Sports Medicine

, Volume 42, Issue 12, pp 1059–1080 | Cite as

Effects of Different Types of Acute and Chronic (Training) Exercise on Glycaemic Control in Type 1 Diabetes Mellitus

A Meta-Analysis
  • Cajsa Tonoli
  • Elsa Heyman
  • Bart Roelands
  • Luk Buyse
  • Stephen S. Cheung
  • Serge Berthoin
  • Romain MeeusenEmail author
Systematic Review



Exercise has been accepted and generally recommended for the management of type 1 diabetes mellitus (T1D) and for improving the overall quality of life in affected individuals. This meta-analysis was conducted to determine the overall effects of exercise (acute bouts of exercise and chronic exercise [or training]) on acute and chronic glycaemic control in patients with T1D, the effects of different types of exercise on glycaemic control and which conditions are required to obtain these positive effects.


PubMed, ISI Web of Knowledge and SPORTDiscus™ were consulted to identify studies on T1D and exercise. Cohen’s d statistics were used for calculating mean effect sizes (ES) as follows: small d = 0.3, medium d = 0.5 and large d = 0.8. Ninety-five percent confidence intervals (95% CIs) were used to establish the significance of our findings.


From a total of 937 studies, 33 that met the inclusion criteria were selected. Nine studies were used to calculate the ES of a single bout of aerobic exercise; 13 studies to calculate the ES of aerobic training; 2 studies to calculate the ES of strength training; 4 studies to calculate the ES of combined (aerobic and strength) training and 6 studies to calculate the ES of high-intensity exercise (HIE) and training. ES for exercise on acute glycaemic control were large, while they were small for chronic glycaemic control. Aerobic exercise, resistance exercise, mixed exercise (aerobic combined with resistance training) and HIE acutely decreased blood glucose levels. To prevent late-onset hypoglycaemic episodes, the use of single bouts of sprints into an aerobic exercise can be recommended. This meta-analysis also showed that a regular exercise training programme has a significant effect on acute and chronic glycaemic control, although not all exercise forms showed significant results. Specifically, aerobic training is a favourable tool for decreasing chronic glycaemic control, while resistance training, mixed and HIE did not significantly improve chronic glycaemic control. Although, this meta-analysis showed there was a tendency for improvement in glycaemic control due to resistance training or resistance training combined with endurance training, there were not enough studies and/or subjects to confirm this statistically.


Based on this meta-analysis, we can conclude that the addition of brief bouts of high-intensity, sprint-type exercise to aerobic exercise can minimize the risk of sustaining a hypoglycaemic episode. We can also conclude that only regular aerobic training will improve the glycated haemoglobin level of a patient with T1D.


Resistance Training Glycaemic Control HbA1c Level Aerobic Exercise Strength Training 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors wish to acknowledge funding through the Vrije Universiteit Brussel (OZR2096BOF). Bart Roelands is a postdoctoral fellow of the Fund for Scientific Research Flanders (FWO). S.S. Cheung is supported by a Canada Research Chair. The authors have no conflicts of interest that are directly relevant to the content of this article.


  1. 1.
    Medicine ACoS. ACSM’s guidelines for exercise testing and prescription. 6th ed. Philadeplhia (PA): Lippincott Williams, Wilkins; 2000.Google Scholar
  2. 2.
    MacDonald MJ. Postexercise late-onset hypoglycemia in insulin-dependent diabetic patients. Diabetes Care. 1987 Sep–Oct; 10(5): 584–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Graveling AJ, Frier BM. Risks of marathon running and hypoglycaemia in type 1 diabetes. Diabet Med 2010 May; 27(5): 585–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Toni S, Reali MF, Barni F, et al. Managing insulin therapy during exercise in type 1 diabetes mellitus. Acta Biomed 2006; 77 Suppl. 1: 34–40.PubMedGoogle Scholar
  5. 5.
    Aussedat B, Dupire-Angel M, Gifford R, et al. Interstitial glucose concentration and glycemia: implications for continuous subcutaneous glucose monitoring. Am J Physiol Endocrinol Metab 2000 Apr; 278(4): E716–28.PubMedGoogle Scholar
  6. 6.
