From the Guidelines
Engaging in 150 minutes of moderate-intensity exercise per week is strongly recommended for individuals with prediabetes, as it can significantly reduce the risk of progression to type 2 diabetes, improve insulin sensitivity, and enhance overall quality of life. This exercise regimen should ideally be spread across at least 3-5 days per week, with each session lasting 30-50 minutes. Effective activities include brisk walking, cycling, swimming, or any activity that raises your heart rate and causes mild sweating while still allowing conversation. The benefits of this exercise dose include improved insulin sensitivity, better glucose uptake by muscles, reduced body fat (particularly visceral fat), and lower blood pressure, as supported by the most recent guidelines 1.
Key Recommendations
- Combine aerobic exercise with 2-3 sessions of resistance training weekly to enhance muscle strength and overall physical fitness.
- Maintain consistent timing of exercise sessions relative to meals to optimize glucose uptake and insulin sensitivity.
- Gradually increase intensity over time as fitness improves to continue challenging the body and promoting progressive adaptations.
- Incorporate activities that promote flexibility and balance, such as yoga or tai chi, especially for older adults, to reduce the risk of falls and improve overall mobility.
Lifestyle Modifications
- Modest dietary changes, including reducing refined carbohydrates and increasing fiber intake, can complement the exercise regimen and further reduce the risk of progressing to type 2 diabetes.
- Breaking up prolonged sedentary time with short bouts of physical activity can also contribute to improved glucose regulation and overall health, as highlighted in recent standards of care 1.
Clinical Implications
- Healthcare providers should encourage individuals with prediabetes to adopt a lifestyle that includes regular physical activity and a balanced diet, emphasizing the importance of these modifications in preventing or delaying the onset of type 2 diabetes.
- Regular monitoring of physical activity levels and sedentary behavior, along with adjustments to the exercise prescription as needed, can help individuals with prediabetes achieve and maintain the recommended levels of physical activity, thereby reducing their risk of developing type 2 diabetes and associated comorbidities, as recommended by recent guidelines 1.
From the Research
Outcomes of 150 minutes per week of exercise in prediabetes
- The American Diabetes Association recommends at least 150 minutes per week of moderate physical activity for adults with prediabetes, which can help reduce the risk of progressing to type 2 diabetes 2.
- Studies have shown that 150 minutes per week of exercise can improve insulin sensitivity, reduce blood pressure and lipid levels, and decrease the risk of cardiovascular disease in individuals with prediabetes 2, 3.
- High-intensity exercise training can be a time-efficient alternative to traditional moderate-intensity exercise training, and can improve skeletal muscle metabolic control and cardiovascular function in individuals with prediabetes 3.
- A combination of calorie restriction and exercise, including at least 150 minutes per week of physical activity, can help decrease glucose levels, reduce HbA1c, and improve insulin resistance and sensitivity in individuals with type 2 diabetes 4.
- Physical activity intervention programs, including at least 150 minutes per week of exercise, can improve oral glucose tolerance, fasting blood sugar, and glycated hemoglobin (HbA1C) levels in individuals with prediabetes 5.
- Regular physical activity, including at least 150 minutes per week of exercise, can enhance health and glycemic management in people with type 2 diabetes, and can help reduce sedentary time and break up sitting time with frequent activity breaks 6.