The Role of Physical Activity in Type 2 Diabetes Prevention: Physiological and Practical Perspectives

Abstract

Lifestyle changes that include a nutritionally balanced diet and increased physical activity (PA) are effective intervention options for persons with prediabetes who want to prevent progression to type 2 diabetes mellitus. Although nutritional counseling is standard practice for patients in a clinical setting, an individualized PA prescription, including recommendations on the type, frequency, duration, and intensity, is much less likely to occur. This is surprising because lifestyle modifications including a PA program are at least as effective in diabetes prevention as any single pharmacological agent. The success of regular PA in improving glycemic control in persons with either prediabetes or type 2 diabetes likely results from adaptations that occur in several organs and tissues, including adipose, skeletal muscle, liver, and pancreas. Increased insulin sensitivity is an important link between increased PA, body composition, and metabolic health, and it is at this link where increases in PA and energy expenditure exert much of their effect on preventing metabolic disorders and improving symptoms of existing disease. In addition to improving insulin sensitivity, regular PA has several cardioprotective effects, especially for persons with metabolic dysfunction, and has been shown to elicit minimal adverse events in these populations. Effective PA prescription is contingent on an understanding of the underlying physiological adaptations and the differing responses to diverse modes and intensities of PA. This article highlights recent findings on the beneficial role of regular PA for improving and/or maintaining insulin sensitivity in persons with prediabetes. We also provide an evidence-informed prescription for the type, intensity, and duration of both resistance and aerobic PA in persons with prediabetes.

ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD – Summary

“…34,35 Randomized clinical trials (RCTs) demonstrate that lifestyle modification, based on modest weight loss and increased physical activity, prevents or delays progression in high-risk individuals with IGT. 36 People at high risk of T2DM and/or with established IGT should be given appropriate lifestyle counselling (see 4.1).…”

Physiological fitness and health adaptations from purposeful training using off-road vehicles

“…This suggests that 6 weeks of off-road riding not only leads to healthy changes in adipose stores but also increases lean muscle mass to offset the weight loss associated with adipose reductions. These improvements in body composition are important health-related fitness improvements which reduce the risk of cardiovascular disease (Thompson et al 2003) and can aid in proper metabolic function to help prevent metabolic disease or the progression of diabetes (Burr et al 2010d).…”

Targeted Screening Reveals High Numbers of Prediabetes and Diabetes Mellitus in Moshi, Tanzania

“…Assessments indicate that there are insufficient medical supplies and treatment facilities in Tanzania [49][50][51]. However, as progression of pre-diabetes to type 2 diabetes mellitus and related complications might be modified with lifestyle changes [52,53], especially increased physical activity, a screening of pre-diabetes or diabetes may be worthwhile.…”