“…Likewise, our findings concur with meta-analyses performed by Umpierre et al (2011) and Snowling and Hopkins (2006) revealing mean decreases in HbA1c of 0.67% and 0.80%, respectively, when adults with type 2 diabetes performed structured land-based aerobic exercise, resistance exercise, or a combination of both training modes for at least 12 weeks. Expressed as a function of study duration, the magnitude of improvement in HbA1c levels following UTT was more than two times that reported in earlier investigations of middle-aged and older adults with type 2 diabetes who participated in both land-based endurance and resistance training programs (Alkurdi et al, 2010;Jones et al, 2009). Proposed mechanisms underlying the beneficial combined aerobic and resistance training on glycemic control include improved insulin action (Castaneda et al, 2002), enhanced glucose uptake due to up-regulation of mitochondrial proteins (Menshikova et al, 2006), increased glucose-4 transporter protein content and glycogen synthase activity 8 International Journal of Aquatic Research and Education, Vol.…”