Effects of Performing Resistance Exercise Before Versus After Aerobic Exercise on Glycemia in Type 1 Diabetes

  1. Ronald J. Sigal, MD, MPH6,8,9
  1. 1Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Ontario, Canada
  2. 2Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
  3. 3University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
  4. 4School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
  5. 5Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  6. 6Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  7. 7Champlain Diabetes Regional Coordination Centre, Ottawa, Ontario, Canada
  8. 8Alberta Health Services, Calgary, Alberta, Canada
  9. 9Departments of Medicine, Cardiac Sciences and Community Health Sciences, and Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
  1. Corresponding author: Ronald J. Sigal, rsigal{at}


OBJECTIVE To determine the effects of exercise order on acute glycemic responses in individuals with type 1 diabetes performing both aerobic and resistance exercise in the same session.

RESEARCH DESIGN AND METHODS Twelve physically active individuals with type 1 diabetes (HbA1c 7.1 ± 1.0%) performed aerobic exercise (45 min of running at 60% V̇o2peak) before 45 min of resistance training (three sets of eight, seven different exercises) (AR) or performed the resistance exercise before aerobic exercise (RA). Plasma glucose was measured during exercise and for 60 min after exercise. Interstitial glucose was measured by continuous glucose monitoring 24 h before, during, and 24 h after exercise.

RESULTS Significant declines in blood glucose levels were seen in AR but not in RA throughout the first exercise modality, resulting in higher glucose levels in RA (AR = 5.5 ± 0.7, RA = 9.2 ± 1.2 mmol/L, P = 0.006 after 45 min of exercise). Glucose subsequently decreased in RA and increased in AR over the course of the second 45-min exercise bout, resulting in levels that were not significantly different by the end of exercise (AR = 7.5 ± 0.8, RA = 6.9 ± 1.0 mmol/L, P = 0.436). Although there were no differences in frequency of postexercise hypoglycemia, the duration (105 vs. 48 min) and severity (area under the curve 112 vs. 59 units ⋅ min) of hypoglycemia were nonsignificantly greater after AR compared with RA.

CONCLUSIONS Performing resistance exercise before aerobic exercise improves glycemic stability throughout exercise and reduces the duration and severity of postexercise hypoglycemia for individuals with type 1 diabetes.

  • Received September 28, 2011.
  • Accepted December 19, 2011.

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