Structured exercise interventions for type 2 diabetes mellitus: Strength of current evidence

Exercise, along with medical nutrition therapy and pharmacological interventions, is an important component in the clinical management of type 2 diabetes mellitus. Current clinical guidelines on Type 2 diabetes provide no detailed information on the modalities of effective exercise intervention in the treatment of Type 2 diabetes. Both endurance and resistance types of exercise seem to be equally effective in improving metabolic control in patients with Type 2 diabetes. Determining the best method of providing exercise is clinically relevant to this population. This paper reviews the epidemiology of diabetes and problems of physical function associated with Type 2 diabetes and discuss the benefits of exercise therapy on the parameters of glycemic control and function in Type 2 diabetes patients, with special reference to Asian Indians. Based on the currently available literature, it is concluded that Type 2 diabetes patients should be encouraged to participate in specifically designed exercise intervention programs. Attention should be paid to the avoidance of cardiovascular and musculoskeletal deconditioning. More clinical research is warranted to establish the efficacy of different dosages of exercise intervention in a holistic approach for Type 2 diabetes sub-populations within different stages of the disease and various levels of co-morbidity.