European Journal of Preventive Medicine

| Peer-Reviewed |

Physical Activity and Its Impact on Diabetes

Received: Nov. 28, 2018    Accepted: Dec. 21, 2018    Published: Jan. 18, 2019
Views:       Downloads:

Share This Article

Abstract

The current wave of the diabetes epidemic has become a global public health issue. Multiple strategies have been studied in trying to curb the menace and promising among these is lifestyle intervention which includes regular physical activity. During physical activity there is an accelerated utilization of substrates particularly stored triglycerides by the muscles thereby improving insulin sensitivity and this is valuable in the prevention of diabetes. On prolonged exercise blood glucose is derived from the breakdown of glycogen and from non carbohydrate substrates via gluconeogenesis. Exercise has a positive effect on diabetes co-morbidities e.g. obesity, hypertension, dyslipidemia as well as all-cause mortality. Regular physical activity mediates molecular events in the various pathways of diabetic complications like exerting anti-inflammatory effects to combat the chronic subclinical inflammation, fortifying the body antioxidant defense systems and reducing the formation and effects of advanced glycation end-products. The maximum health benefits of exercise are obtainable when done regularly and guidelines are available for the general public and individuals with diabetes on how to achieve these benefits. Finally, the emphasis on the importance of physical activity does not exclude the principle that patients with diabetic complications should seek expert counseling before embarking on an exercise program because some activities might be risky for this group of patients.

DOI 10.11648/j.ejpm.20180606.12
Published in European Journal of Preventive Medicine ( Volume 6, Issue 6, November 2018 )
Page(s) 82-89
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetes, Exercise, Physical Activity, Complications

