Acta Diabetologica

, Volume 47, Issue 1, pp 15-22

First online:

Exercise for the management of type 2 diabetes: a review of the evidence

  • Silvano ZanusoAffiliated withDepartment of Exercise Science, Faculty of Medicine, University of Padua Email author 
  • , A. JimenezAffiliated withPhysical Activity and Sports Sciences Faculty, European University of Madrid
  • , G. PuglieseAffiliated withDiabetes Division, Department of Clinical Sciences, S. Andrea Hospital, 2nd Medical School, “La Sapienza” University
  • , G. CoriglianoAffiliated withA.I.D. (Italian Diabetes Association) Outpatient Service
  • , S. BalducciAffiliated withMetabolic Fitness Association


The aim is to critically review the more relevant evidence on the interrelationships between exercise and metabolic outcomes. The research questions addressed in the recent specific literature with the most relevant randomized controlled trials, meta-analysis and cohort studies are presented in three domains: aerobic exercise, resistance exercise, combined aerobic and resistance exercise. From this review appear that the effects of aerobic exercise are well established, and interventions with more vigorous aerobic exercise programs resulted in greater reductions in HbA1c, greater increase in VO2max and greater increase in insulin sensitivity. Considering the available evidence, it appears that resistance training could be an effective intervention to help glycemic control, especially considering that the effects of this form of intervention are comparable with what reported with aerobic exercise. Less studies have investigated whether combined resistance and aerobic training offers a synergistic and incremental effect on glycemic control; however, from the available evidences appear that combined exercise training seems to determine additional change in HbA1c that can be seen significant if compared with aerobic training alone and resistance training alone.


Exercise Physical activity Type-2 diabetes Glycemic control