Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA(1c) in obese type 2 diabetes patients

Diabetologia. 2009 Sep;52(9):1789-97. doi: 10.1007/s00125-009-1354-3. Epub 2009 Apr 16.


Aims/hypothesis: Exercise represents an effective interventional strategy to improve glycaemic control in type 2 diabetes patients. However, the impact of exercise intensity on the benefits of exercise training remains to be established. In the present study, we compared the clinical benefits of 6 months of continuous low- to moderate-intensity exercise training with those of continuous moderate- to high-intensity exercise training, matched for energy expenditure, in obese type 2 diabetes patients.

Methods: Fifty male obese type 2 diabetes patients (age 59 +/- 8 years, BMI 32 +/- 4 kg/m(2)) participated in a 6 month continuous endurance-type exercise training programme. All participants performed three supervised exercise sessions per week, either 55 min at 50% of whole body peak oxygen uptake (VO(2)peak (low to moderate intensity) or 40 min at 75% of VO(2)peak (moderate to high intensity). Oral glucose tolerance, blood glycated haemoglobin, lipid profile, body composition, maximal workload capacity, whole body and skeletal muscle oxidative capacity and skeletal muscle fibre type composition were assessed before and after 2 and 6 months of intervention.

Results: The entire 6 month intervention programme was completed by 37 participants. Continuous endurance-type exercise training reduced blood glycated haemoglobin levels, LDL-cholesterol concentrations, body weight and leg fat mass, and increased VO(2)peak, lean muscle mass and skeletal muscle cytochrome c oxidase and citrate synthase activity (p < 0.05). No differences were observed between the groups training at low to moderate or moderate to high intensity.

Conclusions/interpretation: When matched for energy cost, prolonged continuous low- to moderate-intensity endurance-type exercise training is equally effective as continuous moderate- to high-intensity training in lowering blood glycated haemoglobin and increasing whole body and skeletal muscle oxidative capacity in obese type 2 diabetes patients.

Trial registration: ISRCTN32206301

Funding: None.

MeSH terms

  • Adipose Tissue / anatomy & histology
  • Aged
  • Biopsy
  • Body Mass Index
  • Body Weight
  • Cholesterol, LDL / blood
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / rehabilitation*
  • Exercise / physiology*
  • Fasting
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Leg / anatomy & histology
  • Male
  • Middle Aged
  • Muscle, Skeletal / anatomy & histology
  • Muscle, Skeletal / pathology
  • Muscle, Skeletal / physiopathology
  • Obesity / blood
  • Obesity / physiopathology
  • Obesity / rehabilitation*
  • Oxygen Consumption


  • Cholesterol, LDL
  • Glycated Hemoglobin A

Associated data

  • ISRCTN/ISRCTN32206301