Via practica 2/2020

Physical activity recommendations in the management of patients with obesity and type 2. diabetes

A lack of physical activity that characterizes lifestyle of modern society leads to increased visceral adiposity and sarcopenia, which accelerate dysfunction of systemic energy metabolism, including glucose metabolism. Low physical fitness and increased intake of energetically dense and nutritionally unbalanced food determine pandemic proportions of obesity, prediabetes and type 2 diabetes. Metabolic dysfunction plays a key role in the pathogenesis of type 2 diabetes, but it also substantially contributes to the prevalence of many other chronic noncommunicable diseases, including cardiovascular, neurodegenerative or oncologic diseases. Physical inactivity has been identified as one of the key modifiable lifestyle factors with the profound effect on global morbidity and mortality. On the other hand, ample evidence points at beneficial effects of regular exercise on the parameters of energy metabolism, muscle strength and cardiorespiratory fitness. Large scale intervention trials provide evidence on the effectivity of a complex lifestyle modification in prevention of type 2 diabetes, on the long-term sustainability of the elicited health benefits in individuals complying with the long-term intervention programs and even on type 2 diabetes remission in the early phases of disease. The aim of our work is to point at an important role of regular exercise in the prevention and treatment of individuals with obesity and type 2 diabetes and to present the evidence that the adequate dose of physical activity can influence the whole spectrum of comorbidities and chronic diabetes complications, including atherosclerosis or cognitive dysfunction, in parallel with improving metabolism. Thus, introduction of the recommendations and endorsement of the prescription of the individualized physical activity programs represent one of the cornerstones in the management of patients with obesity, prediabetes or type 2 diabetes.

Keywords: physical activity recommendation and prescription, obesity, type 2 diabetes, sarcopenia, energy & glucose metabolism