References
[1] Physical activity. Global strategy on diet, physical activity and health. World Health Organization. © 2018 WHO. http://www.who.int/dietphysicalactivity/pa/en/ accessed 10/5/2018.
[2] C J Caspersen, K E Powell and G M Christenson. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Report. 1985 Mar-Apr; 100(2): 126–131.
[3] Exercise; definition. Medical dictionary. The free dictionary by Farlex. https://medical-dictionary. hefreedictionary.com/physical+exercise accessed 10/5/2018.
[4] Joram D. Mul, Kristin I. Stanford, Michael F. Hirshman and Laurie J. Goodyear. Exercise and Regulation of Carbohydrate Metabolism. Progress in Molecular Biology and Translational Science 2015; 135: 17–37.
[5] John O. Holloszy, Wendy M. Kohrt and Polly A. Hansen. THE REGULATION OF CARBOHYDRATE AND FAT METABOLISM DURING AND AFTER EXERCISE. [Frontiers in Bioscience 3, d1011-1027, September 15, 1998].
[6] Jeffrey F Horowitz and Samuel Klein. Lipid metabolism during endurance exercise. The American Journal of Clinical Nutrition, Volume 72, Issue 2, 1 August 2000, Pages 558S–563S.
[7] Romijn, J. A., E. F. Coyle, L. S. Sidossis, A. Gastaldelli, J. F. Horowitz, E. Endert & R. R. Wolfe: Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity and duration. American Journal of Physiology 265, E380-E391 (1993).
[8] Van Loon LJ, Greenhaff PL, Constantin-Teodosiu D, Saris WH, Wagenmakers AJ. The effects of increasing exercise intensity on muscle fuel utilization in humans. Journal of Physiology 2001 Oct 1; 536(Pt 1): 295-304.
[9] Wasserman D. H, D. B. Lacy, D. Bracy & P. E. Williams: Metabolic regulation in peripheral tissues and transition to increased gluconeogenic mode during prolonged exercise. American Journal of Physiology 263, E345-E354 (1992).
[10] Richter EA, Ruderman NB, Gavras H, Belur ER, Galbo H. Muscle glycogenolysis during exercise: dual control by epinephrine and contractions. American Journal of Physiology. 1982 Jan; 242(1):E25-32.
[11] Paulina Aarnio, Torsten Lauritsen and Flemming Dela. Insulin Secretion and Glucose Kinetics during Exercise With and Without Pharmacological α1- and α2-Receptor Blockade Diabetes 2001 Aug; 50(8): 1834-1843.
[12] Marker J. C, I. B. Hirsch, L. J. Smith, C. A. Parvin, J. O. Holloszy & P. E. Cryer: Catecholamines in prevention of hypoglycemia during exercise in humans. American Journal of Physiology 23, E705-E712 (1991).
[13] Hirsch I. B, J. C. Marker, L. J. Smith, R. J. Spina, C. A. Parvin, J. O. Holloszy & P. E. Cryer: Insulin and glucagon in prevention of hypoglycemia during exercise in humans. American Journal of Physiology 260, E695-E704 (1991).
[14] Wolfe RR. Metabolic interactions between glucose and fatty acids in humans. American Journal of Clinical Nutrition. 1998 Mar; 67(3Suppl): 519S-526S.
[15] Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes. 2004 Feb; 53(2):294-305.
[16] Zierath JR, He L, Gumà A, Odegoard Wahlström E, Klip A, Wallberg-Henriksson H. Insulin action on glucose transport and plasma membrane GLUT4 content in skeletal muscle from patients with NIDDM. Diabetes. 2004 Feb; 53(2):294-305.
[17] Stephen R Bird, John A Hawley. Update on the effects of physical activity on insulin sensitivity in humans. BMJ open sports and exercise medicine 2017; 2:e000143.
[18] Cartee GD. Roles of TBC1D1 and TBC1D4 in insulin and exercise-stimulated glucose transport of skeletal muscle. Diabetologia 2015;58:19–30.
[19] Vavvas D, A. Apazidis, A. K. Saha, J. Gamble, A. Patel, B. E. Kemp, L. A. Witters & N. B. Ruderman: Contraction-induced changes in acetyl-CoA carboxylase and 5'-AMP-activated kinase in skeletal muscle. J Biol Chem 272, 13256-13261 (1997).
[20] Martin Röhling, Christian Herder, Theodor Stemper and Karsten Müssig. Influence of Acute and Chronic Exercise on Glucose Uptake. Journal of Diabetes Research. 2016; 2016: 2868652.
[21] Borghouts LB, Keizer HA. Exercise and insulin sensitivity: a review. International Journal of Sports medicine 2000 Jan; 21(1): 1-2.
[22] Wang W, P. A. Hansen, B. A. Marshall, J. O. Holloszy & M. Mueckler: Insulin unmasks a COOH-terminal Glut-4 epitope and increases glucose transport across t-tubules in skeletal muscle. Journal of Cell Biology 135, 415-430 (1996).
[23] Holloszy J. O. & E. F. Coyle: Adaptations of skeletal muscle to endurance exercise and their metabolic consequences. Journal of Applied Physiology 56, 831-839 (1984).
[24] Sean A. Newsom, Allison C. Everett, BS Alexander Hinko, and Effrey F. Horowitz. A Single Session of Low-Intensity Exercise Is Sufficient to Enhance Insulin Sensitivity Into the Next Day in Obese Adults. Diabetes Care 2013 Sep; 36(9): 2516-2522.
[25] G. W. Heath, J. R. Gavin 3rd, J. M. Hinderliter, J. M. Hagberg, S. A. Bloomfield and J. O. Holloszy. Effects of exercise and lack of exercise on glucose tolerance and insulin sensitivity. Journal of Applied Physiology Vol. 55, No. 2, 1st Aug. 1983.
