Physical exercise as therapy for type 2 diabetes mellitus

Many studies have highlighted the importance of physical activity (PA) for health, and recent evidence now points to the positive improvements associated with exercise in type 2 diabetes mellitus (T2DM). However, few physicians are willing to prescribe exercise as a therapy for diabetic patients. In addition, there is a lack of information on how to implement exercise therapy especially in long‐term exercise regimens. The purpose of this manuscript is to summarize standards of exercise therapy for patients with T2DM, both in terms of prescribing and monitoring, according to the American College of Sports Medicine and the American Diabetes Association guidelines. We present details of the exercise therapies used in long‐term studies, describing how the parameters for exercise prescription were applied in clinical practice. These parameters are described in terms of frequency, intensity, duration, mode and rate of progression in long‐term therapeutic prescriptions. Individual responses to exercise dose are discussed, and critical issues to be considered in patients with underlying disease and in T2DM patients are highlighted. Copyright © 2013 John Wiley & Sons, Ltd.

[1]  M. Sacchetti,et al.  Exercising for Metabolic Control: Is Timing Important? , 2012, Annals of Nutrition and Metabolism.

[2]  L. Pugliese,et al.  Effect of High- versus Low-Intensity Supervised Aerobic and Resistance Training on Modifiable Cardiovascular Risk Factors in Type 2 Diabetes; The Italian Diabetes and Exercise Study (IDES) , 2012, PloS one.

[3]  M. Tarnopolsky,et al.  Acute high‐intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2 diabetes , 2012, Diabetes, obesity & metabolism.

[4]  A. Nicolucci,et al.  Relationship of exercise volume to improvements of quality of life with supervised exercise training in patients with type 2 diabetes in a randomised controlled trial: the Italian Diabetes and Exercise Study (IDES) , 2012, Diabetologia.

[5]  V. Basevi,et al.  Standards of Medical Care in Diabetes—2012 , 2011, Diabetes Care.

[6]  M. Tarnopolsky,et al.  Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. , 2011, Journal of applied physiology.

[7]  A. Nicolucci,et al.  Improvement of quality of life with supervised exercise training in subjects with type 2 diabetes mellitus. , 2011, Archives of internal medicine.

[8]  B. Fernhall,et al.  Exercise and Type 2 Diabetes , 2010, Diabetes Care.

[9]  A. Nicolucci,et al.  Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). , 2010, Archives of internal medicine.

[10]  G. Corigliano,et al.  Exercise for the management of type 2 diabetes: a review of the evidence , 2010, Acta Diabetologica.

[11]  V. Basevi Standards of Medical Care in Diabetes—2010 , 2010, Diabetes Care.

[12]  S. Del Prato,et al.  Changing the Treatment Paradigm for Type 2 Diabetes , 2009, Diabetes Care.

[13]  A. Jiménez,et al.  Physical activity, a key factor to quality of life in type 2 diabetic patients , 2009, Diabetes/metabolism research and reviews.

[14]  R. Meeusen,et al.  Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA1c in obese type 2 diabetes patients , 2009, Diabetologia.

[15]  A. Nicolucci,et al.  The Italian Diabetes and Exercise Study (IDES): design and methods for a prospective Italian multicentre trial of intensive lifestyle intervention in people with type 2 diabetes and the metabolic syndrome. , 2008, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[16]  C. Earnest Exercise interval training: an improved stimulus for improving the physiology of pre-diabetes. , 2008, Medical hypotheses.

[17]  Chiara Taglioni,et al.  Make your diabetic patients walk: long-term impact of different amounts of physical activity on type 2 diabetes. , 2005, Diabetes care.

[18]  C. Castaneda,et al.  A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. , 2002, Diabetes care.

[19]  J. Shaw,et al.  High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. , 2002, Diabetes care.

[20]  W. Haskell,et al.  What to look for in assessing responsiveness to exercise in a health context. , 2001, Medicine and science in sports and exercise.

[21]  C. Macera,et al.  Physical Activity-Related Injuries in Walkers and Runners in the Aerobics Center Longitudinal Study , 2000, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[22]  B E Ainsworth,et al.  Compendium of physical activities: an update of activity codes and MET intensities. , 2000, Medicine and science in sports and exercise.

[23]  G A Colditz,et al.  A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. , 1999, The New England journal of medicine.

[24]  Carol Ewing Garber,et al.  ACSM Position Stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults , 1998 .

[25]  Peter R. Cavanagh,et al.  Exercise and physical activity for older adults , 1998 .

[26]  A. Bigard,et al.  Mobilization of Visceral Adipose Tissue Related to the Improvement in Insulin Sensitivity in Response to Physical Training in NIDDM: Effects of branched-chain amino acid supplements , 1997, Diabetes Care.

[27]  S. Oparil,et al.  Physical activity and cardiovascular health , 1996 .

[28]  M. Senn,et al.  Exercise Testing and Prescription , 1996, Sports medicine.

[29]  P. Thompson,et al.  ACSM's Guidelines for Exercise Testing and Prescription , 1995 .

[30]  A. Nicolucci,et al.  The Italian diabetes and exercise study (IDES). , 2008 .

[31]  J F Sallis,et al.  Compendium of physical activities: classification of energy costs of human physical activities. , 1993, Medicine and science in sports and exercise.