What is the goal of the exercise training?
Because of the strong association between fitness and survival, increased cardiorespiratory capacity (fitness) should be a primary objective for exercise training for these patients (5). To measure the effect of the training, describe the exercise intensity and assess risk, it is recommended to test the patient's fitness, ideally by testing maximum oxygen uptake. Simple tests of physical function (such as the six minute walking test, stair stepping or the time needed for a given distance) can be registered in most clinical practices. In addition to endurance testing, the most important clinically feasible measures of effect include glycaemic control, lipidemia and blood pressure. Body composition, measured as waist circumference, is regarded as a better measure than body mass. Perhaps counterintuitively, body mass is only recommended as a relevant outcome measure for persons with morbid obesity, or if other reasons indicate that weight loss would be beneficial for the treatment process (4).
Exercise should be regarded as a necessary supplement, and occasionally as an alternative, to drug-based treatment
Persons with type 2 diabetes will often suffer from dysregulation of a number of cardiovascular and metabolic functions. These include reduced glycaemic control, dyslipidemia, obesity, hypertension and reduced physical fitness. Exercise has a positive effect on all these functions.