    Durak EP, Jovanovic-Peterson L, Peterson CM. Randomized crossover study of effect of resistance training on glycemic control, muscular strength, and cholesterol in type I diabetic men. Diabetes Care 1990 Oct; 13(10): 1039–43.PubMedCrossRefGoogle Scholar
  7. 7.
    Ramalho AC, de Lourdes Lima M, Nunes F, et al. The effect of resistance versus aerobic training on metabolic control in patients with type-1 diabetes mellitus. Diabetes Res Clin Pract 2006 Jun; 72(3): 271–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Heyman E, Toutain C, Delamarche P, et al. Exercise training and cardiovascular risk factors in type 1 diabetic adolescent girls. Pediatr Exerc Sci 2007 Nov; 19(4): 408–19.PubMedGoogle Scholar
  9. 9.
    Guelfi KJ, Jones TW, Fournier PA. The decline in blood glucose levels is less with intermittent high-intensity compared with moderate exercise in individuals with type 1 diabetes. Diabetes Care 2005 Jun; 28(6): 1289–94.PubMedCrossRefGoogle Scholar
  10. 10.
    Guelfi KJ, Ratnam N, Smythe GA, et al. Effect of intermittent high-intensity compared with continuous moderate exercise on glucose production and utilization in individuals with type 1 diabetes. Am J Physiol Endocrinol Metab 2007 Mar; 292(3): E865–70.PubMedCrossRefGoogle Scholar
  11. 11.
    Harmer AR, Chisholm DJ, McKenna MJ, et al. Sprint training increases muscle oxidative metabolism during high-intensity exercise in patients with type 1 diabetes. Diabetes Care 2008; 31(11): 2097–102.PubMedCrossRefGoogle Scholar
  12. 12.
    Bussau VA, Ferreira LD, Jones TW, et al. The 10-s maximal sprint: a novel approach to counter an exercise-mediated fall in glycemia in individuals with type 1 diabetes. Diabetes Care 2006 Mar; 29(3): 601–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Pilcher JJ, Nadler E, Busch C. Effects of hot and cold temperature exposure on performance: a meta-analytic review. Ergonomics 2002 Aug 15; 45(10): 682–98.PubMedCrossRefGoogle Scholar
  14. 14.
    Heyman E, Briard D, Gratas-Delamarche A, et al. Normal physical working capacity in prepubertal children with type 1 diabetes compared with healthy controls. Acta Paediatr 2005 Oct; 94(10): 1389–94.PubMedCrossRefGoogle Scholar
  15. 15.
    Tansey MJ, Tsalikian E, Beck RW, et al. The effects of aerobic exercise on glucose and counterregulatory hormone concentrations in children with type 1 diabetes. Diabetes Care 2006 Jan; 29(1): 20–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Heyman E, Delamarche P, Berthon P, et al. Alteration in sympathoadrenergic activity at rest and during intense exercise despite normal aerobic fitness in late pubertal adolescent girls with type 1 diabetes. Diabetes Metab 2007 Dec; 33(6): 422–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Poortmans JR, Saerens P, Edelman R, et al. Influence of the degree of metabolic control on physical fitness in type I diabetic adolescents. Int J Sports Med 1986 Aug; 7(4): 232–5.PubMedCrossRefGoogle Scholar
  18. 18.
    West DJ, Stephens JW, Bain SC, et al. A combined insulin reduction and carbohydrate feeding strategy 30 min before running best preserves blood glucose concentration after exercise through improved fuel oxidation in type 1 diabetes mellitus. J Sports Sci 2011 Feb; 29(3): 279–89.PubMedCrossRefGoogle Scholar
  19. 19.
    Yamanouchi K, Abe R, Takeda A, et al. The effect of walking before and after breakfast on blood glucose levels in patients with type 1 diabetes treated with intensive insulin therapy. Diabetes Res Clin Pract 2002 Oct; 58(1): 11–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Zinman B, Murray FT, Vranic M, et al. Glucoregulation during moderate exercise in insulin treated diabetics. J Clin Endocrinol Metab 1977 Oct; 45(4): 641–52.PubMedCrossRefGoogle Scholar
  21. 21.
