How can type 2 diabetes patients exercise more help to lower blood sugar smoothly? Take a look at the 2022 guideline recommendations

The 378th original article

Today’s article, from this year’s new American College of Sports Medicine (ACSM) exercise/physical activity position statement for people with type 2 diabetes. Quickly share it with your friends with type 2 diabetes to help them control their blood sugar well and improve their quality of life.

11 Core Recommendations

1. Regular aerobic exercise can improve overall blood sugar in adults with type 2 diabetes, reduce the time of hyperglycemia, and reduce overall blood sugar by 0.5% to -0.7% ( Measured as HbA 1c ).

Second, High-intensity resistance training is superior to moderate- and low-intensity resistance training in terms of hypoglycemic effect and insulin level reduction effect.

Third, Exercise after meals is more recommended than exercise before meals. Postprandial exercise can achieve smoother glycemic control by reducing acute glycemic spikes, and the energy expenditure associated with postprandial exercise can reduce overall glycemic levels, regardless of the intensity or type of exercise. The benefit was more stable and more pronounced if the duration was ≥45 minutes.

Fourth, Reducing sedentary time by exercising in small, frequent and regular ways can moderately lower postprandial blood sugar and insulin levels. It is more beneficial for patients with insulin resistance and higher body mass index (BMI).

5. Weight loss > 5% (achieved through lifestyle changes of diet and exercise) is a necessary condition for improving HbA1c, blood lipids, and blood pressure.

Six. Moderate-intensity exercise (about 500kcal consumption) 4-5 times a week can reduce visceral fat.

VII. In young patients with type 2 diabetes treated with metformin, the effect of intensive lifestyle intervention combined with metformin in glycemic control is no better than that of metformin alone. Therefore, exercise intervention cannot be used as a substitute for drug therapy.

Eight.Although data are limited, it is recommended that adolescents with type 2 diabetes maintain the same amount of physical activity as healthy adolescents. That is to complete ≥150-300 minutes of moderate-intensity aerobic exercise per week, or ≥75-150 minutes of high-intensity aerobic exercise, or a combination of the two. Also, make sure to do resistance exercise at least 2 days a week.

Nine, Pregnant women with gestational diabetes should complete at least 20-30 minutes of moderate-intensity exercise every day. That is, regardless of whether there is gestational diabetes, the amount of exercise should be the same.

10. Patients with type 2 diabetes who use insulin or insulin secretagogues should reasonably supplement carbohydrates (or reduce insulin) during and after exercise to prevent Avoid hypoglycemia.

Eleven. Patients with type 2 diabetes who have undergone bariatric surgery should exercise properly before and after surgery. Exercise will make the surgery better and bring additional health benefits, such as reducing the risk of cardiovascular disease.

Effect of different types of exercise on patients with type 2 diabetes


Regular aerobic exercise can increase insulin sensitivity, improve blood sugar, and reduce hyperglycemia. It is recommended that the interval between two exercises should not exceed 48 consecutive hours. People with type 2 diabetes with comorbidities or complications should engage in as much aerobic exercise as their health allows.

Resistance training

Resistance training improves strength, bone mineral density, blood pressure, lipids, and insulin sensitivity while reducing HbA1c in older patients. A combination of aerobic and resistance training is superior to aerobic or resistance training alone.

Flexibility training

Flexibility training alone or in combination with resistance training can improve range of motion. Flexibility training is very friendly to older patients with poor mobility, being less intense and easier to perform.

Balance exercise

Balance exercises improve balance and gait, thereby reducing the risk of falls, even in patients with peripheral neuropathy. Balance exercises also need to include resistance training of lower limbs and core muscles, which can effectively reduce the risk of falls in elderly patients.

Other types of sports

Stretching, yoga, tai chi, and other types of physical activity can also help lower blood sugar. Yoga helps improve blood sugar, blood lipids and bodybody composition. Tai Chi can lower blood sugar, lower BMI, improve neurological symptoms, improve balance, and improve quality of life.

