Exercise and diabetes
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Laboratory of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Publication date: 2022-05-27
Public Health Toxicol 2022;2(Supplement Supplement 1):A48
The prevalence of diabetes is steadily increasing and it is expected that about 783 million people globally will suffer from the disease by the year of 20251. There is strong evidence suggesting that regular exercise reduces the risk for developing type 2 diabetes in individuals at high risk and for developing microvascular and macrovascular disease complications. Furthermore, in gestational diabetes exercise reduces the incidence of microsomia and fetal preeclampsia. Also, regular physical activity provides a better glycemic control, enhances insulin sensitivity and improves emotional and physical well-being2,3,4. Therefore, exercise is considered today as a mandatory supplementary to medical treatment activity by all major scientific bodies [American College of Sports Medicine; American Diabetic Association (ADA); European Association for the study of diabetes (EASD); IDF; International Society for Pediatric and Adolescent Diabetes (ISPAD)]. In terms of exercise guidelines for diabetes, specific recommendations regarding frequency, duration, intensity and modality have been formulated. According to these recommendations exercise/physical activity should be performed at least 3 days/week without more than two consecutive days inactivity, whereas for children and adolescents 1-hour daily exercise is recommended. Aerobic exercise should be performed for > 150 min/week at about 60-80% maximum heart rate. Resistance exercise at an intensity equivalent to 50-80% of maximum should also be carried out 2-3 times/week, but not on consecutive days, while flexibility and balance activities should be practiced almost daily3,4. Despite the beneficial role of exercise, diabetics have low rate of physical activity, putting forward as an excuse the fear of hypoglycemia, although factors such as lower-self-efficacy, inappropriate goal setting and lack of supervision, social support and access to facilities may also be involved4. However, due to technological achievements, the development of continuous glucose monitoring systems together with insulin pumps as well as the detailed guidelines/protocols for dietary and medication modifications for people involved in physical activities provide a very safe environment for patients who wish to incorporate exercise in their daily routine3,4,5. It is the responsibility of physicians to convince their patients to regularly adopt exercise.
International Diabetes Federation. IDF Diabetes Atlas. Accessed May 4, 2022.
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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. doi:10.2337/dc16-1728
Kanaley JA, Colberg SR, Corcoran MH, et al. Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine. Med Sci Sports Exerc. 2022;54(2):353-368. doi:10.1249/MSS.0000000000002800
Moser O, Riddell MC, Eckstein ML, et al. Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA). Diabetologia. 2020;63(12):2501-2520. doi:10.1007/s00125-020-05263-9
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