DOCTOR'S VIEW ARCHIVE
Exercise Therapy in Type 2 Diabetes: Part 1 - The Benefits
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
A 52 year old woman came into my office last week with recently diagnosed diabetes. She works as an administrative assistant and admitted to having a rather non-active lifestyle. We discussed medications and basic nutritional changes. We also talked about the importance of exercise in patients with diabetes.
Physical exercise is important for all of us. Physical conditioning is one of the most important quality of life factors that we can actually improve, thus contributing to a longer and healthier life. Even better, exercise is empowering since each person can control the amount of activity they do to achieve the maximum benefit.
Exercise presents a special challenge in patients with type 1 diabetes, and I will address this topic in another article. In this discussion, I will focus on exercise in type 2 diabetes.
What are the benefits of exercise in people with type 2 diabetes?
For the person with type 2 diabetes, or the high-risk individual who is trying to prevent the development of diabetes, there is an enormous body of research literature documenting the benefits of exercise. Unfortunately, there is little data on how to motivate patients to maintain a long term healthy regimen.
A major benefit of exercise is its effect on the heart and the associated reduction in death from heart disease. In addition to lowering the risk of heart disease in type 2 diabetes, exercise helps to decrease the chances of developing diabetes. This can be especially important for those with borderline diabetes. In one study, the risk of developing diabetes was reduced by 24% (based on an energy expenditure of 2000 calories per week through exercise). This protective effect of exercise was seen the most in the group at highest risk for developing type 2 diabetes. The mechanism for this benefit is that exercising muscles are more sensitive to circulating insulin. They thus take up blood sugar more easily and use sugar more effectively. Research has shown that even short term aerobic exercise improves the sensitivity of muscles to insulin.