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ACE Fitness | To maximize the benefits of exercise for patients with type 2 diabetes



Diabetes is currently one of the leading causes of death in the United States, and it is estimated that more than 500 million people will be adversely affected by type 2 diabetes mellitus (T2DM) by 2030 (Bird et al., 2012 ). T2DM is characterized by insulin resistance and hyperglycemia and is considered a metabolic disorder. People with T2DM have problems with glucose control, mainly due to the inability to use insulin efficiently. Therefore, these individuals are usually dependent on drugs to improve the use of this hormone [American College of Sports Medicine (ACSM), 2018; Bird et al., 2012; Durstine et al., 2009]. In addition, T2DM has a weak genetic link and is usually developed through bad lifestyle choices.

The growing T2DM epidemic can lead to many other medical complications and even increases the risk of premature death. In particular, T2DM is strongly associated with cardiovascular disease, the leading cause of death worldwide (Buse et al., 2007, Colberg et al., 201

0). Here is some good news: Exercise is an effective therapeutic and cost-effective method that can be used to combat this chronic condition by increasing insulin sensitivity and improving pancreatic beta cell function (Madsen et al., 2015).

Indeed The scientific literature suggests that exercise may be the most effective strategy to improve this condition by improving glucose uptake and control with and without insulin (ACSM, 2018, Bird et al., 2012, Coberg et al. , Durstine et al., 2009). In particular, muscle contraction during exercise increases glucose uptake, similar to insulin (Merry et al., 2009). However, glucose uptake by this medium, termed contraction-mediated glucose uptake, is independent of insulin. It is so effective that a systematic exercise program can potentially reduce the risk of this disease by 58% (Bird et al., 2012, Colberg et al., 2010).

Of course, the next logical question is the best type of exercise to increase contraction-mediated glucose uptake, reduce the need and use of medication, and ultimately combat T2DM? Well, the answer is: it depends.

Traditional medium intensity (MIT) training has been recommended for people with T2DM (ACSM, 2018, Durstine et al., 2009, Francois et al., 2015, Hordern et al., 2012). Specific recommendations include aerobic exercise 30 minutes a day and at least 150 minutes a week at an intensity of 40 to 60% VO 2 with an RPE between 11 and 13 (ACSM, 2018). Additional benefits, including reduction in morbidity, are associated with increased exercise duration totaling 300 minutes per week (ACSM, 2018).

This traditional training method offers a large number of physiological benefits to individuals with T2DM, including increasing insulin sensitivity, but strong evidence suggests that high-intensity interval training (HIIT) may be a new, evolving approach to achieving this condition (et al., Bird et al., 2012; Francois et al., 2015; Little et al., 2011; Tjonna et al., 2008).

While scientific literature strongly supports the use of HIIT, which consists of short, high intensity sessions followed by rest or low intensity activity for the treatment of T2DM, limited research has been conducted comparing HIIT with traditional models , Unlike traditional mid-intensity exercises, HIIT is not a continuous form of activity and does not run that often. Rather, it is often recommended to perform HIIT for a few days a week, lasting from one hour to 20 minutes.

In addition, the literature has found HIIT to be effective exercise therapy in clinical populations (Francois et al., 2015; Bird et al., 2012). HIIT has shown improvements in cardiometabolic health (eg improved glucose control) and sometimes even superior results compared to conventional continuous motion (Fisher et al., 2015). Therefore, HIIT offers similar, if not superior, improvements over traditional recommendations and, more importantly, in less time.

Resistance training has also been associated with improving this condition by offering similar benefits to the exercise types described above and should be included in any exercise program. Two to three days a week would be optimal for people with T2DM whose incidence gradually increases over time.

As a health and exercise professional, you have many evidence-based options to choose from, giving similar results when training this population. In my opinion, a combination of all types of training (ie resistance and low to high intensity training) would be most beneficial, funniest and sustainable for these clients. Explaining the purpose of the exercise to combat this disease will motivate your client to complete an exercise program.

When people with T2DM exercise physically, precautionary measures and safety measures are very important. Customers need to get approval from their physicians before starting a training program (ACSM, 2018, Francois et al., 2015). In addition, certain tests (eg, exercise tests) can help to determine the total capacity (ACSM, 2018, Little et al., 2011). If they have been properly tested and tested and meet the appropriate requirements for the exercise, all training forms should be considered safe for use in the training programs of customers who have T2DM.

References

American College of Sports Medicine (2018). The ACSM Guidelines for Stress Testing and Prescribing (10th edition). Philadelphia: Wolters Kluwer.

Bird, S.R. and Hawley, J.A. (2012). Exercise and Type 2 Diabetes: New recipe for an old problem. Maturitas, 72, 4, 311-316

Buse, J. B. (2007). Primary prevention of cardiovascular disease in people with diabetes mellitus: A scientific opinion from the American Heart Association and the American Diabetes Association. Diabetes Care, 30, 1, 162-172.

Colberg, S.R. et al. (2010) Exercise and Type 2 Diabetes: The American College of Sports Medicine and the American Diabetes Association: Summary of Joint Positioning. Diabetes Care, 33, 2692-2696.

Durstine, J.L. et al. (2009). ACSM's Exercise Management for People with Chronic Diseases and Disabilities. Champaign, Ill .: Human Kinetics

Fisher, G. et al. (2015) Interval training with high intensity vs. Moderate-intensity Training to Improve Cardiometabolic Health in Overweight or Obese Men: A Randomized Controlled Trial. PLoS One, 10, 10, e0138853,

Francois, M.E. and Little, J.P. (2015). Efficacy and safety of high-intensity interval training in patients with type 2 diabetes. Diabetes Spectrum, 28, 1, 39-44.

Hordern, M.D. et al. (2012). Exercise recipe for patients with type 2 diabetes and pre-diabetes: A statement from Exercise and Sport Science Australia. Journal of Science and Medicine in Sport, 15, 1, 25-31.

Little, J.P. et al. (2011). High-intensity, low-volume interval training reduces hyperglycemia and increases mitochondrial muscle capacity in patients with type 2 diabetes. Journal of Applied Physiology, 111, 6, 1554-1560.

Madsen, S.M. et al. (2015). High-intensity interval training improves glycemic control and pancreatic β-cell function in type 2 diabetes patients. PLoS One, 10, 8, e0133286.

Merry, T.L. and McConell, G.K. (2009). Muscle uptake of skeletal muscle during exercise: focus on reactive oxygen species and nitric oxide signaling. IUBMB Life 61, 5, 479-484.

Tjonna, A.E. et al. (2008). Aerobic interval training versus continuous moderate training for metabolic syndrome: A pilot study. Circulation, 118, 346-354.


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