The role of exercise in type II diabetes mellitus

A number of studies have demonstrated a beneficial effect of regular physical activity on levels of HgbA(1)C in patients with type II diabetes mellitus, largely due to an increase in insulin sensitivity. Benefits are related to short-term improvements in insulin sensitivity following individual exercise bouts. Regular exercise can prevent or delay the onset of type II diabetes in high-risk populations. The insulin resistant state is associated with a cluster of cardiovascular risk factors all of which improve with regular physical activity. Because of the high incidence of occult coronary disease, patients need a cardiovascular evaluation when initiating an exercise program. High intensity exercise may result in retinal hemorrhage and transient worsening of diabetic proteinuria. The most common complication is hypoglycemia. A combination of aerobic and light resistance exercise is appropriate. Patients should exercise a minimum of three times a week for 30-60 minutes at 50% to 75% of their VO(2max). (c) 2000 by CHF, Inc.