Exercise in Therapy of Diabetes Mellitus

Decreased physical activity, independent of obesity, is a well-established risk factor for the development of type 2 diabetes in high-risk individuals. Insulin resistance and visceral adiposity play an important role in the development of impaired glucose tolerance and frank type 2 diabetes. Therefore, physical activity, by decreasing insulin resistance and visceral adiposity in these high-risk

The risks associated with exercise can be divided into metabolic, vascular, neurologic, and musculoskeletal and are summarized in Table 42.4.

The potential benefits of regular physical activity in patients with diabetes are numerous and include improvements in insulin sensitivity and glycemic control, reduction in cardiovascular risk, improvements in blood pressure, lipid profile and coagulation factors, and weight loss (see Table 42.3).

Exercise Capacity of Patients with DiabetesPatients with type 1 diabetes appear to have a normal exercise capacity when metabolic derangements are well controlled. In chronically under-insulinized patients, an inability to store glycogen and a tendency to dehydration can result in poor endurance capacity. In patients with autonomic dysfunction the cardiovascular response to exercise can be

Exercise has been advocated for patients with diabetes for centuries, but it was only in 1990 that the American Diabetes Association (ADA) felt there was enough evidence of benefit to recommend exercise as a routine part of the treatment of type 2 diabetes mellitus. Since that time, the use of exercise in the treatment of