Po1187 Physical Exercise In Type 2 Diabetes

Ana Neto1 e Diana Neto2
1USF Forte; 2USF Venda Nova
Introduction: Diabetes Mellitus is a chronic disease whose prevalence is increasing. The prevalence of diabetes in 2012 is 12.9% of the Portuguese population aged between 20 and 79 years, which corresponds to an estimated 1 million people. Exercise is considered a mainstay of therapy for diabetes with a proper diet and drug therapy.
Objective: The work aims to review the importance of physical exercise in type 2 Diabetes.
Methods: It was performed a survey of clinical of systematic reviews (SR), meta-analysis (MA), randomized clinical trials (RCTs) and guidelines on the basis of UptoDate, The Cochrane, Medline, published in the last 10 years, in English and Portuguese languages, using the Mesh Terms: ” Physical activity AND type 2 Diabetes Mellitus”. Research was carried out also in the Portuguese Society of Diabetology, American Diabetes Association (ADA) and Diabetes Care sites. Articles were selected according to the interest for the proposed target. To evaluate the results, the taxonomy SORT (Strength of Recommendation Taxonomy) of American Family Physician was used.
Results: Of the 42 studies found, we selected 8 studies: 2 guidelines, 2 SR, 3 RCTs, 1 MA. The transport of glucose for skeletal muscle cells is done by GLUT4 and several studies have shown that it is stimulated by insulin and exercise by independent pathways although this mechanism is not yet well understood. However, it is known that physical exercise increases the tissue sensitivity to insulin, helps reduce blood pressure, decrease body fat and reduce the progression of patients with impaired oral glucose tolerance to type 2 Diabetes. The prescription of exercise for the diabetic patient should take into account specific situations such as prevention and control of hypoglycaemia or adjustment of the exercise to the Diabetes associated co-morbidities. The ADA recommends the practice of moderate-intensity exercise: about 30 to 45 minutes hike in 3 / 5 days a week and resistance exercise with a duration of 20 minutes at least twice a week.
Conclusion: Exercise is a key aspect of treatment of type 2 diabetes (SORT A) by increasing insulin sensitivity, helping to decrease fat mass and increase muscle mass, improving the more common risk factors for cardiovascular disease in diabetic patients and also glycaemic control. Despite these benefits, exercise is still under-valued and physicians have the important role to encourage and integrate it into daily routine of diabetic patients.
type 2 diabetes mellitus; exercise.