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(Circulation. 2009;119:3244-3262.)
© 2009 American Heart Association, Inc.

AHA Scientific Statement

Exercise Training for Type 2 Diabetes Mellitus

Impact on Cardiovascular Risk: A Scientific Statement From the American Heart Association

Thomas H. Marwick, MD, PhD, Chair; Matthew D. Hordern, PhD; Todd Miller, MD, FAHA; Deborah A. Chyun, RN, PhD, FAHA; Alain G. Bertoni, MD, MPH, FAHA; Roger S. Blumenthal, MD, FAHA; George Philippides, MD; Albert Rocchini, MD, FAHA, on behalf of the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; Council on Nutrition, Physical Activity, and Metabolism; and the Interdisciplinary Council on Quality of Care and Outcomes Research

Key Words: AHA Scientific Statements • exercise • diabetes mellitus • prevention • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 

1. Introduction ...3244
   
2. Beneficial Effects of Exercise in T2DM...3245

      Glycemic Control...3245
   

      Body Composition...3248
   

      Risk Factors...3248
   

      Vascular Effects...3248
   

      Myocardial Function...3248
   

      Development of CVD...3248
   

   
   
3. Cardiac Risks of Exercise Training in T2DM...3249

      Generic Cardiac Risks of Training...3249
   

      Screening for Coronary Artery Disease...3249
   

      Prior Studies of CAD Screening...3249
   

      Guidelines/Position Statements...3250
   

   
   
4. Noncardiac Risks of Exercise Training in T2DM...3251

      Hypoglycemia...3251
   

      Peripheral Arterial Disease and Foot Care...3251
   

      Microvascular Disease...3252
   

   
   
5. Exercise Training Guidelines...3252

      Preparation for Exercise...3253

         Frequency...3253
   

         Intensity...3253
   

   
   

      Duration...3254

         Session Duration...3254
   

         Program Duration...3254
   

   
   

      Type...3254

         Aerobic...3254
   

         Resistance...3254
   

   
   

   
   
6. Approaches to Adherence...3254

      Health Behavior...3254
   

      Counseling...3255
   

      Long-Term Efficacy...3255
   

   
   
7. Special/Minority Groups...3255
   
8. Conclusions...3256
   
9. References...3257
   

	1. Introduction

 
The increasing prevalence of overweight and obesity has led to an unprecedented epidemic of type 2 diabetes mellitus (T2DM)^1–4 and is likely to be followed by an epidemic of patients with complications of T2DM.⁵ Given the observed increases in the prevalence of T2DM in adults over the past few decades in developed countries,^1,2,6 population-based efforts to reduce the cardiovascular complications of T2DM are as critical as the measures to prevent the problem.^4,7 T2DM is the sixth-leading cause of death,⁸ with most deaths attributed to cardiovascular disease (CVD; nearly 70%) and with ischemic heart disease being responsible for nearly 50% of these deaths.⁹ The economic cost of T2DM has been estimated to be $172 billion in 2007 in the United States alone³ (up from $132 billion in 2002)¹⁰ and is likely to be greater when the other indirect costs of its associated complications are included.¹¹ These complications are due to atherosclerotic vascular disease⁴ but also reflect a susceptibility of patients with T2DM . . . [Full Text of this Article]

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