THE ROLE OF EXERCISE AND DIET IN THE PREVENTION AND TREATMENT OF TYPE II DIABETES

The role of exercise and diet in the prevention and treatment of Type II Diabetes

The Role of Exercise

Introduction

Diabetes is a major issue for the global health care and is growing rapidly. Medical professionals can expect to spend a large portion of their time caring for diabetic patients in inpatient and outpatient settings as the prevalence of this disease increases steadily (Fowler, 2010). The American Diabetes Association (ADA) no longer recommends classification of diabetes based on treatment of hyperglycemia, but rather on the underlying mechanism involved for example insulin resistance, insulin deficiency and other aspects of disease process. This is because our understanding of diabetes has deepened, the diagnostic criteria and classification scheme of diabetes has now changed.

ADA has revised its criteria for the diagnosis of diabetes in 1997. This classification diagnoses diabetes based on fasting glucose level. It specifies that individuals have diabetes if they 1) have symptoms of diabetes such as polyuria, polydipsia, or unexplained weight loss and a random plasma glucose measurement > 200 mg/dl or 2) have a fasting plasma glucose > 126 mg/dl or a 2-hour plasma glucose level > 200 mg/dl after consumption of 75 g of glucose (Fowler,2007).

The most common of the types of diabetes is Type 2 diabetes, which is a diverse group of conditions that make up approximately 90% of all diabetes cases. This type was previously known as non-insulin-dependent diabetes (NIDD) or adult-onset diabetes. It involves insulin resistance and relative insulin deficiency as opposed to absolute insulin deficiency which is seen in type 1 diabetes.

Results from the Diabetes Control and Complications Trial (DCCT) and the U.K. Prospective Diabetes Study (UKPDS) persuasively demonstrated the importance of glycemic control and Physical Activity in reducing the complications of diabetes (Franz et al, 2002). In both trials, nutrition therapy for management of diabetes was important in achieving treatment goals and not only addresses glycemic control but other aspects of metabolic status as well, including dyslipidemia and hypertension—major risk factors for cardiovascular disease. This is important, as macrovascular complications are the major contributors to the morbidity and mortality associated with diabetes (Haffner, 1998)

Recommendations for diabetes now focus on lifestyle goals and strategies for the treatment of diabetes. Currently recommendations specifically address lifestyle approaches to diabetes prevention or delaying the onset of diabetes.

Literature Review

Extensive research has been conducted over the past decades on diabetes, its causes prevention and treatment.

A systematic search of electronic databases (Medline, PubMed etc) also searching keywords (evidence, exercise , physical activity , diet, diabetes) in search engine Google scholar was performed for articles between 1999 and 2009 investigating the effect of exercise and diet on diabetes. This was then divided into review papers and observational, experimental or randomised controlled studies.

Only English language reports that involved adult human populations were included.

Recent guidance from health agencies was also consulted for information and to identify further studies.

The searches identified significant numbers of relevant studies which needed to be lessened ...