ACSM position stand on exercise and type 2 diabetes

Ann Albright, Marion Franz, Guyton Hornsby, Andrea Kriska, David Marrero, Irma Ullrich, Larry S. Verity

Research output: Contribution to journalReview articlepeer-review

509 Scopus citations


Physical activity, including appropriate endurance and resistance training, is a major therapeutic modality for type 2 diabetes. Unfortunately, too often physical activity is an underutilized therapy. Favorable changes in glucose tolerance and insulin sensitivity usually deteriorate within 72 h of the last exercise session; consequently, regular physical activity is imperative to sustain glucose-lowering effects and improved insulin sensitivity. Individuals with type 2 diabetes should strive to achieve a minimum cumulative total of 1000 kcal · wk-1 from physical activities. Those with type 2 diabetes generally have a lower level of fitness (VO(2max)) than nondiabetic individuals, and therefore exercise intensity should be at a comfortable level (RPE 10-12) in the initial periods of training and should progress cautiously as tolerance for activity improves. Resistance training has the potential to improve muscle strength and endurance, enhance flexibility and body composition, decrease risk factors for cardiovascular disease, and result in improved glucose tolerance and insulin sensitivity. Modifications to exercise type and/or intensity may be necessary for those who have complications of diabetes. Individuals with type 2 diabetes may develop autonomic neuropathy, which affects the heart rate response to exercise, and as a result, ratings of perceived exertion rather than heart rate may need to be used for moderating intensity of physical activity. Although walking may be the most convenient low-impact mode, some persons, because of peripheral neuropathy and/or foot problems, may need to do non- weight-bearing activities. Outcome expectations may contribute significantly to motivation to begin and maintain an exercise program. Interventions designed to encourage adoption of an exercise regimen must be responsive to the individual's current stage of readiness and focus efforts on moving the individual through the various 'stages of change'.

Original languageEnglish (US)
Pages (from-to)1345-1360
Number of pages16
JournalMedicine and Science in Sports and Exercise
Issue number7
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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