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Exercise training in obese diabetic patients. Special considerations
J R Zierath1, H Wallberg-Henriksson
1Department of Clinical Physiology, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
Sports Medicine (Auckland, N.Z.)
|September 1, 1992
Summary
Regular exercise improves metabolic control and lipid profiles in younger individuals with type 2 diabetes mellitus. However, older patients over 55 show limited benefits from physical training due to complicating health issues.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Exercise Physiology
Background:
- Obesity is strongly linked to type 2 diabetes mellitus (T2DM), with most T2DM patients being obese.
- The complex pathogenesis of T2DM involves insulin secretion abnormalities, and both peripheral and hepatic insulin resistance.
- Effective treatment aims to normalize these metabolic alterations and achieve normoglycemia, often starting with diet and exercise for weight reduction.
Purpose of the Study:
- To investigate the impact of physical activity on metabolic control and lipid profiles in obese and lean individuals with type 2 diabetes mellitus.
- To compare the effectiveness of regular exercise in younger versus older T2DM patients.
Main Methods:
- Analysis of existing literature on exercise interventions in type 2 diabetes mellitus patients.
- Review of studies examining metabolic responses (HbA1C, glucose tolerance) and lipid profiles (triglycerides, cholesterol) to physical training.
- Comparison of outcomes based on age groups (under 55 vs. over 55) and body weight (obese vs. lean).
Main Results:
- A single exercise session can partially normalize insulin sensitivity and responsiveness, leading to decreased plasma glucose levels.
- Regular exercise programs can improve metabolic control in T2DM patients under 55, evidenced by better HbA1C and glucose tolerance tests, independent of weight reduction.
- Older T2DM patients (over 55) often experience limited benefits from physical training due to comorbidities, with no significant changes in HbA1C, glucose tolerance, or body weight observed in lean individuals.
- Physical training in obese T2DM individuals improves lipid profiles (decreased triglycerides and total cholesterol), even without significant weight loss in younger patients.
Conclusions:
- Younger individuals with type 2 diabetes mellitus demonstrate a more favorable metabolic response to regular physical training compared to older patients.
- Exercise interventions, particularly in younger T2DM patients, can enhance glucose control and improve lipid profiles, highlighting the importance of physical activity in managing T2DM.
- The reduced efficacy of exercise in older T2DM patients may be attributed to factors like training intensity, comorbidities, and baseline metabolic status.