To elucidate if postprandial exercise can reduce the exaggerated lipidemia seen in type 2 diabetic patients after a high-fat meal. Two mornings eight type 2 diabetic patients (males) (58 +/- 1.2 years, BMI 28.0 +/- 0.9 kg m(-2)) and seven non-diabetic controls ate a high-fat breakfast (680 kcal m(-2), 84% fat). On one morning, 90 min later subjects cycled 60 min at 57% [Formula: see text]. Biopsies from quadriceps muscle and abdominal subcutaneous adipose tissue were sampled after exercise or equivalent period of rest and arterialized blood for 615 min. Postprandial increases in serum total-triglyceride (TG) (incremental AUC: 1,702 +/- 576 vs. 341 +/- 117 mmol l(-1) 600 min), chylomicron-TG (incremental AUC: 1,331 +/- 495 vs. 184 +/- 55 mmol l(-1) 600 min) and VLDL-TG as well as in insulin (incremental AUC: 33,946 +/- 7,414 vs. 13,670 +/- 3,250 pmol l(-1) 600 min), C-peptide and glucose were higher in diabetic patients than in non-diabetic controls (P < 0.05). In diabetic patients these variables were reduced (P < 0.05) by exercise (total-TG incremental AUC being 1,110 +/- 444, chylomicron-TG incremental AUC 1,043 +/- 474 mmol l(-1) 600 min and insulin incremental AUC 18,668 +/- 4,412 pmol l(-1) 600 min). Lipoprotein lipase activity in muscle (11.0 +/- 2.0 vs. 24.1 +/- 3.4 mU g per wet weight, P < 0.05) and post-heparin plasma at 615 min were lower in diabetic patients than in non-diabetic controls, but did not differ in adipose tissue and did not change with exercise. In diabetic patients, 210 min after exercise oxygen uptake (P < 0.05) and fat oxidation (P < 0.1) were still higher than on non-exercise days. In type 2 diabetic patients, after a high-fat meal exercise reduces the plasma concentrations of triglyceride contained in both chylomicrons and VLDL as well as insulin secretion. This suggests protection against progression of atherosclerosis and diabetes.