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Type 2 Diabetes and Exercise: A Literature Review

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Type 2 diabetes is a disease that continues to affects millions of people every day. On a global level, diabetes impacts 415 million people, with the numbers continuing to rise. It is estimated that by 2040, 642 million people will be affected by diabetes (Cradock, ALaighin, Finucane, Gainforth, Quinlan & Ginis, 2017). The focus of research in recent years have shifted from the use of medications to regulate the disease to lifestyle change in order to keep the disease under control. A primary goal would be to exercise in order to manage type 2 diabetes. This literature review takes a comprehensive look at recent literature on the impact of exercise and the prevention and management of diabetes. The conducted research is no less than 5 years old, and the researchers have dedicated these past few years exploring effective ways of finding solutions for this disease. Most of the researchers agree that exercise is important in order for diabetics to overcome this disease.

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Review of Literature
There has been unique research on what constitutes exercise versus overall physical activity as it relates to managing type 2 diabetes (“Reports from”, 2017). While it is much more important to engage in exercise to overcome health issues, physical activity as a whole still leads to progress. Weight is a main cause of type 2 diabetes, therefore, engaging in physical activity has been proven to produce effective results. A recent study of Japanese patients also proved that physical activity can decrease the incidence of diabetic retinopathy (Kuwata, Okamura, Tsujii, & Ishii, 2017). Consequently, this study concludes “higher PA was independently associated with a lower incidence of DR in patients with type 2 diabetes. More research needs to be performed to determine if effective strategies to increase PA will reduce the risk of DR in patients with diabetes” (Kuwata et al., 2017, p. 4375). Even though the researchers recommend more studies to continue to connect physical activity with lower incidence of DR, the findings are certainly promising and opens up dialogue to similar studies.

In addition to exercise, many researchers have focused on diet change and exercise together in order to lower the risks and decrease the chances of the diseases worsening (Cradock, ALaighin, Finucane, Gainforth, Quinlan & Ginis, 2017). It is of their belief that a combination of both would be more effective as a lifestyle change. Since diabetes is a multifactorial lifestyle disease, researchers believe that there is more than one way to manage it. These changes include quitting smoking, eating healthy, and losing weight. Yet, the researchers do believe in the benefits of exercise (Cradock et al., 2017). This study concludes that both diet and physical activity works well together in reducing the number of calories that patients take in (Cradock et al., 2017). The study was specific in the type of exercises that were helpful in getting patients with diabetes to exercise. Cradock et al (2017) states, “All of the included studies focused on aerobic exercise of a moderate intensity, three also focused on strength training” (p. 20). These types of exercises prove to be not as strenuous on the body and can produce effective results. The study was clear to point out that even though the results initially proved that the combination of exercise and diet achieved reduction in HbA1c from a 3- 6-month period, there was little sustainability over a 12 -24-month period of time. Therefore, the researchers agreed that guidance on behavior for patients can consistently keep them proactive in their exercise goals (Cradock et al., 2017).

Other researchers had more moderate success in showing consistency in patients and weight loss in management of diabetes because the exercise programs were thoroughly planned out. Tester (2016) focuses on Paleolithic diet in combination with exercise. Yet, the exercise regime that is posed in these findings did produce effective results for the participants. Tester (2016) writes, “All subjects followed and consumed a paleo diet for 12 weeks. Participants were assigned on a 1:1 basis to either a standard care exercise recommendations (PD) or 1-hour supervised exercise sessions, combining aerobic exercise and resistance training, three times per week (PD-EX)” (p. 96). However, unlike the previous discussed study, this program included consultation and an active plan for patients to focus on their own daily routine. The patients participated in group sessions with a dietician and were advised to perform moderate exercise for at least 30 minutes daily (Tester, 2016). The results did show some success in the patients once the researchers collected data. The data showed that there was a significant reduction in fat mass. The insulin levels also improved (Tester, 2016). While the results were not overwhelmingly positive, they did show hope and progress. The diet itself sparked the most change, but the exercise did help to increase cardiovascular fitness (Tester, 2016). Overall, the researchers recommend more students are conducted with larger subject numbers.

As discussed, it is no secret that diabetes is of major concern. Moreover, type 2 diabetes has ultimately been linked to physical inactivity. According to Balducci, D’Errico, Haxhi, Sacchetti, Orlando, Cardelli (2017), the major determinant of type 2 diabetes is a result of lack of physical activity. Therefore, it is only fitting that exercise and other forms of physical activity are used in order to prevent and manage diabetes. Balducci et al. (2017) conducted a study that proved that physical inactivity is a leading cause of type 2 diabetes. The results of the study found a direct correlation between diabetes and physical inactivity. The PA level is low in patients with diabetes who do not exercise and engage in other physical activities. As with the previous study, cardiovascular factors also weigh on diabetes patients who do not exercise. This becomes a trickle-down impact, and patients are encouraged to engage in exercise on a whole because it increases the overall physical health of the patients (Balducci et al., 2017). The researchers recommend that a closer look is given to diabetes patients who engage in physically active lifestyles versus those who do not. It would provide a clearer picture of just how successful a change in diet and exercise can be to type 2 diabetics.

Overall, it is of great importance to find solutions to the prevention and management of type 2 diabetes. Given its significant impact on millions of people yearly, type 2 diabetes will continue to be a health crisis. The dedication of researchers to this topic is commendable and over time it is believed that more measures are taken to overcome this disease. Since physical activity is a leading determinant of the disease, it would benefit researchers and diabetics alike to focus on alternative methods besides the more traditional methods that doctors suggest. A lifestyle change should always include a change in diet and exercise. These studies have proven that exercise is beneficial to the overall health of diabetics. Furthermore, physical activity is a proactive approach to diabetics improving their overall quality of health. As the researchers in their studies recommend, more time, money and other resources need to be dedicated to finding ways for patients to stay consistent in implementing exercise in their daily lives. The key is not just for them to start, but to sustain a physically active lifestyle.

  • Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., …Pugliese, G. (2017). Level and correlates of physical activity and sedentary behavior in patients with type 2 diabetes: A cross-sectional analysis of the Italian Diabetes and Exercise Study_2. PLoS ONE, 12(3), e0173337.
  • Cradock, K. A., ALaighin, G., Finucane, F. M., Gainforth, H. L., Quinlan, L. R., & Ginis, K. A. M. (2017). Behaviour change techniques targeting both diet and physical activity in type 2 diabetes: A systematic review and meta-analysis. The International Journal of Behavioral Nutrition and Physical Activity, 14(1).
  • Kuwata, H., Okamura, S., Hayashino, Y., Tsujii, S., & Ishii, H. (2017). Higher levels of physical activity are independently associated with a lower incidence of diabetic retinopathy in Japanese patients with type 2 diabetes: A prospective cohort study, Diabetes Distress and Care Registry at Tenri (DDCRT15). PLoS ONE, 12(3), e0172890.
  • Reports from New York University Highlight Recent Findings in Type 2 Diabetes (Using Qualitative Methods to Understand Physical Activity and Weight Management Among Bangladeshis in New York City, 2013). (2017, March 18). Obesity, Fitness & Wellness Week, 4369.
  • Tester, J. (2016). Paleolithic diet and exercise in type 2 diabetes. Australian Journal of Herbal Medicine, 28(3), 96+.