Joint Position Statement by the American College of Sports Medicine and the American Diabetes Association. 2010. Exercise and Type 2 diabetes

Human Movement Sciences Department, Old Dominion University, Norfolk, Virginia, USA.
Diabetes care (Impact Factor: 8.42). 12/2010; 33(12):e147-67. DOI: 10.2337/dc10-9990
Source: PubMed


Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes, many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower type 2 diabetes risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes mellitus, and safe and effective practices for PA with diabetes-related complications.

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Available from: Barry Braun, Dec 30, 2014
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    • "The current guidelines of the American Diabetes Association and the American College of Sports Medicine suggest 150 minutes per week of moderate-intensity aerobic exercise and three sessions per week of resistance training for patients with type 2 diabetes [10] [11]. Despite the long list of positive effects provided by physical exercises and the current international guidelines, just a minor part of people with type 2 diabetes is physically active. "
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    ABSTRACT: Context: Physical exercise is a key component of treatment and management of people with Type 2 Diabetes, but the role of strategies and interventions to increase and promote physical activity is unclear. Objective: To conduct a systematic review of intervention studies assessing the effects of physical activity counselling on health outcomes in subjects with type 2 diabetes mellitus. Data sources: The Cochrane Library, MEDLINE, EMBASE, CINAHL, LILACS, databases were used for the literature search. Data Selection: Studies that assessed the effects of interventions mainly based on physical activity counselling strategies, on physical activity level and glycosylated hemoglobin (HbA1c) were included in the review. Data Extraction: Two independent reviewers extracted the data. Data Synthesis: A total of 23 studies out of 1425 retrieved from databases search, were included in the review. The global number of subjects included in the selected studies was 9913, and the mean age of participants was 58.8 (±8.2) years (min = 46.3; max = 73.6). The most part of the studies (19) reported values of physical activity level; 13 of them (68.4%) found a significant effect after the counselling intervention, while 6 (31.6%) did not found significant changes. Among the 17 studies reporting data on HbA1c 9 (52.9%) described a significant decrease in the counselling intervention group, while 7 (41.2%) did not find any statistically significant change and 1 (5.9%) reported a significant HbA1c reduction in the comparison group rather than the counselling group. Conclusions: The results presented in this systematic review seem to affirm the usefulness of physical counselling interventions on physical activity and HbA1c, however the lack of homogeneity in the intervention protocols and the contrasting results limit the comprehension of the usefulness of such an approach in patient with type 2 diabetes.
    Journal of Diabetes Mellitus 05/2015; 5(2):97-110. DOI:10.4236/jdm.2015.52012
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    • "Participation in routine physical activity can prevent insulin resistance and is currently an accepted and effective method for treatment of individuals with type 2 diabetes mellitus [18]. Recent studies suggest that aerobic exercise training can significantly attenuate adipose macrophage content and inflammation in mice fed a HF diet [19] [20] [21], yet the impact of exercise on these events in skeletal muscle has not been determined. "
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    ABSTRACT: Obesity is a primary cause of muscle insulin resistance and is also associated with morphological and functional changes in the skeletal muscle including fibrosis. Studies suggest that macrophages in obese skeletal muscle may be primed to secrete transforming growth factor β1 (TGFβ1), a factor that can stimulate type I collagen gene expression via Smad3 activation but the extent to which exercise could modulate high fat (HF) diet-induced inflammation and fibrosis in skeletal muscle remains to be determined. The purpose of this study was to determine the extent to which moderate intensity exercise training can attenuate pro-inflammatory cytokine gene expression and markers of fibrosis in skeletal muscle in response to concomitant HF diet. Male C57BL/6J mice (6 wk old) were randomly assigned to one of four treatment groups: (1) Control diet-No Exercise (CON-No Ex), (2) CON-Ex, (3) HF-No Ex, or (4) HF-Ex. Mice were exercised on a motorized treadmill 40min/day at 12m/min, 5% grade, 5days/wk, for 12weeks. Macrophage (F4/80, CD11c, CD206), inflammatory cytokine (TNFα, IL-6, IL-10), TGFβ1, and collagen (Col1α) gene expression were evaluated in skeletal muscle by qPCR. Frozen muscle sections were stained to assess collagen content and fiber cross sectional area (CSA). F4/80, CD206 and IL-6 gene expression were increased by HF diet, and exercise only attenuated the increase in F4/80 and IL-6 (p<0.05). No differences in CD11c, TNFα and IL-10 gene expression were found between the groups. HF diet increased TGFβ1 protein expression, Smad3 activation, and collagen deposition in skeletal muscle, and exercise attenuated TGFβ1 protein expression and collagen deposition in skeletal muscle (p<0.05). Muscle fiber CSA was not different between the groups. The results from this study suggest that HF diet can increase skeletal muscle macrophage gene expression and fibrosis and that exercise can attenuate these changes. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Cytokine 02/2015; 73(1):23-29. DOI:10.1016/j.cyto.2015.01.013 · 2.66 Impact Factor
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    • "Exercise is a subcategory of physical activity (Caspersen et al., 1985). Although exercise promotes beneficial effects in diabetic patients (Colberg et al., 2010; Moura et al., 2014), some studies (King et al., 2007; King, Hopkins, Caudwell, Stubbs, & Blundell, 2008; Yates et al., 2014) have questioned the degree of their importance in terms of the increase in total energy expenditure . These studies report that for some people, the simple fact of enrolling in an exercise programme reduces their physical activity levels (PAL). "
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    ABSTRACT: Abstract Although exercise promotes beneficial effects in diabetic patients, some studies have questioned the degree of their importance in terms of the increase in total energy expenditure. In these studies, the decrease of physical activity levels (PAL) was referred as "compensatory effect of exercise". However, our aim was to investigate whether aerobic exercise has compensatory effects on PAL in type 2 diabetes patients. Eight volunteers (51.1 ± 8.2 years) were enrolled in a supervised exercise programme for 8 weeks (3 d · wk(-1), 50-60% of VO2 peak for 30-60 min). PAL was measured using tri-axial accelerometers in the 1st, 8th and 12th weeks. Biochemical tests, cardiorespiratory fitness, anthropometric assessment and body composition were measured in the 2nd and 11th weeks. Statistical analysis was performed using non-parametric tests (Friedman and Wilcoxon, P < 0.05). We found no significant differences in PAL between intervention periods, and participants spent the majority of their awake time in sedentary activities. However, the exercise programme generated a significant 14.8% increase in VO2 peak and a 15% reduction in fructosamine. The exercise programme had no compensatory effects on PAL in type 2 diabetes patients, but improved their cardiorespiratory fitness and glycaemic control.
    Journal of Sports Sciences 09/2014; 33(6):1-7. DOI:10.1080/02640414.2014.951875 · 2.25 Impact Factor
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