[26] D. S. King, G. P. Dalsky, W. E. Clutter, D. A. Young, M. A. Staten, P. E. Cryer and J. O. Holloszy. Effects of exercise and lack of exercise on insulin sensitivity and responsiveness. Journal of Applied Physiology Vol. 64, No. 5. 1st May 1988.
[27] Sudip Bajpeyi, Charles J. Tanner, Cris A. Slentz, Brian D. Duscha, Jennifer S. McCartney, Robert C. Hickner, William E. Kraus and Joseph A. Houmard. Effect of exercise intensity and volume on persistence of insulin sensitivity during training cessation. Journal of Applied Physiology (1985). 2009 Apr; 106(4): 1079–1085.
[28] McLaughlin T, Schweitzer P, Carter S, Yen CG, Lamendola C, Abbasi F, Reaven G. Persistence of improvement in insulin sensitivity following a dietary weight loss programme. Diabetes Obesity and Metabolism. 2008 Dec;10(12):1186-94.
[29] Diabetes Prevention Program. National Institute of Diabetes Digestive and Kidney diseases, US Department of Health and Human Services. https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp accessed 31/5/2018.
[30] Jaana Lindström, Anne Louheranta, Marjo Mannelin, Merja Rastas, Virpi Salminen, Johan Eriksson, Matti Uusitupa, Jaakko Tuomilehto and or the Finnish Diabetes Prevention Study Group. Lifestyle intervention and 3-year results on diet and physical activity. The Finnish Diabetes Prevention Study (DPS). Diabetes Care 2003 Dec; 26(12): 3230-3236.
[31] Li G, Zhang P, Wang J, Gregg EW, Yang W, Gong Q, Li H, Li H, Jiang Y, An Y, Shuai Y, Zhang B, Zhang J, Thompson TJ, Gerzoff RB, Roglic G, Hu Y, Bennett PH. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet. 2008 May 24; 371(9626):1783-9.
[32] Kinori Kosaka, Mitsuihiko Noda and Takeshi Kuzuya. Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males. Diabetes Research and Clinical Practice February 2005Volume 67, Issue 2, Pages 152–162.
[33] Frank B Hu, Tricia Y Li, Graham A Colditz, Walter C Willet and JoAnn E Manson. Television watching and other sedentary behaviours in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA April 9 2003 Vol 289 No 14 1785-1791.
[34] Susan P. Helmrich, David R. Ragland, Rita W, Leung, and Ralph S. Paffenbarger Jr. Physical activity and the occurrence of non insulin dependent diabetes mellitus. New England Journal of Medicine 1991; 325:147-152.
[35] Braun B, Sharoff C, Chipkin SR, Beaudoin FJ. Effects of insulin resistance on substrate utilization during exercise in overweight women. Journal of Applied Physiology (1985). 2004 Sep; 97(3):991-997.
[36] Sheri R. Colberg, Ronald J. Sigal, Bo Fernhall, Judith G. Regensteiner, Bryan J. Blissmer, Richard R. Rubin, Lisa Chasan-Taber, Ann L. Albright and Barry Braun. Exercise and Type 2 Diabetes. The American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010 Dec; 33(12): e147–e167.
[37] Ibañez J, Izquierdo M, Argüelles I, Forga L, Larrión JL, García-Unciti M, Idoate F, Gorostiaga EM. Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes. Diabetes Care. 2005 Mar; 28(3):662-7.
[38] Tikkanen-Dolenc H, Wadén J, Forsblom C, Harjutsalo V, Thorn LM, Saraheimo M, Elonen N, Rosengård-Bärlund M, Gordin D, Tikkanen HO and Groop PH. FinnDiane Study Group. Frequent and intensive physical activity reduces risk of cardiovascular events in type 1 diabetes. Diabetologia. 2017 Mar; 60(3):574-580.
[39] Gregg EW, Gerzoff RB, Caspersen CJ, Williamson DF, Narayan KM. Relationship of walking to mortality among US adults with diabetes. Archives of Internal Medicine 2003 Jun 23; 163(12):1440-7.
[40] Wei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN. Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Annals of Internal Medicine 2000 Apr 18;132(8):605-11.
[41] Ross R, Dagnone D, Jones PJ, Smith H, Paddags A, Hudson R, Janssen I. Reduction in obesity and related co-morbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized controlled trial. Annals of Internal Medicine 2000 Jul 18; 133(2):92-103.
[42] Figueroa A, Baynard T, Fernhall B, Carhart R, Kanaley JA. Endurance training improves post-exercise cardiac autonomic modulation in obese women with and without type 2 diabetes. European Journal of Applied Physiology. 2007 Jul;100(4):437-44.
[43] Balducci S, Zanuso S, Nicolucci A, De Feo P, Cavallo S, Cardelli P, Fallucca S, Alessi E, Fallucca F, Pugliese G; Italian Diabetes Exercise Study (IDES) Investigators. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Archives of Internal Medicine 2010 Nov 8;170(20):1794-803.
[44] Giugliano D, Ceriello A, Paolisso G. Oxidative stress and diabetic vascular complications. Diabetes Care. 1996 Mar; 19 (3):257-67.
[45] J. L. Evans, I. D. Goldfine, B. A. Maddux and G. M. Grodsky. “Oxidative stress and stress-activated signaling pathways: a unifying hypothesis of type 2 diabetes,” Endocrine Reviews, vol. 23, no. 5, pp. 599–622, 2002.
