Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes and prediabetes. Recommendations and precautions vary depending on individual characteristics and health status. In this Position Statement, we provide a clinically oriented review and evidence- based recommendations regarding physical activity and exercise in people with type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, and prediabetes. ![]() Physical activity includes all movement that increases energy use, whereas exercise is planned, structured physical activity. Exercise improves blood glucose control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss, and improves well- being (1,2). Regular exercise may prevent or delay type 2 diabetes development (3). Regular exercise also has considerable health benefits for people with type 1 diabetes (e. The challenges related to blood glucose management vary with diabetes type, activity type, and presence of diabetes- related complications (5,6). Physical activity and exercise recommendations, therefore, should be tailored to meet the specific needs of each individual. TYPES AND CLASSIFICATIONS OF DIABETES AND PREDIABETESPhysical activity recommendations and precautions may vary by diabetes type. The primary types of diabetes are type 1 and type 2. Type 1 diabetes (5%–1. Although it can occur at any age, . Type 2 diabetes (9. Gestational diabetes mellitus occurs during pregnancy, with screening typically occurring at 2. Prediabetes is diagnosed when blood glucose levels are above the normal range but not high enough to be classified as diabetes; affected individuals have a heightened risk of developing type 2 diabetes (7) but may prevent/delay its onset with physical activity and other lifestyle changes (8). Nutritional quality indices show plant-based diets are the healthiest, but do vegetarians and vegans reach the recommended daily intake of protein? The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes and prediabetes. Tweet; This post came about as a result of people asking me almost on a daily basis how to calculate their macros for a successful diet or cut. I found myself either. Manage your page to keep your users updated View some of our premium pages: google.com. Upgrade to a Premium Page. Melancholy aeon November 27, 2012 @Gus ! I eat 1650 calories a. TYPES OF EXERCISE AND PHYSICAL ACTIVITYAerobic exercise involves repeated and continuous movement of large muscle groups (9). Activities such as walking, cycling, jogging, and swimming rely primarily on aerobic energy- producing systems. Resistance (strength) training includes exercises with free weights, weight machines, body weight, or elastic resistance bands. Flexibility exercises improve range of motion around joints (1. Balance exercises benefit gait and prevent falls (1. Activities like tai chi and yoga combine flexibility, balance, and resistance activities. BENEFITS OF EXERCISE AND PHYSICAL ACTIVITYAerobic Exercise Benefits. Aerobic training increases mitochondrial density, insulin sensitivity, oxidative enzymes, compliance and reactivity of blood vessels, lung function, immune function, and cardiac output (1. Moderate to high volumes of aerobic activity are associated with substantially lower cardiovascular and overall mortality risks in both type 1 and type 2 diabetes (1. In type 1 diabetes, aerobic training increases cardiorespiratory fitness, decreases insulin resistance, and improves lipid levels and endothelial function (1. Arnold Schwarzenegger; 38th Governor of California; In office November 17, 2003 In individuals with type 2 diabetes, regular training reduces A1. C, triglycerides, blood pressure, and insulin resistance (1. Alternatively, high- intensity interval training (HIIT) promotes rapid enhancement of skeletal muscle oxidative capacity, insulin sensitivity, and glycemic control in adults with type 2 diabetes (1. Brad Schoenfeld, Ph.D, C.S.C.S., is an internationally renowned fitness expert and widely regarded as one of the leading authorities on body composition training. Women: You'll Get Bigger Before You Get Smaller How to do a Healthy Food Prep Under $50 The Reason Many of You are Getting Bigger and Not Smaller. A hedge is an investment position intended to offset potential losses or gains that may be incurred by a companion investment. In simple language, a hedge is used to. After hooking himself up to a bunch of electrodes, the author discovers the best exercises for building a rock-solid midsection. Resistance Exercise Benefits. Diabetes is an independent risk factor for low muscular strength (2. The health benefits of resistance training for all adults include improvements in muscle mass, body composition, strength, physical function, mental health, bone mineral density, insulin sensitivity, blood pressure, lipid profiles, and cardiovascular health (1. The effect of resistance exercise on glycemic control in type 1 diabetes is unclear (1. However, resistance exercise can assist in minimizing risk of exercise- induced hypoglycemia in type 1 diabetes (2. When resistance and aerobic exercise are undertaken in one exercise session, performing resistance exercise first results in less hypoglycemia than when aerobic exercise is performed first (2. Resistance training benefits for individuals with type 2 diabetes include improvements in glycemic control, insulin resistance, fat mass, blood pressure, strength, and lean body mass (2. Benefits of Other Types of Physical Activity. Flexibility and balance exercises are likely important for older adults