Physical Activity/Exercise and Type 2 Diabetes

Department of Medicine, University of Ottawa, Canada.
Diabetes Care (Impact Factor: 8.42). 11/2004; 27(10):2518-39. DOI: 10.2337/diaspect.18.2.88
Source: PubMed


F or decades, exercise has been consid-ered a cornerstone of diabetes man-agement, along with diet and medication. However, high-quality evi-dence on the importance of exercise and fitness in diabetes was lacking until recent years. The last American Diabetes Associ-ation (ADA) technical review of exercise and type 2 diabetes (formerly known as non–insulin dependent diabetes) was published in 1990. The present work emphasizes the advances that have oc-curred since the last technical review was published. Major developments since the 1990 technical review include: ● Advances in basic science, increasing our understanding of the effects of ex-ercise on glucoregulation. ● Large clinical trials demonstrating that lifestyle interventions (diet and exer-cise) reduce incidence of type 2 diabe-tes in people with impaired glucose tolerance (IGT). ● Meta-analyses of structured exercise in-terventions in type 2 diabetes showing: 1) effectiveness of exercise in reducing HbA 1c , independent of body weight; and 2) association between exercise training intensity and change in HbA 1c . ● Large cohort studies showing that low aerobic fitness and low physical activity level predict increased risk of overall and cardiovascular disease (CVD) mor-tality in people with diabetes. ● Clinical trials showing effectiveness of resistance training (such as weight lift-ing) for improving glycemic control in type 2 diabetes. ● New data on safety of resistance train-ing in populations at high risk for CVD.

Full-text preview

Available from:
  • Source
    • "AET has been recognized as an efficient and safe preventive and therapeutic strategy for cardiovascular diseases[113,114], as it reduces a number of cardiovascular risk factors[115,116]and improves peak oxygen uptake (peak VO 2 ), exercise tolerance, and quality of life[25,117]. Indeed, both European[118]and American[119]guidelines have agreed upon the recommendation of AET for all stable outpatients, in addition to optimal pharmacological therapy. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Skeletal myopathy has been identified as a major comorbidity of heart failure (HF) affecting up to 20% of ambulatory patients leading to shortness of breath, early fatigue, and exercise intolerance. Neurohumoral blockade, through the inhibition of renin angiotensin aldosterone system (RAS) and β -adrenergic receptor blockade ( β -blockers), is a mandatory pharmacological therapy of HF since it reduces symptoms, mortality, and sudden death. However, the effect of these drugs on skeletal myopathy needs to be clarified, since exercise intolerance remains in HF patients optimized with β -blockers and inhibitors of RAS. Aerobic exercise training (AET) is efficient in counteracting skeletal myopathy and in improving functional capacity and quality of life. Indeed, AET has beneficial effects on failing heart itself despite being of less magnitude compared with neurohumoral blockade. In this way, AET should be implemented in the care standards, together with pharmacological therapies. Since both neurohumoral inhibition and AET have a direct and/or indirect impact on skeletal muscle, this review aims to provide an overview of the isolated effects of these therapeutic approaches in counteracting skeletal myopathy in HF. The similarities and dissimilarities of neurohumoral inhibition and AET therapies are also discussed to identify potential advantageous effects of these combined therapies for treating HF.
    Full-text · Article · Jan 2016 · Oxidative medicine and cellular longevity
  • Source
    • "En los últimos años, se ha despertado el interés por determinar los efectos de los programas de acondicionamiento neuromuscular en los pacientes de DM2 (Chulvi & Sola, 2009;ACSM & ADA, 2010;Sigal, Kenny, Wasserman, Castaneda-Sceppa & White, 2006;Sigal, Wasserman, Kenny & Castaneda-Sceppa, 2004). El levantamiento de pesas y los ejercicios de resistencia muscular, cuando se realizan con regularidad y una intensidad de moderada a alta son beneficiosos para las personas con DM2.CatanedaSigal et al., 20061-3 x 8-15 (60-90% 1 RM); 1-2 mi n de descanso 2-3 días/semZacker, 20051-3 x 8-10 3 días/semSigal et al., 2004Ejercicios Carga (series-repeticiones- intensidad) Frecuencia Autor Tabla 2 Pr ograma de acondicionamiento muscular adapta dade Chulvi y Sola (2009)Activ idades que conlleven pocos impactos (caminar, biciclet a elípt ica, yoga, natación y actividades acuáticasColado & Chulvi, 2008;Chulvi & Sola, 2009) afirman que la adecuada prescripción del programa de acondicionamiento muscular debe estar ordenado en un circuito incluyendo de ocho a 10 ejercicios poli-articulares que involucren los principales grupos musculares realizados con volúmenes entre una y tres series, de ocho a 15 repeticiones realizadas con una carga submáxima (60-80% de una RM). Cuando no exista contraindicación se podría hacer uso de cargas cercanas a las máximas (80-95% de una RM). "

    Full-text · Article · Jan 2016 · Retos: nuevas tendencias en educación física, deporte y recreación
  • Source
    • "Most CVDs are largely preventable with regular exercise and physical activity having been shown to improve CVD risk factors. Additionally, exercise improves other diseases associated with inactivity and obesity, such as type 2 diabetes and hypertension (Fletcher et al., 1996; Sigal et al., 2006; Thompson et al., 2003). By improving CVD risk factors that contribute to the progression of the disease, the risk of all-cause mortality from CVD can be significantly reduced (Gordon et al., 1989, Gould et al., 2007, Lee et al., 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to compare the effectiveness of either continuous moderate intensity exercise training (CMIET) alone vs. CMIET combined with a single weekly bout of high intensity interval training (HIIT) on cardiorespiratory fitness. Twenty nine sedentary participants (36.3 ± 6.9 yrs) at moderate risk of cardiovascular disease were recruited for 12 weeks of exercise training on a treadmill and cycle ergometer. Participants were randomised into three groups: CMIET + HIIT (n = 7; 8-12 x 60 sec at 100% VO2max, 150 sec active recovery), CMIET (n = 6; 30 min at 45-60% oxygen consumption reserve (VO2R)) and a sedentary control group (n = 7). Participants in the CMIET + HIIT group performed a single weekly bout of HIIT and four weekly sessions of CMIET, whilst the CMIET group performed five weekly CMIET sessions. Probabilistic magnitude-based inferences were determined to assess the likelihood that the true value of the effect represents substantial change. Relative VO2max increased by 10.1% (benefit possible relative to control) in in the CMIET + HIIT group (32.7 ± 9.2 to 36.0 ± 11.5 mL·kg-1·min-1) and 3.9% (benefit possible relative to control) in the CMIET group (33.2 ± 4.0 to 34.5 ± 6.1 mL·kg-1·min-1), whilst there was a 5.7% decrease in the control group (30.0 ± 4.6 to 28.3 ± 6.5 mL·kg-1·min-1). It was 'unclear' if a clinically significant difference existed between the effect of CMIET + HIIT and CMIET on the change in VO2max. Both exercising groups showed clinically meaningful improvements in VO2max. Nevertheless, it remains 'unclear' whether one type of exercise training regimen elicits a superior improvement in cardiorespiratory fitness relative to its counterpart.
    Full-text · Article · Sep 2014 · Journal of sports science & medicine
Show more