me or anyone else with insulin- it’s supposed to be given subcutaneously… no need to jab.
Did anyone else see this episode?
@willtrentabc #diabetesawareness #diabetesmisinformation #diabetes #diabetesfacts #diabeteseducator
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Jan 22

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Inspiration as you start the new week: Be proud of your accomplishments. 
Our 6 month old puppy has now learned not to take my shoes nor clothes out of my closet. Big win and feeling proud! 
@springerrescueamerica #englishspringerspanielpuppy #inspiration #growingup

Inspiration as you start the new week: Be proud of your accomplishments.
Our 6 month old puppy has now learned not to take my shoes nor clothes out of my closet. Big win and feeling proud!
@springerrescueamerica #englishspringerspanielpuppy #inspiration #growingup
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Jan 13

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Celebrating National Oatmeal Month with a serving of cooked oats this morning. But I forgot to add protein to my breakfast so my blood sugar spiked 😳 
Diabetes friendly reminder to add a source of protein when you eat your oats. 😄 
What’s your favorite protein to add when eating oats??

Happy #nationaloatmealmonth #oatmeal #bloodsugarbalance 
#diabetes
#typeonediabetes 
#type2diabetes 
#breakfastideas

Celebrating National Oatmeal Month with a serving of cooked oats this morning. But I forgot to add protein to my breakfast so my blood sugar spiked 😳
Diabetes friendly reminder to add a source of protein when you eat your oats. 😄
What’s your favorite protein to add when eating oats??

Happy #nationaloatmealmonth #oatmeal #bloodsugarbalance
#diabetes
#typeonediabetes
#type2diabetes
#breakfastideas
...

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Jan 11

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Attention people with diabetes ( or anyone else experiencing stressful moments)… here’s an idea on how to reduce your stress- participate in a Tea Meditation! Here’s how to do it: 
1. Brew your favorite tea
2. Hold the very warm cup for a couple minutes as you slow down your stressful thoughts.
3. Smell the wonderful aroma of your tea.
4. Sip your tea slowly and reverently even. 
Wow! It’s a great practice of self care. Drinking tea mindfully. 🙌 Has anyone done this before? 
TY @diabetessangha for introducing me to this type of meditation. 
#meditation 
#diabetes
#type1diabetes #type2
#stressrelief #stressmanagement #tea #freshbrewedtea #mindfulness

Attention people with diabetes ( or anyone else experiencing stressful moments)… here’s an idea on how to reduce your stress- participate in a Tea Meditation! Here’s how to do it:
1. Brew your favorite tea
2. Hold the very warm cup for a couple minutes as you slow down your stressful thoughts.
3. Smell the wonderful aroma of your tea.
4. Sip your tea slowly and reverently even.
Wow! It’s a great practice of self care. Drinking tea mindfully. 🙌 Has anyone done this before?
TY @diabetessangha for introducing me to this type of meditation.
#meditation
#diabetes
#type1diabetes #type2
#stressrelief #stressmanagement #tea #freshbrewedtea #mindfulness
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Jan 5

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What’s for dinner? I’m eating this meal two nights in a row because I love it so much! Plant based meal that is only 35 grams of carb. Can make this lower carb if you don’t use the breaded cutlet. Did you see the grams of protein and fiber? 🙌 
If you are looking for quick meal prep plant based ideas, this is it 👏
@meatifoods #plantbased #mealideas #diabetes #diabetesfriendly #diabetesfood #type1diabetes #type2diabetes #quickmeals

What’s for dinner? I’m eating this meal two nights in a row because I love it so much! Plant based meal that is only 35 grams of carb. Can make this lower carb if you don’t use the breaded cutlet. Did you see the grams of protein and fiber? 🙌
If you are looking for quick meal prep plant based ideas, this is it 👏
@meatifoods #plantbased #mealideas #diabetes #diabetesfriendly #diabetesfood #type1diabetes #type2diabetes #quickmeals
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Jan 4

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When managing diabetes or pre-diabetes, weight loss is recommended to help increase insulin sensitivity and improve beta cell function.  I’m sharing some tips in my latest YouTube video on how to cut 100 calories ( or more) without feeling like you are missing out.  Link to video in my bio. 
#diabetes #prediabetes #diabetes2 #diabetes1 #weightlosstips #diabetesmanagement #loseweight

When managing diabetes or pre-diabetes, weight loss is recommended to help increase insulin sensitivity and improve beta cell function. I’m sharing some tips in my latest YouTube video on how to cut 100 calories ( or more) without feeling like you are missing out. Link to video in my bio.
#diabetes #prediabetes #diabetes2 #diabetes1 #weightlosstips #diabetesmanagement #loseweight
...

