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Keywords Aerobicfitness .Exerciseprescription .Glycaemiccontrol .LeanbodymassTo the Editor:DrChacko[1] is to be congratulated for herconsideration of the timing and intensity of physical activityupon improvements in glycaemic control in type 2 diabeticpatients. She suggests that the best timing for moderate exer-cise to improve glycaemic control in patients with type 2diabetesisbetween the 30and 90min post-meal mark. Whileher and the field’s focus on improving glycaemia with exer-cise is a valuable starting place, this exercise prescription isunlikely to produce the optimal health benefits for longevitythat exercise can provide in this growing population. Tooptimally improve health, increasing and maintaining fitnessand lean body mass must be considered. As regards fitness, a60 min/day walking only prescription would not meet theweeklymetabolicequivalents(METS)thresholdthathasbeenshown to result in a 10 year reduction in coronary heartdisease risk in high-risk patients [2]. Furthermore, walkingexercise alone may not maximally increase, or maintain, car-diovascular fitness and lean muscle mass, the latter of whichmustbemaintainedinordertocontinue walkingand physicalactivity throughout the ageing process. Our point here issimple: although our first goal should be to increase physicalactivity,wemustalsoprovidetype2diabeticpatientswiththecrucial ammunition needed for battling further disease devel-opmentandlivingahealthy,longlife[3].Thus,usingexerciseto improve glycaemic control in addition to maintaining aer-obic fitness and leanbodymass (strength)should all bea partofthe ‘exerciseformula’ prescribedtopatientswith, or atriskof developing, type 2 diabetes.

Timing and intensity of exercise for glucose control. Reply to Chacko E. [letter]