 |
|
 |
 |
 |
 |
| Home > Education > Publications |  |
 |
|
Literature Compendium |
Current Concepts in Type 2 Diabetes
Volume 1
Overview of Type 2 Diabetes Pathogenesis, Complications, Risk Reduction, and Lifestyle Intervention
Chapter 4
Prevention and Management of Type 2 Diabetes Through Lifestyle Modification
The prevalence of diabetes around the world continues to rise. This increase parallels the rising rates of obesity and overweight observed over the past decade. Lifestyle modification is a key initial component of diabetes management and is a necessary and vital therapy at all stages of disease. Regular exercise can improve glycaemic control in persons with Type 2 diabetes and is associated with substantial reductions in cardiovascular morbidity and mortality. In this chapter, 3 papers supporting the implementation of lifestyle modification in people with Type 2 diabetes and its precursor states are presented.
In 2004, the American Diabetes Association published a position statement regarding the importance of physical activity in persons with Type 2 diabetes.1 Recommendations were updated from the previous guideline (published in 1990) based on several new lines of evidence. As delineated in the updated paper, numerous large clinical trials have demonstrated that diet and exercise can reduce the incidence of diabetes in persons with impaired glucose tolerance. In addition, several meta-analyses of structured exercise interventions have shown the effectiveness of exercise in reducing HbA1c, independent of body weight, and several large cohort studies have shown that low levels of aerobic fitness and physical activity are associated with an increased risk of overall and cardiovascular disease (CVD)–associated mortality in persons with Type 2 diabetes. The overwhelming weight of evidence now supports the implementation of a physical activity/exercise regimen as part of the management strategy for individuals with Type 2 diabetes.
The Diabetes Prevention Program Research Group performed a secondary analysis of a prospective trial to assess the impact of lifestyle intervention and metformin therapy on the rates of hypertension, dyslipidaemia, and CVD events in 3234 individuals with IGT.2 These investigators found that intensive lifestyle intervention reduced known risk factors for CVD, including hypertension, hypertriglyceridaemia, low levels of high-density lipoprotein cholesterol, and the presence of proatherogenic small, dense low-density lipoprotein particles.
In a post hoc analysis of the role of physical activity in preventing Type 2 diabetes in 487 individuals with IGT who participated in the Finnish Diabetes Prevention Study,3 individuals who increased their levels of moderate-to-strenuous physical activity or participated in a strenuous, structured physical activity programme were up to 65% less likely to develop Type 2 diabetes than those who did not engage in such activity. Benefits were also achieved with low-intensity physical activity (eg, walking).
These papers delineate the numerous beneficial effects of medical nutrition therapy and physical activity both in persons with impaired glucose tolerance and in those with overt Type 2 diabetes.
References
Click to proceed to Programme Evaluation and Post-test.
Click to return to Opening Page.
Click to return to Table of Contents.
Click to return to Introduction.
Click to return to Chapter 1.
Click to return to Chapter 2.
Click to return to Chapter 3.
The Literature Compendium is funded by an educational grant from Pfizer Inc.
 |
Return to Education homepage |
|
|
|
|
|
|
 |
||
 |
|
Print this page |
|
||
 |
Add to Favourites |
|
|