The-role-of-physical-activiy-in-managing-diabetes_AL

The role of Physical activity in managing diabetes Dr Alistair Lumb, Oxford on behalf of Professor Rob Andrews University of Exeter / Taunton NHS trust 23rd May 2019 Overview • Supervised exercise studies • Real world studies • Breaking up sitting Supervised exercise programs Exercise and HbA1c in T2DM Aerobic -0.73% Resistance training -0.57% Combined training – 0.67% The more you the better >150 minutes -0.89% 4 Hours walked per week Gregg EW et al Arch Intern Med 2003 Physical activity and microvascular complications in T2DM • No definitive study • Some studies suggest protective against eyes and kidney complications • Others not Exercise and mental health and T2DM Measure Quality of life Well-being Depression Anxiety Type of exercise Number of studies Results Aerobic Five no effect, improvement Anaerobic Four no effect, improvement Mixed Ten no effect, improvement Aerobic Three showed improvement, did not Anaerobic Two showed improvement other did not Mixed One No effect Aerobic Two Both improved Anaerobic One Improved Mixed One No effect Aerobic One Reduced anxiety Anaerobic None - Mixed None - Chapter 26, Textbook of Diabetes Lifestyle Issues: Exercise MZ Chen & R.C Andrews Supervised exercise and Beta cell function In type DM regular exercise improves beta cell function Dela F et al Am J Physiol Endocrinol Metab 2004 What about real world studies? “Running a red light does not count You still need to get more exercise.” Look ahead study 5,145 randomised (56.9% of those screened) 2,570 Intensive lifestyle intervention 2463 DM support & education Weekly behavioral group Calorie controlled diet with meal replacement Home based exercise programme Orlistat after 6/12 if needed group sessions in year Look ahead Diabetes Care 2007 Jun;30(6):1374-83 Percentage reduction in HbA1c Change HbA1c -1 P