The Effects of Exercise Order in Patients with Type 1 Diabetes

Should Patients Perform Aerobic Exercises or Resistance Training Routines First?

Elderly woman exercising in the parkIt is well known that exercising can help people with diabetes manage their condition—but could the order in which patients complete their workout regimen have an effect on blood glucose levels? Researchers set out to answer this question in a study, “Effects of performing resistance exercise before versus after aerobic exercise on glycemia in type 1 diabetes.” The study was published in the April 2012 issue of Diabetes Care.

The study authors tested 2 types of physical activity on patients with type 1 diabetes: aerobic exercise and resistance training. The researchers were interested in whether completing the aerobic exercise prior to the resistance training would provide different effects than completing the resistance training first.

Twelve people were included in the study. All of the participants had type 1 diabetes and were relatively active individuals. They performed 45 minutes of resistance training exercises (3 sets of 7 exercises) and 45 minutes of aerobic exercise (running). Some of the participants began with the resistance training, while the others started with the running.

Patients’ plasma glucose levels were measured during and after the exercises were completed. Their interstitial glucose levels were monitored before, during, and after exercise.

During the first 45-minute exercise period, the blood glucose levels of people in the group that performed the aerobic exercises before the resistance training (AR) decreased significantly. This drop was not seen in the group that began with the resistance training (RA). During the second 45-minute session, the blood glucose levels of participants in the RA group decreased, while the levels went back up in the AR group. By the end of the exercise, the glucose levels of the 2 groups were not significantly different.

The study also found that the duration and extent of hypoglycemia following the workouts was greater (nonsignificant) in the AR group than the RA group.

The study authors state that their findings demonstrate that patients with type 1 diabetes who do resistance training exercises before aerobic exercises may have more blood glucose stability during exercise, and they may experience shorter and milder hypoglycemia following their workout. 

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