with diabetes. Limited joint mobility is frequently present, resulting in part from the formation of advanced glycation end products, which accumulate during normal aging and are accelerated by hyperglycemia (2. Stretching increases range of motion around joints and flexibility (1. Balance training can reduce falls risk by improving balance and gait, even when peripheral neuropathy is present (1. Group exercise interventions (resistance and balance training, tai chi classes) may reduce falls by 2. The benefits of alternative training like yoga and tai chi are less established, although yoga may promote improvement in glycemic control, lipid levels, and body composition in adults with type 2 diabetes (2. Tai chi training may improve glycemic control, balance, neuropathic symptoms, and some dimensions of quality of life in adults with diabetes and neuropathy, although high- quality studies on this training are lacking (2. BENEFITS OF AND RECOMMENDATIONS FOR REDUCED SEDENTARY TIMERecommendations. All adults, and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior. BProlonged sitting should be interrupted with bouts of light activity every 3. CThe above two recommendations are additional to, and not a replacement for, increased structured exercise and incidental movement. CSedentary behavior—waking behaviors with low energy expenditure (TV viewing, desk work, etc.)—is a ubiquitous and significant population- wide influence on cardiometabolic health (2. Higher amounts of sedentary time are associated with increased mortality and morbidity, mostly independent of moderate- to- vigorous physical activity participation (3. In people with or at risk for developing type 2 diabetes, extended sedentary time is also associated with poorer glycemic control and clustered metabolic risk (3. Prolonged sitting interrupted by brief (. In adults with type 2 diabetes, interrupting prolonged sitting with 1. The longer- term health efficacy and durability of reducing and interrupting sitting time remain to be determined for individuals with and without diabetes. PHYSICAL ACTIVITY AND TYPE 2 DIABETESRecommendations. Daily exercise, or at least not allowing more than 2 days to elapse between exercise sessions, is recommended to enhance insulin action. BAdults with type 2 diabetes should ideally perform both aerobic and resistance exercise training for optimal glycemic and health outcomes. CChildren and adolescents with type 2 diabetes should be encouraged to meet the same physical activity goals set for youth in general. CStructured lifestyle interventions that include at least 1. AInsulin Action and Physical Activity. Insulin action in muscle and liver can be modified by acute bouts of exercise and by regular physical activity (4. Acutely, aerobic exercise increases muscle glucose uptake up to fivefold through insulin- independent mechanisms. After exercise, glucose uptake remains elevated by insulin- independent (. Improvements in insulin action may last for 2. Even low- intensity aerobic exercise lasting . If enhanced insulin action is a primary goal, then daily moderate- or high- intensity exercise is likely optimal (5. Regular training increases muscle capillary density, oxidative capacity, lipid metabolism, and insulin signaling proteins (4. Both aerobic and resistance training promote adaptations in skeletal muscle, adipose tissue, and liver associated with enhanced insulin action, even without weight loss (5. Regular aerobic training increases muscle insulin sensitivity in individuals with prediabetes (5. Even low- volume training (expending just 4. Those with higher baseline insulin resistance have the largest improvements, and a dose response is observed up to about 2,5. Resistance training enhances insulin action similarly (5. HIIT and other modes (2,1. Combining endurance exercise with resistance exercise may provide greater improvements (6. HIIT may be superior to continuous aerobic training in adults with diabetes (1. Physical Activity in Adults With Type 2 Diabetes. The Look AHEAD (Action for Health in Diabetes) trial (6. The intensive lifestyle intervention group targeted weight loss of at least 7% through a modest dietary energy deficit and at least 1. Major cardiovascular events were the same in both groups, possibly in part due to greater use of cardioprotective medications in the diabetes support and education group (6. However, as reviewed by Pi- Sunyer (6. This trial provided very strong evidence of profound health benefits from intensive lifestyle intervention. Moreover, aerobic exercise clearly improves glycemic control in type 2 diabetes, particularly when at least 1. Resistance exercise (free weights or weight machines) increases strength in adults with type 2 diabetes by about 5. A1. C by 0. 5. 7% (6. A meta- analysis of 1. For glycemic control, combined training is superior to either type of training undertaken alone (6. Therefore, adults with type 2 diabetes should ideally perform both aerobic and resistance exercise training for optimal glycemic and health outcomes. Physical Activity in Youth With Type 2 Diabetes. Randomized trials evaluating exercise interventions in youth with type 2 diabetes are limited and inconclusive, although benefits are likely similar to those in adults. In the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study (6. The lifestyle intervention included modest weight loss achieved through dietary energy restriction and increased physical activity (minimum 2.
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