Sedentary and exercise intervals

Inactivity (sitting or lying down) increases the risk of developing type 2 diabetes. For adults who were sedentary for 9 hours a day, each additional hour of sedentary time was associated with a 22% increased risk of developing type 2 diabetes.

For people with type 2 diabetes, break the sedentary habit, increase interval movement, for example, stand up and walk for 3 minutes for every 30 minutes of sitting, or do some simple resistance exercises to help reduce Postprandial blood glucose, C-peptide and triglyceride levels. These “small doses” of physical activity that help break up sedentary periods cannot be underestimated. They are even slightly more effective in lowering postprandial blood sugar and insulin levels than continuous moderate-intensity exercise, so for people with insulin resistance and higher BMI, The impact is more significant.

Specific recommendations for different types of sports


It is recommended to gradually increase the intensity and duration of exercise based on individual health, age, weight and personal goals.

Type: brisk walking, jogging, biking, swimming, water sports, boating, dancing, etc.

Frequency: 3-7 times per week, no more than 48 consecutive hours between workouts

Exercise: No less than 150-300 minutes per week of moderate intensity (i.e. some breathing, but conversational) or 75-150 minutes of high intensity (very breathing, only on and off dialogue), or an equivalent combination of the two intensities.

️Resistance Exercise

It is recommended to increase resistance first, then increase the number of sets, and finally increase the frequency of training.

Type: Exercises that use equipment, bands, or body weight as resistance, such as bodyweight squats, push-ups, band hip and leg exercises, weighted squats, weights Glute bridge, gym equipment exercise, etc. These exercises target major muscle groups in the human body and help increase muscle mass and muscular endurance

Frequency: 2-3 days per week, but not every day continuously

Volume: 8-10 exercises for major muscle groups. Do only 1-3 sets of 10-15 repetitions per training day for a specific body part. The training intensity is generally 50-69% of the maximum endurance intensity, and those with strong ability can also achieve 70-85%.

Flexibility training

Recommended after muscle and joint warm-ups are complete.

Type: Stretching, balance exercises, yoga and tai chi, etc. to the point of tightness or mild discomfort

Frequency: ≥2~3 days per week

Exercise amount: Hold each stretch for 10~30 seconds, repeat 2~4 times, stretch to the maximum range that is painless and tolerable

Balance exercise

Careful and careful during balance training is recommended to minimize the risk of falls.

Type: Resistance exercises for lower body and core, yoga, Tai Chi

Frequency: ≥2~3 days per week, no duration set


Actually, for friends without type 2 diabetes, especially middle-aged and elderly friends, the above exercise suggestions are applicable. Regular exercise has many health benefits, not just for weight control.

After reading this article, quickly start making your exercise plan!

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(The picture used in the text comes from the Internet)

So humble and broken thoughts

Life is movement

Brief Introduction

Liu Suiqian: Australian DAA certification registrationLicensed Dietitian (APD), Certified Registered Dietitian of Chinese Nutrition Society, member of Australian DAA and Chinese Nutrition Society, Master of Clinical Nutrition (MND) of University of Sydney, and holds the certificate of Pediatric Nutrition Graduate Program of Boston University School of Medicine, Clinical Nutrition Teacher, popular science worker, member of China Health Promotion Foundation’s Expert Group on Maternal Health Public Welfare Activities, Member of Beijing Health Management Association Nutrition Management Expert Committee, and Expert Member of Infant Complementary Food Professional Committee of China Nutrition and Health Food Association. He is a translation committee member of translations such as “Krause Nutritional Diagnosis and Treatment”, and a nutrition columnist for many magazines and media. He has edited five sets of maternal and infant books, and authored the book “7 Lessons of Baby Feeding, Say Goodbye to Anxiety and Start with Food Education”. In the past ten years, in the face of clinical elderly, young and pregnant patients, we have determined that disease prevention and psychological support are the direction for doctors to help and heal – the road to popular science, we work together.

Personal WeChat Official Account Platform: Liu_suiqian


JILL A. KANALEY et al, Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine, Medicine & Science in Sports & Exercise (2022).