    Zinman B, Zuniga-Guajardo S, Kelly D. Comparison of the acute and long-term effects of exercise on glucose control in type I diabetes. Diabetes Care 1984 Nov–Dec; 7(6): 515–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Huttunen NP, Lankela SL, Knip M, et al. Effect of once-a-week training program on physical fitness and metabolic control in children with IDDM. Diabetes Care 1989 Nov–Dec; 12(10): 737–40.PubMedCrossRefGoogle Scholar
  23. 23.
    Rowland TW, Swadba LA, Biggs DE, et al. Glycemic control with physical training in insulin-dependent diabetes mellitus. Am J Dis Child 1985 Mar; 139(3): 307–10.PubMedGoogle Scholar
  24. 24.
    Wong CH, Chiang YC, Wai JP, et al. Effects of a homebased aerobic exercise programme in children with type 1 diabetes mellitus. J Clin Nurs 2010 Mar; 20(5–6): 681–91.Google Scholar
  25. 25.
    Bernardini AL, Vanelli M, Chiari G, et al. Adherence to physical activity in young people with type 1 diabetes. Acta Biomed 2004 Dec; 75(3): 153–7.PubMedGoogle Scholar
  26. 26.
    Marrero DG, Fremion AS, Golden MP. Improving compliance with exercise in adolescents with insulin-dependent diabetes mellitus: results of a self-motivated home exercise program. Pediatrics 1988 Apr; 81(4): 519–25.PubMedGoogle Scholar
  27. 27.
    Michaliszyn SF, Faulkner MS. Physical activity and sedentary behavior in adolescents with type 1 diabetes. Res Nurs Health 2011 Oct; 33(5): 441–9.CrossRefGoogle Scholar
  28. 28.
    Ruzic L, Sporis G, Matkovic BR. High volume-low intensity exercise camp and glycemic control in diabetic children. J Paediatr Child Health 2008 Mar; 44(3): 122–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Sideraviciute S, Gailiuniene A, Visagurskiene K, et al. The effect of long-term swimming program on glycemia control in 14–19-year aged healthy girls and girls with type 1 diabetes mellitus. Medicina (Kaunas) 2006; 42(6): 513–8.Google Scholar
  30. 30.
    Laaksonen DE, Atalay M, Niskanen LK, et al. Aerobic exercise and the lipid profile in type 1 diabetic men: a randomized controlled trial. Med Sci Sports Exerc 2000 Sep; 32(9): 1541–8.PubMedGoogle Scholar
  31. 31.
    Lehmann R, Kaplan V, Bingisser R, et al. Impact of physical acitivity on cardiovascular risk factors in IDDM. Diabetes Care 1997; 20(10): 1603–11.PubMedCrossRefGoogle Scholar
  32. 32.
    Wallberg-Henriksson H, Gunnarsson R, Rossner S, et al. Long-term physical training in female type 1 (insulin-dependent) diabetic patients: absence of significant effect on glycaemic control and lipoprotein levels. Diabetologia 1986; 29: 53–7.PubMedCrossRefGoogle Scholar
  33. 33.
    D’Hooge R, Hellinckx T, Van Laethem C, et al. Influence of combined aerobic and resistance training on metabolic control, cardiovascular fitness and quality of life in adolescents with type 1 diabetes: a randomized controlled trial. Clin Rehabil 2011 Apr; 25(4): 349–59.PubMedCrossRefGoogle Scholar
  34. 34.
    Mosher PE, Nash MS, Perry AC, et al. Aerobic circuit exercise training: effect on adolescents with well-controlled insulin-dependent diabetes mellitus. Arch Phys Med Rehabil 1998 Jun; 79(6): 652–7.PubMedCrossRefGoogle Scholar
  35. 35.
