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Perspectives

Exercise in prediabetes and type 2 diabetes: moving beyond advice

Callum J. Baker, Nathan A. Johnson

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Abstract

Exercise can reduce the level of health risk in people with prediabetes and type 2 diabetes. However, merely advising patients to exercise is not enough – appropriate screening and management are required to ensure the safety and efficacy of the prescribed exercise program.

Key Points

  • Lifestyle intervention involving regular exercise reduces the risk of adults with prediabeties progressing to type 2 diabetes.
  • Regular aerobic or resistance exercise, either alone or in combination, can improve glycaemic control in type 2 diabetes. Improvements are superior for people who achieve or exceed current exercise guidelines.
  • Regular exercise also improves common comorbidities in type 2 diabetes (e.g. hypertension, dyslipidaemia, abdominal fatness and mental health).
  • Providing people only with advice to engage in exercise is associated with poor patient adherence and has little effect on markers of glucose control.
  • Appropriate pre-exercise screening and management of comorbidities and medication interactions is required for safe and effective exercise programs for people with type 2 diabetes, including blood glucose management during and after exercise.
  • Referral to an accredited exercise physiologist is recommended before starting a new exercise regimen, or significantly changing a current one. This includes consideration of comorbidities and diabetes complications such as and microvascular disease, when exercise may need to be modified or is contraindicated.

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