Type 2 diabetes mellitus and physical activity
What is Type 2 diabetes mellitus?
The most common type of diabetes mellitus (type 2 diabetes, T2DM), is a disease which affects the blood sugar. The hormone insulin allows the glucose, which is an energy resource from the food, to go from the blood into the cells. When you have T2DM, your body does not produce or use insulin properly, and the glucose cannot be transferred well to the cells . The result of this deficiency is an increased concentration of glucose in the blood, causing damage to the body's systems, in particular the blood vessels and nerves . A 2006 study showed that 3.8% of the Luxembourg population were treated with T2DM, but about 1.5% of the population were not aware of their disease . T2DM increases with age. Some of the risk factors of T2DM can be tackled, such as overweight, physical inactivity and high blood pressure .
What are the effects of physical activity on Type 2 diabetes mellitus?
Besides the well-known effect of physical activity in reducing the incidence of T2DM by 60% in people at risk , physical activity is one the three complementary treatments of T2DM, along with diet and medication. Among its plethora of benefits, aerobic physical activity (including also high-intensity interval training) improves the glycaemic control by increasing insulin sensitivity and decreasing insulin resistance and glycated haemoglobin type A1c (up to -0.6%) [6-8]. Physical activity improves local and systemic endothelial function and attenuates the capillary rarefaction in skeletal muscle associated with insulin resistance . Among the general benefits on health of the resistance training, it improves glycaemic control in decreasing insulin resistance and glycated haemoglobin type A1c (from -0.3%) [10, 11]. Flexibility and balance exercises may reverse the T2DM-related limited joint mobility and can reduce the risk of falls, especially in the elderly people [12, 13]. Even if the evidence of the benefits of tai-chi on glycaemic control is still lacking , other alternative trainings, such as yoga, may be considered as they may have an impact on short-term glycaemic control .
What are the risks?
Beside the common risks of practicing a physical activity, a comprehensive list of physical activity precautions for patients with diabetes has been published by the American Diabetes Association (list available here: http://care.diabetesjournals.org/content/39/11/2065) . Physical activity must be encouraged but adapted in T2DM patients with cardiovascular diseases, nerve disease, eye diseases, kidney diseases and orthopaedic limitations.
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- Stoa EM, Meling S, Nyhus LK, et al. High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes. Eur J Appl Physiol 2017;117(3):455-467. Available at: http://dx.doi.org/10.1007/s00421-017-3540-1.
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- Gordon BA, Benson AC, Bird SR,Fraser SF. Resistance training improves metabolic health in type 2 diabetes: a systematic review. Diabetes Res Clin Pract 2009;83(2):157-75. Available at: http://dx.doi.org/10.1016/j.diabres.2008.11.024.
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- Colberg SR, Sigal RJ, Yardley JE, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016;39(11):2065-2079. Available at: http://dx.doi.org/10.2337/dc16-1728.
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- Exercise is Medecine Australia. Exercise is Medecine Australia Factsheet: Type 2 Diabetes and exercise. 2014 [cited 2017 21/12/2017]; Available from: http://exerciseismedicine.com.au/wp-content/uploads/2016/11/2014-T2DM-FULL-v2.pdf.
Authors & experts
Expert: Marc Keipes3.
1 Luxembourg Institute of Health, Sports Medicine Research Laboratory, L-1460 Luxembourg, Luxembourg
2 Luxembourg Institute of Health, Epidemiology and Public Health Research Unit, L-1445 Strassen, Luxembourg
3 Hôpitaux Robert Schuman, Zithaklinik, L-2763 Luxembourg, Luxembourg