INTRODUCTION: The effectiveness of physical exercise in the management of diabetes mellitus type 2 is well established. The purpose of this investigation was to evaluate the effect of long term exercise on glycemic and metabolic control measured after eight months in contrast to patients who had ceased their training after four months. METHODS: After an effective 4 months' strength training or endurance training period, ten patients (5 male and 5 female, mean age +/- SE: 57.1 +/- 1.6 yr) were randomised to a further 4 months of combined endurance and strength training, while a control group of 10 patients (5 male and 5 female, mean age +/- SE: 56.9 +/- 1.6 yr) ceased training. RESULTS: Long term glycemic control improved and HbA1C values fell from 6.9 +/- 0.4 to 6.2 +/- 0.2 in active patients and increased from 7.5 +/- 0.4 to 8.7 +/- 0.6 in control patients (p = 0.002). Baseline levels of total cholesterol significantly decreased in training group (205.5 mg/dl +/- 14.1 to 177.5 +/- 13.3) and increased in controls (185.9 +/- 14.1 to 220.2 +/- 15.8) (p = 004). In addition, significant decreases in LDL-cholesterol and triglyceride levels (both p < 0.05) were observed in the training group compared to controls. CONCLUSION: This study showed that in addition to a 4 month training period, continuation of training proved highly beneficial with further reductions in fasting blood glucose, HbA1C, total cholesterol, LDL-cholesterol, triglyceride, and an elevation in HDL-cholesterol concentrations in diabetes mellitus type 2 patients, thus resulting in a reduced atherogenic lipid profile. In contrast, patients who ceased training after 4 months developed an atherogenic lipid profile and a worsened glycemic control. The results of this study indicate that long term exercise plays an important role in the treatment of diabetes mellitus type 2 and may protect against the development of cardiovascular diseases.

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