Endocrine

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May the force be with you: why resistance training is essential for subjects with type 2 diabetes mellitus without complications

  • Roberto Codella
  • Marta Ialacqua
  • Ileana Terruzzi
  • Livio Luzi
Review

Abstract

Physical activity, together with diet and pharmacological therapy, represents one of the three cornerstones in type 2 diabetes mellitus treatment and care. The therapeutic appeal of regular physical activity stems from: (i) its non-pharmacological nature; (ii) its beneficial effects on the metabolic risk factors associated with diabetes complications; (iii) its low costs. Evidence accumulated in the last years suggests that aerobic training—endurance training—constitutes a safe modality of intervention, achievable, and effective in diabetes treatment, whenever it is not limited by comorbidities. Aerobic training exerts insulin-mimetic effects and has been shown to lower mortality risk too. Anaerobic, intense physical activity, such as that of strength or power sports disciplines, is not univocally recognized as safe and simple to realize, however, it is important in stimulating energy and glucose metabolism. According to recent evidence, high-intensity training may be prescribed even in the face of cardiovascular diseases, peripheral vascular disease, or osteoarthritis. Some studies have shown resistance training to be more efficient than aerobic exercise in improving glycemic control. This review explores the most up-to-date indications emerging from literature in support of the beneficial effects of strength stimulation and resistance training in patients with type 2 diabetes without complications.

Keywords

Resistance training Strength Type 2 diabetes Glycemic control 

Abbreviations

ACSM

American College of Sports Medicine

ADA

American Diabetes Association

AE

aerobic exercise

AMPK

phosphorylated adenosine monophosphate-activated protein kinase

ATP

adenosine triphosphate

AKT

protein kinase B

CaMKII

calmodulin-dependent protein kinase II

BMI

body mass index

DSME

diabetes self-management education

ECG

electrocardiogram

ESSA

Exercise and Sport Science Australia

GLP-1

glucagon-like peptide

GLUT4

glucose transporter 4

GSK3β

glycogen synthase kinase 3β

HbA1c

glycosylated hemoglobin

HDACs

histone deacetylases

HRM

maximum heart rate

IDF

International Diabetes Federation

Ig

immunoglobuline

IL

interleukin

LPS

lipopolysaccharide

MEF2

myocite enhancer factor 2

mTOR

mammalian target of rapamycin

NAFLD

nonalcoholic fatty liver disease

PI3K

phosphatidylinositol 3 kinase

PGC-1α

peroxisome proliferator-activated receptor-gamma coactivator 1α

PRT

progressive resistance training

1RM

one repetition maximum

RT

resistance training

T1D

type 1 diabetes

T2D

type 2 diabetes

TCA

tricarboxylic acid

TNF

tumor necrosis factor

TPE

therapeutic patient education

WHO

World Health Organization

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

All authors were responsible for drafting the manuscript and revising it critically for valuable intellectual content. All authors approved the version to be published.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Roberto Codella
    • 1
    • 2
  • Marta Ialacqua
    • 1
  • Ileana Terruzzi
    • 3
  • Livio Luzi
    • 1
    • 2
  1. 1.Department of Biomedical Sciences for HealthUniversità degli Studi di MilanoMilanItaly
  2. 2.Metabolism Research Center, IRCCS Policlinico San DonatoSan Donato MilaneseItaly
  3. 3.Diabetes Research Institute, Metabolism, Nutrigenomics and Cellular Differentiation UnitSan Raffaele Scientific InstituteMilanItaly

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