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Jan 3

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Happy New Year 2023!

There's no one diet that’s best for everyone. That is why it is important to understand the nuances of each diet. As a panelist for U.S. News & World Report’s #BestDiets, I provided insight into each of the ranked diets. @usnews #diabetesdiet #eatingplan #rdapproved #whattoeat #healthyeating 

https://health.usnews.com/best-diet/best-diets-overall

Happy New Year 2023!

There's no one diet that’s best for everyone. That is why it is important to understand the nuances of each diet. As a panelist for U.S. News & World Report’s #BestDiets, I provided insight into each of the ranked diets. @usnews #diabetesdiet #eatingplan #rdapproved #whattoeat #healthyeating

https://health.usnews.com/best-diet/best-diets-overall
...

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Dec 21

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Winter has officially begun! Do you find yourself feeling more hungry at this cold time if the year? Plus the wintery forecast leaves you limited to outdoor exercise options. I’m sharing a couple ideas for snacks that aren’t high in calories nor carbs but will curb that hunger. Please share some of your favorite tips below to add to my list. #winterhunger #hungry #diabetes #type1diabetes #type1 #type2diabetes #type2 #snackideas #lowcarb #lowcaloriesnack #lowcarbsnack #bloodsugarbalance @superseedzofficial #popcorn #chaitealatte

Winter has officially begun! Do you find yourself feeling more hungry at this cold time if the year? Plus the wintery forecast leaves you limited to outdoor exercise options. I’m sharing a couple ideas for snacks that aren’t high in calories nor carbs but will curb that hunger. Please share some of your favorite tips below to add to my list. #winterhunger #hungry #diabetes #type1diabetes #type1 #type2diabetes #type2 #snackideas #lowcarb #lowcaloriesnack #lowcarbsnack #bloodsugarbalance @superseedzofficial #popcorn #chaitealatte ...

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Dec 20

Open
For many of us, the holiday season can get stressful. For all the parents of young children OR puppies, you will understand this. Yes, I was in the middle of cooking for a holiday party when this was happening. 
I hope this reel brings you joy, laughter and big smiles. #stress #puppylove @springerrescueamerica #englishspringerspaniel #englishspringerspanielpuppy #stressrelief

For many of us, the holiday season can get stressful. For all the parents of young children OR puppies, you will understand this. Yes, I was in the middle of cooking for a holiday party when this was happening.
I hope this reel brings you joy, laughter and big smiles. #stress #puppylove @springerrescueamerica #englishspringerspaniel #englishspringerspanielpuppy #stressrelief
...

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Dec 20

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Ohhh sooo good! This recipe is a winner on 2 fronts: 1) our friends loved eating these latkes ( potato pancakes) and 2) this was a healthier version of the traditional potato pancake because it replaced white potato with sweetpotato (yes it’s spelled as one word) and they were baked using a little oil, unlike frying the the potato pancakes. Extra bonus especially for people with diabetes or people that like to reduce waste… I used the whole sweetpotato- using the skin of this potato has been shown to improve its glycemic index ( rise in blood sugar after eating a food). 

Let me know if you try this. Happy holidays-

#sweetpotatolatke #chanukah #potatolatkesarethebest #potatopancakes #ncsweetpotatoes @ncsweetpotatoes #makeitncsweet #sweetpotatoisoneword

Ohhh sooo good! This recipe is a winner on 2 fronts: 1) our friends loved eating these latkes ( potato pancakes) and 2) this was a healthier version of the traditional potato pancake because it replaced white potato with sweetpotato (yes it’s spelled as one word) and they were baked using a little oil, unlike frying the the potato pancakes. Extra bonus especially for people with diabetes or people that like to reduce waste… I used the whole sweetpotato- using the skin of this potato has been shown to improve its glycemic index ( rise in blood sugar after eating a food).

