Exercise in therapy and prevention of type II diabetes. Implications for blacks.

Department of Medicine, Boston University Medical Center, Massachusetts.
Diabetes Care (Impact Factor: 7.74). 12/1990; 13(11):1163-8. DOI: 10.2337/diacare.13.11.1163
Source: PubMed

ABSTRACT The rationale for the use of exercise in the treatment of type II (non-insulin-dependent) diabetes and its special implications for Blacks are reviewed herein. When performed on a regular basis, exercise may improve glycemic control and improve several risk factors for coronary heart disease including hypertriglyceridemia, hypertension, and hyperinsulinemia. In addition, it may be a useful adjunct to diet in producing weight loss. The metabolic benefits of exercise in part appear to be related to its ability to enhance insulin sensitivity. Benefits are short lived after discontinuing exercise. Because of problems with compliance and concurrent medical problems, many patients with type II diabetes are not good candidates for an exercise-diet program. For this reason, the optimum target population may be people at risk for type II diabetes and premature atherosclerosis. Such a population might include the offspring of patients with these disorders and individuals with impaired glucose tolerance, hyperinsulinemia, gestational diabetes, and/or an android pattern of fat distribution. Type II diabetes is more common in Blacks than in the general population. In most instances, it is associated with cardiovascular risk factors benefited by exercise. Despite this, there are no available studies regarding the effects of regular exercise in Blacks with type II diabetes or those at risk for it.

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    ABSTRACT: Persons from ethnic minority populations in the United States suffer disproportionately more from type 2 diabetes and its complica- tions than do Caucasians. Genetic and ac- quired factors likely contribute to the ethnic disparities of type 2 diabetes. The pathophys- iologic hallmarks consist of insulin resistance, progressive pancreatic b-cell dysfunction, and excessive hepatic glucose production. The ideal treatment for type 2 diabetes should correct insulin resistance and b-cell dysfunc- tion; and normalize hepatic glucose output; and prevent, delay, or reverse diabetic com- plications. The discovery of a new class of drugs, thiazolidinediones, has provided an effective tool to correct key underlying defects in type 2 diabetes. Thiazolidinediones improve insulin sensitivity and have beneficial effects on pancreatic b-cell function and hepatic glucose production. Furthermore, their potent insulin-sensitization effect predicts that treat- ment with thiazolidinediones will improve cardiovascular risk factors, including lipid pro- file, fibrinolysis, endothelial function, and atheroinflammatory markers. These benefits are expected to be particularly important among ethnic minority patients who tend to have greater insulin resistance than do Cauca- sians. (Ethn Dis. 2006;16:51-57)

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