Synopsis
This consensus statement is an update to the 2010 position on exercise and type 2 diabetes (T2D) published jointly by the American College of Sports Medicine (ACSM) and the American Diabetes Association (ADA). published a considerable body of research on select topics related to exercise in people of various ages with T2D, while the prevalence of diabetes continued to expand throughout the world.
The objective of this consensus statement is to provide readers with a summary of current evidence and to expand and update previous recommendations from 2010. The writing group used a consensus approach to synthesize available evidence from clinical trials and case reports, narrative reviews and systematic, and meta-analyses, and the recommendations represent the consensus of the writing panel and the ACSM and incorporate guidance from other professional organizations with expertise in this area, such as the ADA.
Current science, new discussion topics, and clinical experience are highlighted in making recommendations for the participation of people with T2D of all ages. In addition, the title of the consensus statement and the text itself have been expanded to include the physical activity (AF), a broader and more comprehensive definition of human movement of which structured or planned exercise is a subset.
People with type 2 diabetes should engage in regular physical activity and should be encouraged to reduce sedentary time and break up the time they spend sitting with frequent breaks for activity. Any activity undertaken with acute and chronic health complications related to diabetes may require accommodations to ensure safe and effective participation. Other topics addressed are timing of exercise to maximize its glucose-lowering effects, and barriers and inequalities in taking up and maintaining physical activity.
Introduction
Diabetes currently affects more than 463 million people worldwide (3), and its prevalence in the United States is 10.5% (4). T2D accounts for 90% to 95% of all cases. The goal of treatment for T2D is to facilitate an individualized treatment plan, which may include education, glycemic control, cardiovascular disease (CVD) risk reduction, and ongoing screening for microvascular complications, to achieve and maintain optimal blood glucose levels. blood, lipid, and blood pressure levels that prevent or delay chronic complications.
Lifestyle interventions and/or medications are usually prescribed for the treatment of type 2 diabetes, and more recently, bariatric surgery has also become part of a possible treatment plan.
During any type of physical activity (PA), glucose uptake in active skeletal muscles is increased through insulin-independent pathways.
Blood glucose levels are maintained by glucoregulatory hormone-derived increases in hepatic glucose output and free fatty acid mobilization, which may be affected by insulin resistance or diabetes. The improvements in insulin sensitivity systemic, and possibly hepatic, after any AF may last from 2 to 72 hours, with reductions in blood glucose closely associated with the duration and intensity of AF.