Physical Activity in Diabetes

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Definitions/Statistics[edit | edit source]

Physical activity is defined as any bodily movement produced by skeletal muscles that result in energy expenditure.It includes all forms of activity, such as everyday walking or cycling to get from A to B, active play, work-related activity, active recreation (such as working out in a gym), dancing, gardening or playing active games, as well as organized and competitive sport[1]. Exercise is a subset of physical activity that is planned,structured, repeated and has a final or an intermediate objective to the improvement or maintenance of physical fitness[2]

Diabetes is a metabolic condition in which the body does not produce sufficient insulin to regulate blood glucose levels or where the insulin produced is unable to work effectively[3]. There are two main types of diabetes:

  • Type 1 diabetes (T1D) is an auto-immune condition in which the cells that produce insulin are destroyed so lifelong treatment with insulin is required to prevent death.
  • Type 2 diabetes (T2D) accounts for at least 90% of all cases of diabetes[4]. It occurs when the body either stops producing enough insulin for its needs or becomes resistant to the effect of insulin produced. The condition is progressive requiring lifestyle management (diet and exercise) at all stages. Over time most people with type 2 diabetes will require oral drugs and or insulin. Type 2 diabetes may remain undetected for many years[5].

The estimated diabetes prevalence worldwide for 2011 was 366 million and it is expected to affect 552 million people by 2030[6].In England, 6% of people aged 17 years or older had diagnosed with diabetes in 2013[3].

A UK based study in 2004, which studied both type 1 and type 2 diabetes patients, found that only 34% of patients took some form of physical activity and only 9% of these patients exercised sufficiently to achieve a large change in heart rate or breathing[7].

Physical Activity and the Prevention of T2D[edit | edit source]

There is a 30% to 40% lower risk of metabolic syndrome and type 2 diabetes in at least moderately active people compared with those who are sedentary[1].

In a study of female registered nurses aged 34–59 years at baseline, women who reported engaging in vigorous exercise at least once a week had a lower incidence of self-reported type 2 diabetes during the 8 years of follow-up than did women who did not exercise weekly[8]. Similar findings were observed between exercise and incidence of type 2 diabetes in a 5-year prospective study of male physicians aged 40–84 years[9]. Likewise, in a large cohort of postmenopausal women aged 55–69 years, the 12-year incidence of diabetes was lower in those women who reported any physical activity compared with the sedentary women[10].

Physical activity may reduce the risk for type 2 diabetes directly through improvements in insulin sensitivity[11]. This may be independent of any effect of activity on weight loss and fat distribution [11]. According to a cross-sectional population study, physical activity was shown to be negatively associated with insulin concentrations in two populations at high risk for diabetes that differed greatly by body mass index[12].

However, a large portion of the effect of physical activity in decreasing insulin resistance is short lived and may last only few days[13][14]. Thus, the consistency of an individual’s activity throughout the years is essential to ensure getting the benefits of exercise on insulin sensitivity.

Key Evidence[edit | edit source]

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Resources[edit | edit source]

The Motivate2Move website, created by Wales Deanery has a useful section on physical activty and metabolic health.

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. ↑ 1.0 1.1 Officers, C. M. (n.d.). Start Active , Stay Active.
  2. ↑ Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports (Washington, D.C. : 1974), 100(2), 126–31. https://doi.org/10.2307/20056429)
  3. ↑ 3.0 3.1 England, P. H. (n.d.). Adult obesity and type 2 diabetes About Public Health England.
  4. ↑ National Collaborating Centre for Chronic Conditions. Type 2 diabetes. National clinical guideline for management in primary and secondary care (update). London: Royal College of Physicians, 2008. 
  5. ↑ International Diabetes Federation. Types of diabetes. Secondary International Diabetes Federation. Types of diabetes. http://www.idf.org/types-diabetes.
  6. ↑ DIABETES IN THE UK 2012 Key statistics on diabetes. (2012), (April).
  7. ↑ Thomas N, Alder E, Leese GP. Barriers to physical activity in patient with diabetes. Postgrad Med J 2004; 80:287–91.
  8. ↑ Manson JE, Rimm EB, Stampfer MJ, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991;338:774–8.
  9. ↑ Manson JE, Nathan DM, Krolewski AS, et al. A prospective study of exercise and incidence of diabetes among US male physicians. JAMA 1992;268:63–7.
  10. ↑ Folsom AR, Kushi LH, Hong CP. Physical activity and incident diabetes mellitus in postmenopausal women. Am J Public Health 2000;90:134–8mellitus. Exerc Sport Sci Rev 1999; 27:1–35.
  11. ↑ 11.0 11.1 Ivy JL, Zderic TW, Fogt DL. Prevention and treatment of noninsulin-dependent diabetes 16. Manson JE, Rimm EB, Stampfer MJ, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991;338:774–8.
  12. ↑ Kriska AM, Pereira MA, Hanson RL, et al. Association of physical activity and serum insulin concentrations in two populations at high risk for type 2 diabetes but differing by BMI. Diabetes Care 2001;24:1175–80.
  13. ↑ Heath GW, Gavin JR 3rd, Hinderliter JM, et al. Effects of exercise and lack of exercise on glucose tolerance and insulin sensitivity. J Appl Physiol 1983;55:512–17.
  14. ↑ Koivisto VA, Yki-Jarvinen H, DeFronzo RA. Physical training and insulin sensitivity. Diabetes Metab Rev 1986;1:445–81.

 

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