Exercise Training for Diabetes: The “Strength ” of the Evidence

Exercise is an essential component in the treatment ofdiabetes mellitus. Lifestyle factors affect the prevention, development, and treatment of diabetes mellitus and its close relation, the metabolic syndrome (1). The Finnish Diabetes Prevention Study (2) and the Diabetes Preven-tion Program (3) tested lifestyle interventions that included a physical activity program. Both studies showed the power of exercise, nutrition, and weight loss to prevent diabetes mellitus in at-risk individuals. However, exercise comes in several flavors, and the clinician should think critically about the effects of differ-ent types of exercise training. It is useful to think of exer-cise training as a drug with a specific dose–response rela-tionship (4). For example, exercise can be delivered in various “doses”: differing number of sessions per week (fre-quency), number of minutes per session (duration), or de