11/12/2023 0 Comments Incontrol intensity![]() ![]() ![]() This association is especially significant given that people with T1D and T2D have a two to six-fold increase in morbidity and premature mortality from clinical cardiovascular disease (CVD) ( 5).ĭespite these positive links, 34.3% of Americans diagnosed with diabetes are categorized as physically inactive (<10 minutes per week of moderate or vigorous physical activity) and 23.8% are meeting the 150-minute segment of physical activity guidelines ( 6). Meeting physical activity guidelines has been associated with a 40% decrease in cardiovascular mortality with an even greater impact on all-cause mortality ( 3, 4). Regular exercise is associated with prevention and minimization of weight gain, reduction in blood pressure, improvement in insulin sensitivity and glucose control, and optimization of lipoprotein profile, all of which are independent risk factors for the development of T2D ( 2, 3). They specify that this should entail at least 150 minutes of moderate-to-vigorous aerobic activity per week, spread over at least three days per week to minimize consecutive days without activity, and two to three sessions of resistance exercise per week on nonconsecutive days ( 1). In their 2022 Standards of Medical Care in Diabetes, The American Diabetes Association (ADA) recommends that adults with diabetes participate in both aerobic activity and resistance training. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, INTRODUCTIONĮxercise, together with medical nutrition therapy, forms the cornerstone of diabetes therapy. However, there is no debate that exercise provides a health benefit for people with and at risk for diabetes. There are still many unknowns regarding the diabetes-mediated impairment in cardiorespiratory fitness, the variability and individual response to exercise training, and the impact of sex and gender. In this review, we will discuss the preventative value of exercise for T2D development, the therapeutic impact of exercise on diabetes metabolic and cardiovascular outcomes, the barriers to exercise including hypoglycemia, and the impact of sex and gender on cardiorespiratory fitness and adaptive training response in people with and without diabetes. Defining optimal dose, duration, timing, and type of exercise is still uncertain for individual health benefits of physical activity. Interestingly, there is variability in the response to exercise by sex, genetics, and environment, further complicating the expectations for individual benefit from physical activity. There are additional social and psychological stressors including depression and reduced self-efficacy. Physiological barriers include diabetes-mediated impairment in functional exercise capacity, increased rates of perceived exertion with lower workloads, and decision making regarding glycemic management. However, there are physiological and behavioral barriers to exercise that people with both T2D and T1D must overcome to achieve these benefits. For type 1 diabetes (T1D), we have evidence to support that exercise can reduce diabetes associated complications. These recommendations are based on positive associations between physical activity and T2D prevention, treatment, and disease-associated morbidity and mortality. ![]() Exercise is a key component to lifestyle therapy for prevention and treatment of type 2 diabetes (T2D). ![]()
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