Physical training as a part of the therapy for adult-onset diabetes

Albeit physical exercise and training have been recommended as an integral part of diabetes therapy only limited data are available to prove such beneficial effects of physical exertion in normalizing the metabolism in diabetes. It is the purpose of this review to critically summarize studies concerning the effects of physical training in maturity-onset diabetes. Based upon available evidence in animal experimentation, i.e. in normal and fat ZUCKER rats, as well as on data in non-diabetic man, physical training is expected to increase peripheral insulin sensitivity; thus a decrease of insulin requirements might be achieved in the course of a physical training program. So far, however, the preliminary evidence of only two studies on the effect of training in maturity-onset diabetes has been presented: slight improvements of glucose tolerance and a considerable, but--at least in one study--short-lived decrease of circulating insulin levels have been described. These improvements have to be weighed against the possible hazards of physical training programs in maturity-onset diabetic patients who--as a group--have to be considered at high coronary risk. More and more detailed and prolonged studies, however, are urgently needed to document and to prove beyond any doubt the benefits of physical training in the metabolic syndrome of maturity-onset diabetes mellitus.