Exercise and Diabetes. Sheri R. Colberg

the warm-up and cooldown involve doing an activity at a slower speed or lower intensity (such as engaging in 5–10 min of brisk walking before and after jogging).

      • The aerobic exercise prescription should address mode (type of activity), intensity (how difficult), frequency (how often), duration (how long), and appropriate progression.

      • Although doing any physical activity can be beneficial to health, moderate- to vigorous-intensity physical activity is generally recommended to achieve aerobic and metabolic improvements in people with diabetes.

      • Lower-intensity activities will expend calories and help with weight maintenance, but may or may not have much of an acute impact on blood glucose levels or enhance cardiovascular fitness as much.

      • Appropriate measures of intensity include the “talk test,” perceived exertion, and target HR (using the Karvonen formula for HR reserve).

      • Physical activity should be performed 3–5 days/week to achieve significant health benefits, with no more than 2 consecutive days without aerobic activity to optimize insulin action; exercise done only 2 days/week results in lesser fitness improvements.

      • Both moderate- and vigorous-intensity aerobic activity should be performed in episodes of at least 10 min, with a goal of 30 min or more of continuous activity.

      • Progress by increasing physical activity gradually over time whenever more activity is necessary to meet guidelines or health goals; inactive individuals should “start low and go slow” by gradually increasing how often and how long activities are done.

      • A full exercise prescription should include both how to start a fitness program and what to expect in terms of progress over a period of 4–6 months, including initial, improvement, and maintenance phases (although fit individuals may skip the initial phase).

      • For individuals with T1D without complications, exercise recommendations are similar to those for individuals with no known health problems (i.e., a minimum of 150 min of moderate or 60–75 min of vigorous activity weekly).

      • Recommendations for T2D closely align with guidelines for sedentary adults and older adults; most individuals with T2D should at the very least undertake 150 min or more of moderate to vigorous aerobic exercise per week for cardiovascular risk reduction.

      • Women with uncomplicated GDM should engage in 30 min of moderate intensity activity like brisk walking on most days of the week (150 min weekly).

      • Empowering individuals to set their own specific goals is the ultimate aim of providing them with a specific exercise prescription for aerobic training.

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