    Iscoe KE, Campbell JE, Jamnik V, et al. Efficacy of continuous real-time blood glucose monitoring during and after prolonged high-intensity cycling exercise: spinning with a continuous glucose monitoring system. Diabetes Technol Ther 2006 Dec; 8(6): 627–35.PubMedCrossRefGoogle Scholar
  36. 36.
    Iscoe KE, Riddell MC. Continuous moderate-intensity exercise with or without intermittent high-intensity work: effects on acute and late glycaemia in athletes with type 1 diabetes mellitus. Diabet Med 2011 Jul; 28(7): 824–32.PubMedCrossRefGoogle Scholar
  37. 37.
    Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates, 1988.Google Scholar
  38. 38.
    Gibala MJ. High-intensity interval training: a time-efficient strategy for health promotion? Curr Sports Med Rep 2007 Jul; 6(4):211–3.PubMedCrossRefGoogle Scholar
  39. 39.
    Harbour R. A new system for grading recommendations in evidence based guidelines. BMJ 2001; 1(1): 334–6.CrossRefGoogle Scholar
  40. 40.
    Perrone C, Laitano O, Meyer F. Effects of carbohydrate ingestion on the glycemic response of type 1 diabetic adolescents during exercise. Diabetes Care 2005 Oct; 28(10): 2537–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Raile K, Kapellen T, Schweiger A, et al. Physical activity and competitive sports in children and adolescents with type 1 diabetes. Diabetes Care 1999 Nov; 22(11): 1904–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Aman J, Skinner TC, de Beaufort CE, et al. Associations between physical activity, sedentary behavior, and glycemic control in a large cohort of adolescents with type 1 diabetes: the Hvidoere Study Group on Childhood Diabetes. Pediatric Diabetes 2009; 10: 234–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Michaliszyn SF, Shaibi GQ, Quinn L, et al. Physical fitness, dietary intake, and metabolic control in adolescents with type 1 diabetes. Pediatr Diabetes 2009 Sep; 10(6): 389–94.PubMedCrossRefGoogle Scholar
  44. 44.
    Costill DL, Fink WJ, Getchell LH, et al. Lipid metabolism in skeletal muscle of endurance-trained males and females. J Appl Physiol 1979 Oct; 47(4): 787–91.PubMedGoogle Scholar
  45. 45.
    Wallymahmed ME, Morgan C, Gill GV, et al. Aerobic fitness and hand grip strength in type 1 diabetes: relationship to glycaemic control and body composition. Diabet Med 2007 Nov; 24(11): 1296–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Kelly RB. Diet and exercise in the management of hyperlipidemia. Am Fam Physician 2010 May 1; 81(9): 1097–102.PubMedGoogle Scholar
  47. 47.
    Ludvigsson J. Physical exercise in relation to degree of metabolic control in juvenile diabetics. Acta Paediatr Scand Suppl 1980; 283: 45–9.PubMedCrossRefGoogle Scholar
  48. 48.
    Nermoen I, Jorde R, Sager G, et al. Effects of exercise on hypoglycaemic responses in insulin-dependent diabetes mellitus. Diabetes Metab 1998 Apr; 24(2): 131–6.PubMedGoogle Scholar
  49. 49.
    Roberts L, Jones TW, Fournier PA. Exercise training and glycemic control in adolescents with poorly controlled type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2002 May; 15(5): 621–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Sonnenberg GE, Kemmer FW, Berger M. Exercise in type 1 (insulin-dependent) diabetic patients treated with continuous subcutaneous insulin infusion: prevention of exercise induced hypoglycaemia. Diabetologia 1990 Nov; 33(11): 696–703.PubMedCrossRefGoogle Scholar
  51. 51.
    Valerio G, Spagnuolo MI, Lombardi F, et al. Physical activity and sports participation in children and adolescents with type 1 diabetes mellitus. Nutr Metab Cardiovasc Dis 2007 Jun; 17(5): 376–82.PubMedCrossRefGoogle Scholar
  52. 52.
    Vanelli M, Corchia M, Iovane B, et al. Self-monitoring adherence to physical activity in children and adolescents with type 1 diabetes. Acta Biomed 2006; 77 Suppl. 1: 47–50.PubMedGoogle Scholar
  53. 53.
