Table 3

Exercise training recommendations: types of exercise, intensity, duration, frequency, and progression

AerobicResistanceFlexibility and Balance
Type of exercise
  • Prolonged, rhythmic activities using large muscle groups (e.g., walking, cycling, and swimming)

  • May be done continuously or as HIIT

  • Resistance machines, free weights, resistance bands, and/or body weight as resistance exercises

  • Stretching: static, dynamic, and other stretching; yoga

  • Balance (for older adults): practice standing on one leg, exercises using balance equipment, lower-body and core resistance exercises, tai chi

Intensity
  • Moderate to vigorous (subjectively experienced as “moderate” to “very hard”)

  • Moderate (e.g., 15 repetitions of an exercise that can be repeated no more than 15 times) to vigorous (e.g., 6–8 repetitions of an exercise that can be repeated no more than 6–8 times)

  • Stretch to the point of tightness or slight discomfort

  • Balance exercises of light to moderate intensity

Duration
  • At least 150 min/week at moderate to vigorous intensity for most adults with diabetes

  • For adults able to run steadily at 6 miles per h (9.7 km/h) for 25 min, 75 min/week of vigorous activity may provide similar cardioprotective and metabolic benefits

  • At least 8–10 exercises with completion of 1–3 sets of 10–15 repetitions to near fatigue per set on every exercise early in training

  • Hold static or do dynamic stretch for 10−30 s; 2−4 repetitions of each exercise

  • Balance training can be any duration

Frequency
  • 3–7 days/week, with no more than 2 consecutive days without exercise

  • A minimum of 2 nonconsecutive days/week, but preferably 3

  • Flexibility: ≥2−3 days/week

  • Balance: ≥2−3 days/week

Progression
  • A greater emphasis should be placed on vigorous intensity aerobic exercise if fitness is a primary goal of exercise and not contraindicated by complications

  • Both HIIT and continuous exercise training are appropriate activities for most individuals with diabetes

  • Beginning training intensity should be moderate, involving 10−15 repetitions per set, with increases in weight or resistance undertaken with a lower number of repetitions (8−10) only after the target number of repetitions per set can consistently be exceeded

  • Increase in resistance can be followed by a greater number of sets and finally by increased training frequency

  • Continue to work on flexibility and balance training, increasing duration and/or frequency to progress over time