Let me know if you try this. Happy holidays-

#sweetpotatolatke #chanukah #potatolatkesarethebest #potatopancakes #ncsweetpotatoes @ncsweetpotatoes #makeitncsweet #sweetpotatoisoneword
...

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Dec 19

Open
There’s still plenty of time to order any of my gift ideas for people with diabetes. All of my ideas are set up to be ordered online. Super quick! 

My list is here… https://health.usnews.com/health-news/blogs/eat-run/articles/top-holiday-gifts-for-people-with-diabetes

#diabetesgiftguide #diabetes #type1diabetes #type1
#typeonediabetes #type2diabetes #type2 #holidaygifts @mbkwear @getjoydays #yogagear @evansoroka #bestdiabetesbooks #gifts @usnews

There’s still plenty of time to order any of my gift ideas for people with diabetes. All of my ideas are set up to be ordered online. Super quick!

My list is here… https://health.usnews.com/health-news/blogs/eat-run/articles/top-holiday-gifts-for-people-with-diabetes

#diabetesgiftguide #diabetes #type1diabetes #type1
#typeonediabetes #type2diabetes #type2 #holidaygifts @mbkwear @getjoydays #yogagear @evansoroka #bestdiabetesbooks #gifts @usnews
...

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Dec 11

Open
Do you find yourself hungrier when the weather gets colder? I find that I do- even when it’s not that cold here! But it’s December and cooler weather is here. Check out my tips for a way to get more food on your plate to fill your hunger. #diabetes #diabetesmanagement #type1diabetes #type1 #type1warrior #lowcaloriemeals #lowcarbmeals #fiber #mealideas #diabetesfriendly #winterhunger #eggenthusiast #eggs

Do you find yourself hungrier when the weather gets colder? I find that I do- even when it’s not that cold here! But it’s December and cooler weather is here. Check out my tips for a way to get more food on your plate to fill your hunger. #diabetes #diabetesmanagement #type1diabetes #type1 #type1warrior #lowcaloriemeals #lowcarbmeals #fiber #mealideas #diabetesfriendly #winterhunger #eggenthusiast #eggs ...

tobysmithson

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Dec 11

Open
Senior dog rules! #puppylife #englishspringerspaniel #englishspringerspanielpuppy #dogslife #beggingdog @springerrescueamerica

Senior dog rules! #puppylife #englishspringerspaniel #englishspringerspanielpuppy #dogslife #beggingdog @springerrescueamerica ...

tobysmithson

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Dec 7

Open
The holidays are coming…
1 week + 4 days or
2weeks + 4 days 
Is the holidays and I’ve got you covered with ideas for gifts for people with diabetes. 

https://health.usnews.com/health-news/blogs/eat-run/articles/top-holiday-gifts-for-people-with-diabetes 

@usnews @mbkwear @getjoydays @evansoroka @ninjakitchen #yoga #yogaequipment @jewellsblackwell #diabetes #diabetesfriendly #diabetesgifts #giftideas #type1diabetes #type2diabetes

The holidays are coming…
1 week + 4 days or
2weeks + 4 days
Is the holidays and I’ve got you covered with ideas for gifts for people with diabetes.

https://health.usnews.com/health-news/blogs/eat-run/articles/top-holiday-gifts-for-people-with-diabetes

@usnews @mbkwear @getjoydays @evansoroka @ninjakitchen #yoga #yogaequipment @jewellsblackwell #diabetes #diabetesfriendly #diabetesgifts #giftideas #type1diabetes #type2diabetes
...

tobysmithson

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Dec 6

Open
Enrolled in a class given by Eliza Pinckney ( reenactment) who developed and brought Indigo Blue dye here to South Carolina. I took photos of the Indigo plant with the seeds ( they look like very tiny bananas) that are used to make the dye. 
Creating ( tie dye shirts) was sooo much fun, exciting and relaxing. #funday #indigoblue #southcarolina @dimmosher @coastaldiscoverymuseum

Enrolled in a class given by Eliza Pinckney ( reenactment) who developed and brought Indigo Blue dye here to South Carolina. I took photos of the Indigo plant with the seeds ( they look like very tiny bananas) that are used to make the dye.
Creating ( tie dye shirts) was sooo much fun, exciting and relaxing. #funday #indigoblue #southcarolina @dimmosher @coastaldiscoverymuseum
...

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