    Fayolle C, Brun JF, Bringer J, et al. Accuracy of continuous subcutaneous glucose monitoring with the GlucoDay in type 1 diabetic patients treated by subcutaneous insulin infusion during exercise of low versus high intensity. Diabetes Metab 2006 Sep; 32(4): 313–20.PubMedCrossRefGoogle Scholar
  54. 54.
    Meinders AE, Willekens FL, Heere LP. Metabolic and hormonal changes in IDDM during long-distance run. Diabetes Care 1988 Jan; 11(1): 1–7.PubMedCrossRefGoogle Scholar
  55. 55.
    Herbst A, Kordonouri O, Schwab K, et al. Impact of physical activity on cardiovascular risk factors in children with type 1 diabetes. Diabetes Care 2007; 30(8): 2098–100.PubMedCrossRefGoogle Scholar
  56. 56.
    Sackey AH, Jefferson IG. Physical activity and glycaemic control in children with diabetes mellitus. Diabet Med 1996 Sep; 13(9): 789–93.PubMedCrossRefGoogle Scholar
  57. 57.
    Faulkner MS, Michaliszyn SF, Hepworth JT. A personalized approach to exercise promotion in adolescents with type 1 diabetes. Pediatr Diabetes 2010 May; 11(3): 166–74.PubMedCrossRefGoogle Scholar
  58. 58.
    Ligtenberg PC, Blans M, Hoekstra JB, et al. No effect of long-term physical activity on the glycemic control in type 1 diabetes patients: a cross-sectional study. Neth J Med 1999 Aug; 55(2): 59–63.PubMedCrossRefGoogle Scholar
  59. 59.
    Dahl-Jorgensen K, Meen HD, Hanssen KF, et al. The effect of exercise on diabetic control and hemoglobin A1 (HbA1) in children. Acta Paediatr Scand Suppl 1980; 283: 53–6.PubMedCrossRefGoogle Scholar
  60. 60.
    Nugent AM, Steele IC, al-Modaris F, et al. Exercise responses in patients with IDDM. Diabetes Care 1997 Dec; 20(12): 1814–21.PubMedCrossRefGoogle Scholar
  61. 61.
    Clarke WL, Cox DJ, Gonder-Frederick LA, et al. The relationship between nonroutine use of insulin, food, and exercise and the occurrence of hypoglycemia in adults with IDDM and varying degrees of hypoglycemic awareness and metabolic control. Diabetes Educ 1997 Jan–Feb; 23(1): 55–8.PubMedCrossRefGoogle Scholar
  62. 62.
    Szmigiel C, Dziadkowiak H, Jesionek D, et al. The influence of physical effort of variable intensity on glycemia in children with diabetes. Pediatr Pol 1996 May; 71(5): 423–30.PubMedGoogle Scholar
  63. 63.
    McCargar LJ, Taunton J, Pare S. Benefits of exercise training for men with insulin-dependent diabetes mellitus. Diabetes Educ 1991 May–Jun; 17(3): 179–84.PubMedCrossRefGoogle Scholar
  64. 64.
    Stratton R, Wilson DP, Endres RK, et al. Improved glycemic control after supervised 8-wk exercise program in insulin-dependent diabetic adolescents. Diabetes Care 1987 Sep–Oct; 10(5): 589–93.PubMedCrossRefGoogle Scholar
  65. 65.
    Jensen MD, Miles JM. The roles of diet and exercise in the management of patients with insulin-dependent diabetes mellitus. Mayo Clin Proc 1986 Oct; 61(10): 813–9.PubMedCrossRefGoogle Scholar
  66. 66.
    Hubinger A, Ridderskamp I, Lehmann E, et al. Metabolic response to different forms of physical exercise in type I diabetics and the duration of the glucose lowering effect. Eur J Clin Invest 1985 Aug; 15(4): 197–203.PubMedCrossRefGoogle Scholar
  67. 67.
