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 Although exercise improves blood sugar control, insulin sensitivity,
blood pressure and cholesterol levels, most people with diabetes do
not engage in regular exercise, the authors write.
“Exercise and physical activity can help to control type 2
diabetes,” said lead author Dr. Romeu Mendes of the Public Health
Unit, ACES Douro I—Marao e Douro Norte in Vila Real, Portugal.
“There are many successful case-studies of patients who reversed
metabolic dysfunction only with lifestyle strategies (exercise plus
diet),” but the benefits disappear when healthy diet and regular
exercise stop, he said.
“Diabetes is a chronic disease and must be managed for life,” Mendes
said. “Regular exercise and a healthy nutritional pattern are the
basis of the treatment.”
The researchers reviewed published recommendations or guidelines for
exercise prescriptions for people with type 2 diabetes issued by
international scientific organizations in the field of diabetology,
endocrinology, cardiology, public health and sports medicine.
They included 11 publications from institutions like the European
Association for the Study of Diabetes, American Diabetes
Association, Francophone Diabetes Society and Swedish National
Institute of Health.
“We were not aware that there were so many scientific organizations
issuing specific recommendations for exercise prescription in this
population,” Mendes told Reuters Health by email.
The guidelines agreed that people with type 2 diabetes should
accumulate at least 150 minutes of moderate to vigorous aerobic
exercise per week, spread over at least three days of the week, and
also recommend resistance exercise at least twice weekly.
Aerobic exercise can include brisk walking, running, cycling,
swimming or other activities, and resistance exercise should target
large muscle groups with machines or free weights. Some institutions
also recommend some flexibility training, Mendes and colleagues
reported in the British Journal of Sports Medicine.
“The ultimate and most important variable for people is quality of
life,” Mendes said, noting that exercise particularly improves
health-related quality of life.
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Exercise has indisputable life-saving benefits, but there is limited
research on the benefits of exercise among people with diabetes,
said Huseyin Naci, a health policy researcher at the London School
of Economics who was not part of the new review.
“According to our previous research, there is a bias against testing
exercise,” Naci told Reuters Health by email. “Medical research
increasingly favors drug interventions over strategies to modify
lifestyle.”
“The vast majority of patients with type 2 diabetes do not engage in
regular exercise,” Mendes said. “This may be explained by
insufficient awareness about the potential benefits of exercise and
the lack of specific knowledge about current recommendations.”
Advising patients to increase their exercise levels is not enough,
he said. Prescriptions should include specific information on the
type, mode, duration, intensity and weekly frequency, and the
exercise strategies must be adapted for each individual, based on
other health conditions, contraindications and realistic personal
goals.
“According to the U.S. Centers for Disease Control and Prevention,
roughly one third of doctors prescribe exercise in primary care,”
Naci said. “This is promising, but more doctors should discuss and
give brief advice to their patients about the benefits of exercise
and refer patients with diabetes to structured exercise programs.”
SOURCE: bit.ly/1R7iECk British Journal of Sports Medicine, online
December 30, 2015.
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