The Role of Exercise in Type II Diabetes Mellitus

A number of studies have demonstrated a beneficial effect of regular physical activity on levels of HgbA 1 C in patients with type II diabetes mellitus, largely due to an increase in insulin sensitivity. Benefits are related to short term improvements in insulin sensitivity following individual exercise bouts. Regular exercise can prevent or delay the onset of type II diabetes in high risk populations. The insulin resistant state is associated with a cluster of cardiovascular risk factors all of which improve with regular physical activity. Because of the high incidence of occult coronary disease, patients need a cardiovascular evaluation when initiating an exercise program. High intensity exercise may result in retinal hemorrhage and transient worsening of diabetic proteinuria. The most common complication is hypoglycemia. A combination of aerobic and light resistance exercise is appropriate. Patients should exercise a minimum of three times a week for 30–60 minutes at 50% to 75% of their Vo 2max .