Put yourself in control: exercise in the management of type 2 diabetes

This study assessed the influence of exercise and physical activity on the management of type 2 diabetes.

Physical activity has long been considered as a cornerstone in the treatment of diabetes mellitus along with adequate nutrition and medical therapy. In an attempt to determine the exact role of physical activity in the management of diabetes, this paper analyzed recently published literature on the clinical significance of physical activity according to the type and extent of exercise used.

25 published studies were found eligible for review, 65% of which were randomized controlled trials (the gold standard for assessing the effectiveness of a new treatment or management strategy). The majority of exercise training programs were based on aerobic exercises, such as swimming, cycling, rowing, walking and running. Only a few studies focused on resistance exercises, or strength training, such as weightlifting, yoga and climbing.

The review found that aerobic exercise significantly improves cardiovascular and respiratory functions, thought to be crucial in the prevention of diabetic complications. Most of the studies reviewed showed that regular aerobic exercise not only produced weight loss, but also improved glycemic control and fasting blood-glucose levels. Aerobic exercise was also shown to significantly improve insulin sensitivity, considered an accurate estimate of disease progression. Several recent studies have also demonstrated the ability of aerobic exercise to reduce arterial stiffness, a known contributor to cardiovascular complications associated with diabetes.

Resistance exercise, also known as strength training, is mainly employed to increase bone strength, metabolism and the strength and mass of muscles. Several studies have reported strength training to enhance insulin sensitivity, daily energy expenditure and most significantly, overall quality of life. The increase in muscle strength and mass due to resistance training has also been suggested to improve glycemic control. Studies suggest the frequency and intensity of resistance exercise should vary from 30 to 60 minutes a day, typically 2 to 3 times per week.

Overall, most studies suggest that exercise associated insulin sensitivity improvements normally last no more than 72 hours, indicating a need for exercise or physical activity at least 2 to 3 times per week.

This review concluded that regular exercise, two to three times weekly, results in effective disease management among type 2 diabetics, regardless of medical treatment. Both aerobic and resistance exercise showed improved insulin sensitivity levels following activity.