Louay Labban
Diabetes Mellitus is considered a major chronic disease and its complications have become a main cause of morbidity and mortality worldwide. The goal of treatment in type 2 diabetes is to achieve and maintain optimal BG, lipid, and blood pressure (BP) levels to prevent or delay chronic complications of diabetes. Many people with type 2 diabetes can achieve BG control by following a nutritious meal plan and exercise program, losing excess weight, implementing necessary self-care behaviors, and taking oral medications, although others may need supplemental insulin. Recently, studies have started to focus on the relationship between exercise and Insulin dependent Diabetes Mellitus (IDDM). Several studies have shown reduced insulin dosage with increased physical activity along with better glycemic control. In fact, moderate to vigorous activity has been associated with greater overall fitness, an increased fat free mass, and decreased glycosylated hemoglobin (HbA1c) levels in people with type 1 DM. That exercise could act by protecting islets during the onset of the disease, because in animal models of type 2 DM, long-term aerobic exercise resulted in increased islet ?-cell proliferation, increased ?-cell mass, and a partial sparing of the abnormal islet morphology noted in the sedentary diabetic rats. Exercise blocked the age-associated morphological changes in the pancreas, including multi lobulated, fibrotic islets. BG reductions are related to the duration and intensity of the exercise, pre exercise control, and state of physical training. Although previous PA of any intensity generally exerts its effects by enhancing uptake of BG for glycogen synthesis and by stimulating fat oxidation and storage in muscle, more prolonged or intense PA acutely enhances insulin action for longer periods. Women diagnosed with GDM are at substantially increased risk of developing type 2 diabetes; therefore, PA may be considered a tool to prevent both GDM and possibly type 2 diabetes at a later date.
