Energy Expenditure in People with Diabetes Mellitus: A Review

Abstract

Physical activity (PA) is an important non-therapeutic tool in primary prevention and treatment of diabetes mellitus (DM). To improve activity-based health management, patients need to quantify activity-related energy expenditure and the other components of total daily energy expenditure. This review explores differences between the components of total energy expenditure in patients with DM and healthy people and presents various tools for assessing the energy expenditure in subjects with DM. From this review, it appears that patients with uncontrolled DM have a higher basal energy expenditure (BEE) than healthy people which must be considered in the establishment of new BEE estimate equations. Moreover, studies showed a lower activity energy expenditure in patients with DM than in healthy ones. This difference may be partially explained by patient with DMs poor compliance with exercise recommendations and their greater participation in lower intensity activities. These specificities of PA need to be taken into account in the development of adapted tools to assess activity energy expenditure and daily energy expenditure in people with DM. Few estimation tools are tested in subjects with DM and this results in a lack of accuracy especially for their particular patterns of activity. Thus, future studies should examine sensors coupling different technologies or method that is specifically designed to accurately assess energy expenditure in patients with diabetes in daily life.

Low basal metabolic rate as a risk factor for development of insulin resistance and type 2 diabetes

“…Since BMR constitutes an important risk factor for development of T2D in humans, the lack of consideration for BMR variation in the animal models may undermine their clinical relevance. 11 13 38 As both obesity 39 40 and BMR 23 are highly heritable, selection on traits directly related to variation in the rate of energy expenditures should provide an ample opportunity for identification of metabolic risk factors of development of T2D. Here, we demonstrated that mice with genetically determined low BMR have higher propensity to spontaneous weight gain and IR, while their high BMR counterparts manifested much slower development of T2D.…”

Short-term impact of COVID-19 lockdown on metabolic control of patients with well-controlled type 2 diabetes: a single-centre observational study

“…Of note, people also reported an increase in anxiety level that should lead, as known, to emotional eating and increase in the assumption of the so-called comfort food which is mainly rich in simple carbohydrates [6,7]. In such context, patients with type 2 diabetes have been more likely than non-diabetic individuals to gain weight, due to a higher basal, but a lower activity energy expenditure [8], and a potentially rapid effect of such forced change of lifestyle and recommended good clinical practice rules, like preferential outdoor life and physical exercise, would be expected in worsening metabolic Managed by Massimo Federici.…”

Exercise as ‘precision medicine’ for insulin resistance and its progression to type 2 diabetes: a research review

“…For example, Boushel et al observed a decrease in electron-transport capacity for obese subjects with T2D that was totally attributable to a decrease in mitochondrial content [ 58 ]. The authors reasoned that mitochondrial compromise was, therefore, not a cause, but a consequence of T2D [ 58 ] or, more specifically, the low level of physical activity that subjects with T2D typically experience [ 59 – 61 ]. This suggestion is supported by longitudinal studies involving training interventions that improve mitochondrial content in patients with T2D [ 62 , 63 ].…”

“…Whether this reduction is a cause or consequence of T2D cannot be ascertained from this cross-sectional study; however, it is interesting to note that subjects diagnosed with prediabetes demonstrated similar total activity counts compared to healthy controls [ 60 ]. It has also been shown that in addition to a reduction in the total amount of physical activity, individuals with T2D appear to engage in lower-intensity efforts compared to healthy subjects [ 61 ]. Collectively, these related to physical activity facilitate the positive energy balance and associated metabolic decline that is typically present for patients with T2D [ 150 ].…”