Title : The effect of exercise on diabetes
Abstract:
Diabetes mellitus, which is characterized with insulin resistance, is a leading cause of mortality worldwide (Nouri et al., 2022). According to a recent International Diabetes Federation (IDF) (IDF, 2020) report, global diabetes prevalence was 463 million in 2019 and is expected to rise to 578 million in 2030 and 700 million in 2045 (IDF, 2020) The IDF also reported that diabetes affects people of all ages, typically showing higher prevalence with increasing age, up to 60–69 years (IDF, 2020).
Diabetes mellitus is a group of disorders affecting glucose uptake and storage associated with either absent insulin (type 1) or resistance to the effect of insulin (type 2). The resulting high sugar levels in the blood cause the complications of diabetes. Exercise has been proven to help prevent type 2 diabetes and be useful in the management and control of the blood sugar in both type 1 and type 2. Type 1 diabetes (T1D) is an auto-immune disorder in which the beta cells of the pancreas are destroyed, resulting in chronic insulin deficiency (Punthakee et al., 2018). People with T1D share many of the same benefits from exercise as their non-diabetic counterparts (Chimen et al., 2012), in addition to the exercise-specific effects in this population such as reduced insulin requirements, reduced insulin resistance, and favorable changes in lipids (Chimen et al., 2012). Diabetes mellitus type 2 (DM2) is a chronic metabolic condition characterized by high blood glucose levels due to impaired insulin sensitivity and associated with autonomic dysfunction, retinopathy, neuropathy, nephropathy, and cardiovascular diseases, among other complications (Cho et al, 2018). In this regard, cardiovascular diseases are the most common cause of death among people with diabetes mellitus (Einarson et al., 2018). Therefore, controlling risk factors such as blood glucose and blood pressure (BP) is essential for reducing cardiovascular complications during both rest and effort (Turnbull et al, 2005).
Both resistance exercise and aerobic exercise have benefits. Regular exercise (at least 150 min per week) is recommended in both adults with and without T1D to maintain a balanced and healthy lifestyle (Yang et al., 2019; Bull et al., 2020), by improving cardiorespiratory fitness, muscular strength (Schroeder et al., 2019), mental health (Ruegsegger and Booth, 2018), and quality of life (ACSM Brochures. American College of Sports Medicine. 2016). In addition, exercise also lowers the risk of a variety of chronic conditions, such as type 2 diabetes, CVD, hypertension, and dementia, while slowing age-related decline in physical function (ACSM Brochures. American College of Sports Medicine. 2016; Ferraro et al., 2019).
There are two kinds of physical activity: aerobic and muscle-strengthening. Examples of aerobic exercises include walking, swimming and cycling. Examples of muscle-strengthening exercises include weight-bearing exercises such as weightlifting and dumbbells (Manciaet al., 2013). If the patient does not have uncontrolled diabetes or severe complications, it is recommended to conduct muscle-strengthening exercises like any healthy adult.
It is recommended to do at least 30 minutes of moderate-intensity aerobic exercise a day, 5–7 days a week. In the other word, everybody must do 150 minutes of moderate-intensity aerobic exercise a week. Examples of moderate intensity aerobic physical activity are brisk walking, hand mopping and badminton, swimming or cycling for leisure purposes (Manciaet al., 2013). It is the recommendation of the European Society of Cardiology (ESC) to exercise five times weekly for at least 30 minutes at a time. However, the discipline of American College of Sports Medicine (ACSM) still recommends following WHO’s guideline which is to exercise more than 150 minutes weekly (Manciaet al., 2013).
Weight-bearing physical activities cause to enhance of body flexibility, reduce of injury risk, increase of basal metabolic rate, help to control weight. Muscle-strengthening exercises enhance body flexibility, reducing the risk of injury during exercise. It also increases basal metabolic rate, thus helping with weight control. Examples of muscle-strengthening exercises include dumbbells, weight-lifting, sit-ups and exercise band workouts (ACSM Brochures. American College of Sports Medicine. 2016). Everybody must do Weight-bearing physical activities two to four times/week , involve 8–10 major muscle groups , 8–12 times for each muscle group, repeat 1–3 sets.
Types of muscle-strengthening exercises include lifting weights, dumbbell exercises, pull-up bar, sit-ups, pushups, lifting objects, weight training equipment in gyms, resistance bands (ACSM Brochures. American College of Sports Medicine. 2016). Muscle-strengthening activities should be done two to four days a week. If these exercises are done every day, there is a higher risk of injury, and insufficient recovery time for minor muscle injuries sustained in the course of weight-bearing exercise. Everybody must do some type of muscle-strengthening exercise at least two days/week, using 8–10 major muscle, Repeates each move 8–12 times per set, repeat sets once or twice, Free weights such as dumbbells, weights, resistance bands, or medicine balls and weight-training equipment can be used (ACSM Brochures. American College of Sports Medicine. 2016).
According to people over 65 years old are talented for diabetic disease, Physical activity for old adults must include balance enhancement, standing on one foot, standing on heels, standing with eyes closed, or standing on a sloped surface, fall prevention, lower extremity and flexibility exercises. In case of poor mobility, everybody should do exercises to enhance your balance and prevent falls three or more days per week (World Health Organization. Global recommendations on physical activity for health. 2010.).