    Schiffrin A, Parikh S, Marliss EB, et al. Metabolic response to fasting exercise in adolescent insulin-dependent diabetic subjects treated with continuous subcutaneous insulin infusion and intensive conventional therapy. Diabetes Care 1984 May–Jun; 7(3): 255–60.PubMedCrossRefGoogle Scholar
  68. 68.
    Sills IN, Cerny FJ. Responses to continuous and intermittent exercise in healthy and insulin-dependent diabetic children. Med Sci Sports Exerc 1983; 15(6): 450–4.PubMedGoogle Scholar
  69. 69.
    Guler HP, Walter H, Morell B, et al. Effect of prolonged optimal blood sugar control by i.v. insulin administration on plasma free fatty acid and glycerol concentrations of insulin-dependent diabetics during exercise. Acta Diabetol Lat 1982 Jul–Sep; 19(3): 261–71.PubMedCrossRefGoogle Scholar
  70. 70.
    Zander E, Schulz B, Chlup R, et al. Muscular exercise in type I-diabetics, II: hormonal and metabolic responses to moderate exercise. Exp Clin Endocrinol 1985 Feb; 85(1): 95–104.PubMedCrossRefGoogle Scholar
  71. 71.
    Baharlouei k. The effect of aerobic training on selected variables in patients with type 1 diabetes mellitus. Br J Sports Med 2010; 44 Suppl. 1:121.CrossRefGoogle Scholar
  72. 72.
    Jette DU. Physiological effects of exercise in the diabetic. Phys Ther 1984 Mar; 64(3): 339–42.PubMedGoogle Scholar
  73. 73.
    Riddell MC, Iscoe KE. Physical activity, sport, and pediatric diabetes. Pediatr Diabetes 2006 Feb; 7(1): 60–70.PubMedCrossRefGoogle Scholar
  74. 74.
    Riddell MC, Milliken J. Preventing exercise-induced hypoglycemia in type 1 diabetes using real-time continuous glucose monitoring and a new carbohydrate intake algorithm: an observational field study. Diabetes Technol Ther 2011 Aug; 13(8): 819–25.PubMedCrossRefGoogle Scholar
  75. 75.
    Steppel JH, Horton ES. Exercise in the management of type 1 diabetes mellitus. Rev Endocr Metab Disord 2003 Dec; 4(4): 355–60.PubMedCrossRefGoogle Scholar
  76. 76.
    Smith NJ, Stanitski CL, Dyment CL, et al. Glycemic control with physical trainin in insulin-dependent diabetes mellitus. Sports Med 1985; 139: 307–10.Google Scholar
  77. 77.
    Rabasa-Lhoret R, Bourque J, Ducros F, et al. Guidelines for premeal insulin dose reduction for postprandial exercise of different intensities and durations in type 1 diabetic subjects treated intensively with a basal-bolus insulin regimen (ultralente-lispro). Diabetes Care 2001 Apr; 24(4): 625–30.PubMedCrossRefGoogle Scholar
  78. 78.
    Riddell M, Perkins BA. Exercise and glucose metabolism in persons with diabetes mellitus: perspectives on the role for continuous glucose monitoring. J Diabetes Sci Technol 2009; 3(4): 914–23.PubMedGoogle Scholar
  79. 79.
    Jimenez C, Santiago M, Sitler M, et al. Insulin-sensitivity response to a single bout of resistive exercise in type 1 diabetes mellitus. J Sport Rehabil 2009 Nov; 18(4): 564–71.PubMedGoogle Scholar
  80. 80.
    Iafusco D. Diet and physical activity in patients with type 1 diabetes. Acta Biomed 2006; 77 Suppl 1: 41–6.PubMedGoogle Scholar
  81. 81.
    Zander E, Bruns W, Wulfert P, et al. Muscular exercise in type I-diabetics, I: different metabolic reactions during heavy muscular work in dependence on actual insulin availability. Exp Clin Endocrinol 1983 Jul; 82(1): 78–90.PubMedGoogle Scholar
  82. 82.