[46] Fatmah A Matough, Siti B Budin, Zariyantey A Hamid, Nasar Alwahaibi and Jamaludin Mohamed. The Role of Oxidative Stress and Antioxidants in Diabetic Complications. Sultan Qaboos University Medical Journal 2012 Feb; 12(1): 5–18.
[47] Nada Sallam and Ismail Laher. Exercise Modulates Oxidative Stress and Inflammation in Aging and Cardiovascular Diseases. Oxidative Medicine and Cellular Longevity 2016; 2016: 7239639.
[48] Monica Pittaluga, Antonio Sgadari, Ivan Dimauro, Barbara Tavazzi, Paolo Parisi and Daniela Caporossi. Physical Exercise and Redox Balance in Type 2 Diabetics: Effects of Moderate Training on Biomarkers of Oxidative Stress and DNA Damage Evaluated through Comet Assay. Oxidative Medicine and Cellular Longevity, Volume 2015, Article ID 981242.
[49] Melpomeni Peppa, Helen Vlassara. Advanced glycation end products and diabetic complications: A General overview. Hormones 2005 4(1): 28-37.
[50] Choi KM, Han KA, Ahn HJ, Hwang SY, Hong HC, Choi HY, Yang SJ, Yoo HJ, Baik SH, Choi DS, Min KW. Effects of exercise on sRAGE levels and cardiometabolic risk factors in patients with type 2 diabetes: a randomized controlled trial. Journal Clinical Endocrinology Metabolism 2012 Oct;97(10):3751-8.
[51] Michael Sponder, Ioana-Alexandra Campean, Michael Emich, Monika Fritzer-Szekeres, Brigitte Litschauer, Senta Graf, Daniel Dalos and Jeanette Strametz-Juranek. Long-term physical activity leads to a significant increase in serum sRAGE levels: a sign of decreased AGE mediated inflammation due to physical activity? Heart and Vessels 2018: 1-8.
[52] Yoshikawa T, Miyazaki A, Fujimoto S. Decrease in serum levels of advanced glycation end-products by short-term lifestyle modification in non-diabetic middle-aged females. Medical Science Monitor. 2009 Jun; 15(6):PH65-73.
[53] Alaa Badawi, Amira Klip, Pierre Haddad, David EC Cole, Bibiana Garcia Bailo, Ahmed El-Sohemy, and Mohamed Karmali. Type 2 diabetes mellitus and inflammation: Prospects for biomarkers of risk and nutritional intervention. Diabetes Metabolic Syndrome and Obesity. 2010; 3: 173–186.
[54] John C. Pickup. Inflammation and Activated Innate Immunity in the Pathogenesis of Type 2 Diabetes. Diabetes Care 2004 Mar; 27(3): 813-823.
[55] Bansal S, Ridker PM. Comparison of characteristics of future myocardial infarctions in women with baseline high versus baseline low levels of high-sensitivity C-reactive protein. American Journal of Cardiology 2007 Jun 1; 99(11):1500-3.
[56] Rodríguez-Morán M, Guerrero-Romero F: Increased levels of C-reactive protein in noncontrolled type II diabetic subjects. Journal of Diabetes Complications 13:211–215, 1999.
[57] Bente Klarlund Pedersen, Thorbjorn C. A. Akerstrom, Anders R. Nielsen, and Christian P. Fischer. Role of myokines in exercise and metabolism. Journal of Applied Physiology 103: 1093–1098, 2007.
[58] E. Hopps, B. Canino and G. Caimi. Effects of exercise on inflammation markers in type 2 diabetic subjects. Acta Diabetologica (2011) 48:183–189.
[59] Kristen M. Beavers, Tina E. Brinkley, and Barbara J. Nicklas. Effect of exercise training on chronic inflammation. Clinical Chimical Acta. 2010 Jun 3; 411(0): 785–793.
[60] Physical activity guidelines for adults. Office of diseases prevention and health promotion. https://health.gov/paguidelines/guidelines/adults.aspx accessed 13/6/2018.
[61] Australian physical activity and sedentary behavour guidelines. Australian government department of health. http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines accessed 12/6/2018.
[62] UK physical activity guidelines. Guidance from the Chief Medical Officer (CMO) on how much physical activity people should be doing, along with supporting documents. https://www.gov.uk/government/publications/uk-physical-activity-guidelines. accessed 12/6/2018.
[63] Sheri R. Colberg, Ronald J. Sigal, Jane E. Yardley, Michael C. Riddell, David W. Dunstan, Paddy C. Dempsey, Edward S. Horton, Kristin Castorino and Deborah F. Tate. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016 Nov; 39(11): 2065-2079.
[64] Anne K Schreiber, Carina FM Nones, Renata C Reis, Juliana G Chichorro, and Joice M Cunha. Diabetic neuropathic pain: Physiopathology and treatment. World Journal of Diabetes. 2015 Apr 15; 6(3): 432–444.
[65] Ismail Lawal Dahiru, Kenneth Ezenwa Amaefule, Innocent Onaja Okpe, Abdulrasheed Ibrahim and Salisu Babura Muazu. An overview of diabetic foot disease. Nigeria Journal of Basic and clinical sciences 2016 Vol. 13 Issue 1Pg 1-12.
[66] Vinik AI: Neuropathy. In The Health Professional's Guide to Diabetes and Exercise. Alexandria (VA): American Diabetes Association; 1995. p. 183–97.
[67] Exercising with diabetes complications. Joslin Diabetes Center. http://www.joslin.org/info/exercising-with-diabetes-complications.html accessed 16/6/2018.
Cite This Article
  • APA Style

