New data suggest that combined aerobic and resistance training, rather than either alone, is the best course of action for controlling both blood sugar and blood fat profiles among people with type 2 diabetes. The investigation, led by Lukas Schwingshackl, University of Vienna, Austria, and published July 2 in Diabetologia, sought to correct the fact that no systematic review had compared the direct and indirect effect of these training modalities on the outcomes of blood sugar control and blood fats in patients with this particular condition.

Additional Resources CardioSmart for Your Patients: About Type 2 Diabetes

Assessing the efficacy of aerobic exercise training, resistance training, and combined training, a total of 14 trials enrolling 915 participants were included in the systematic review and meta-analysis. Results showed that in patients with established diabetes, aerobic exercise training could potentially be more effective in reducing HbA_1c and fasting glucose when compared with resistance training. Additionally, combined training demonstrated to be more beneficial in reducing HbA_1c compared with aerobic exercise training, and more effective in reducing HbA_1c, fasting blood glucose and blood fats when compared with resistance training. Culling together direct and indirect evidence on aerobic exercise training, resistance training, and combined training, combined training was the most efficacious exercise intervention in regards to its impact on HbA_1c, fasting glucose, good cholesterol, blood fats, diastolic blood pressure and bodyweight.

However, the authors note that these results ultimately could not be confirmed since their clinical relevance is limited by the "overall low to moderate quality of the studies included." Further, while only studies where the training was supervised and thus objectively validated were included in the analysis, and previous research has shown supervised exercise is more effective than unsupervised training, the authors note it is possible that either aerobic exercise training, resistance training, and combined training may be easier to perform effectively without supervision and affect the external validity of the study's results.

The authors ultimately conclude that "further high quality with long-term exercise interventions are needed to develop definitive recommendations. In the meantime, combined aerobic and resistance training can be recommended as part of a lifestyle programme in the management of type 2 diabetes wherever possible. Due to the limited information on potential adverse effects of exercise, supervised workouts should be favoured."

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