    Bussau VA, Ferreira LD, Jones TW, et al. A 10-s sprint performed prior to moderate-intensity exercise prevents early post-exercise fall in glycaemia in individuals with type 1 diabetes. Diabetologia 2007 Sep; 50(9): 1815–8.PubMedCrossRefGoogle Scholar
  83. 83.
    Baldi JC, Cassuto NA, Foxx-Lupo WT, et al. Glycemic status affects cardiopulmonary exercise response in athletes with type I diabetes. Med Sci Sports Exerc 2011 Aug; 42(8): 1454–9.Google Scholar
  84. 84.
    Khoharo HK, Ansari S, Ali Shaikh I, et al. Cardiac autonomic neuropathy (CAN) in type-1 diabetes mellitus patients and its association with the duration of disease and glycemic control. J Coll Physicians Surg Pak 2009 Apr; 19(4): 232–5.PubMedGoogle Scholar
  85. 85.
    Ismail I, Keating SE, Baker MK, et al. A systematic review and meta-analysis of the effect of aerobic vs. resistance exercise training on visceral fat. Obes Rev 2012 Jan; 13(1): 68–91.PubMedCrossRefGoogle Scholar
  86. 86.
    Svensson MK, Eriksson JW. Change in the amount of body fat and IL-6 levels is related to altered insulin sensitivity in type 1 diabetes patients with or without diabetic nephropathy. Horm Metab Res 2011 Mar; 43(3): 209–15.PubMedCrossRefGoogle Scholar
  87. 87.
    Tresierras MA, Balady GJ. Resistance training in the treatment of diabetes and obesity: mechanisms and outcomes. J Cardiopulm Rehabil Prev 2009 Mar–Apr; 29(2): 67–75.PubMedGoogle Scholar
  88. 88.
    Irvine C, Taylor NF. Progressive resistance exercise improves glycaemic control in people with type 2 diabetes mellitus: a systematic review. Aust J Physiother 2009; 55(4): 237–46.PubMedCrossRefGoogle Scholar
  89. 89.
    Sundell J. Resistance training is an effective tool against metabolic and frailty syndromes. Adv Prev Med 2011; 984683–7.Google Scholar
  90. 90.
    Heymsfield SB, Gallagher D, Kotler DP, et al. Body-size dependence of resting energy expenditure can be attributed to nonenergetic homogeneity of fat-free mass. Am J Physiol Endocrinol Metab 2002 Jan; 282(1): E132–8.PubMedGoogle Scholar
  91. 91.
    Brun J-F, Marti B, Fédou C, et al. Two parameters statistically explain blood glucose decrease during exercise at steady state in type 1 diabetics: pre-exercise blood glucose and insulinemia. Sci Sports. In press.Google Scholar
  92. 92.
    Brazeau AS, Rabasa-Lhoret R, Strychar I, et al. Barriers to physical activity among patients with type 1 diabetes. Diabetes Care 2008 Nov; 31(11): 2108–9.PubMedCrossRefGoogle Scholar
  93. 93.
    Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000 Jun; 56(2): 455–63.PubMedCrossRefGoogle Scholar
  94. 94.
    Song F, Gilbody S. Bias in meta-analysis detected by a simple, graphical test. Increase in studies of publication bias coincided with increasing use of meta-analysis. BMJ 1998 Feb 7; 316(7129): 469–71.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2012

Authors and Affiliations

  • Cajsa Tonoli
    • 1
    • 2
  • Elsa Heyman
    • 2
  • Bart Roelands
    • 1
    • 3
  • Luk Buyse
    • 1
  • Stephen S. Cheung
    • 4
  • Serge Berthoin
    • 5
  • Romain Meeusen
    • 1
    Email author
  1. 1.Human Physiology and Sports Medicine, Faculty of Physical Education and Physical TherapyVrije Universiteit BrusselsBrusselsBelgium
  2. 2.UDSL, EA4488Activité Physique-Muscle-SantéLilleFrance
  3. 3.Fund for Scientific Research Flanders (FWO)FlandersBelgium
  4. 4.Department of KinesiologyBrock UniversitySt CatharinesCanada
  5. 5.EA4488, Activité Physique-Muscle-SantéLilleFrance

Personalised recommendations