    Amin Muhammad Ibrahim. (2019). Physical Activity and Its Impact on Diabetes. European Journal of Preventive Medicine, 6(6), 82-89. https://doi.org/10.11648/j.ejpm.20180606.12

    Copy | Download

    ACS Style

    Amin Muhammad Ibrahim. Physical Activity and Its Impact on Diabetes. Eur. J. Prev. Med. 2019, 6(6), 82-89. doi: 10.11648/j.ejpm.20180606.12

    Copy | Download

    AMA Style

    Amin Muhammad Ibrahim. Physical Activity and Its Impact on Diabetes. Eur J Prev Med. 2019;6(6):82-89. doi: 10.11648/j.ejpm.20180606.12

    Copy | Download

  • @article{10.11648/j.ejpm.20180606.12,
      author = {Amin Muhammad Ibrahim},
      title = {Physical Activity and Its Impact on Diabetes},
      journal = {European Journal of Preventive Medicine},
      volume = {6},
      number = {6},
      pages = {82-89},
      doi = {10.11648/j.ejpm.20180606.12},
      url = {https://doi.org/10.11648/j.ejpm.20180606.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ejpm.20180606.12},
      abstract = {The current wave of the diabetes epidemic has become a global public health issue. Multiple strategies have been studied in trying to curb the menace and promising among these is lifestyle intervention which includes regular physical activity. During physical activity there is an accelerated utilization of substrates particularly stored triglycerides by the muscles thereby improving insulin sensitivity and this is valuable in the prevention of diabetes. On prolonged exercise blood glucose is derived from the breakdown of glycogen and from non carbohydrate substrates via gluconeogenesis. Exercise has a positive effect on diabetes co-morbidities e.g. obesity, hypertension, dyslipidemia as well as all-cause mortality. Regular physical activity mediates molecular events in the various pathways of diabetic complications like exerting anti-inflammatory effects to combat the chronic subclinical inflammation, fortifying the body antioxidant defense systems and reducing the formation and effects of advanced glycation end-products. The maximum health benefits of exercise are obtainable when done regularly and guidelines are available for the general public and individuals with diabetes on how to achieve these benefits. Finally, the emphasis on the importance of physical activity does not exclude the principle that patients with diabetic complications should seek expert counseling before embarking on an exercise program because some activities might be risky for this group of patients.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Physical Activity and Its Impact on Diabetes
    AU  - Amin Muhammad Ibrahim
    Y1  - 2019/01/18
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ejpm.20180606.12
    DO  - 10.11648/j.ejpm.20180606.12
    T2  - European Journal of Preventive Medicine
    JF  - European Journal of Preventive Medicine
    JO  - European Journal of Preventive Medicine
    SP  - 82
    EP  - 89
    PB  - Science Publishing Group
    SN  - 2330-8230
    UR  - https://doi.org/10.11648/j.ejpm.20180606.12
    AB  - The current wave of the diabetes epidemic has become a global public health issue. Multiple strategies have been studied in trying to curb the menace and promising among these is lifestyle intervention which includes regular physical activity. During physical activity there is an accelerated utilization of substrates particularly stored triglycerides by the muscles thereby improving insulin sensitivity and this is valuable in the prevention of diabetes. On prolonged exercise blood glucose is derived from the breakdown of glycogen and from non carbohydrate substrates via gluconeogenesis. Exercise has a positive effect on diabetes co-morbidities e.g. obesity, hypertension, dyslipidemia as well as all-cause mortality. Regular physical activity mediates molecular events in the various pathways of diabetic complications like exerting anti-inflammatory effects to combat the chronic subclinical inflammation, fortifying the body antioxidant defense systems and reducing the formation and effects of advanced glycation end-products. The maximum health benefits of exercise are obtainable when done regularly and guidelines are available for the general public and individuals with diabetes on how to achieve these benefits. Finally, the emphasis on the importance of physical activity does not exclude the principle that patients with diabetic complications should seek expert counseling before embarking on an exercise program because some activities might be risky for this group of patients.
    VL  - 6
    IS  - 6
    ER  - 

    Copy | Download

Author Information
  • Department of General Medicine, Ayodele Specialist Hospital, Lagos, Nigeria

  • Section