Which type of physical activity has the greatest impact on blood glucose levels in patients with pre-DM?

Rate our content: Aguarde enquanto o login é efetuado

There was an error making your request , please try again!

Your evaluation is essential for us to continue improving the Pebmed Portal

Do you want to access this and other content in full?

Register for Free

Already registered? Make your login

Login or register for free to have unlimited access to all articles, clinical cases and tools on the PEBMED Portal

The PEBMED Portal is intended for doctors and health professionals. Our contents inform recent panoramas of medicine.

If you are interested in publishing your curriculum on the internet, connecting with patients and increasing your differentials, create a free profile on AgendarConsulta, the partner site of PEBMED.

THE physical activity is almost always within the list of basic guidelines that we pass on to patients with different purposes, and in many these times the recommendations are made vaguely and without a clear intention. Furthermore, despite having learned in the medical course that the daily practice of exercise brings benefits, we often do not question the real impact of these and what outcomes we are thinking about avoiding when we guide such measure to a specific patient.

A good example of the positive impact of physical activity is pre-diabetes (diagnosed with altered fasting blood glucose levels, between 100 and 125 mg/dL, or glycated hemoglobin – HbA1c – between 5.7% and 6.4%), a situation that substantially increases the risk of developing diabetes in the years subsequent ones. To avoid the risk of progression, measures such as lifestyle change (MEV) and metformin have been evaluated in classic studies such as the 2002 DPP published in the NEJM. At a mean follow-up of 2.8 years, there was a 58% reduction in the incidence of DM in the SEM group compared to 31% in the metformin group (both compared to usual care), ie, SEM was superior to metformin in reducing incidence of DM. The SEM consisted of changes in diet, frequent reassessments made by professionals who monitored the patients, and moderate-intensity physical activity 150 minutes/week.

Know more : Pre-pregnancy BMI and physical activity: is there an increased risk of type 1 diabetes in the offspring?

atividade física

Make the best clinical decisions, update yourself. Sign up and access medical content written and peer-reviewed for free

  • But what is the best type of physical activity?

    Seeking a more definitive answer on the subject, a systematic review with meta-analysis was recently published in BMC Endocrine Disorders whose objective was to evaluate what would be the best type of physical activity to advise when considering DM2 prevention in pre-DM patients. For this, the authors selected studies whose intervention was aerobic physical activity (AAA), resistance activity (RA) or both compared with control activity (CA), which consisted of explaining the benefits of physical activity but without recommending its performance. The evaluated outcomes were fasting glucose (FG), HbA1c, BMI and insulin resistance, assessed by the HOMA-IR index. In the end, 13 articles, published between 1998 and 2019, were selected, totaling 567 participants from different countries. Most studies had a mean follow-up of 12 weeks.

    Meta-analysis indicated that AAA or RA can reduce to HbA1c significantly when compared to AC. There was a small difference between AAA and AR, but not significantly in the direct meta-analysis:

    • Aerobic activity (AAA) vs. control (AC): mean difference: – 0.673 (-0.94 to -0.4, 95% CI)

    • Resisted activity vs. control (AC): mean difference: – 1.001 (-1.358 to – 0.64, 95% CI)

    • Resisted Activity (AR) vs. aerobic activity (AAA): mean difference: 0.27 (-0.2 to 0.7, 95% CI)
    • Read also: Eating fruits daily may decrease the risk of developing diabetes type 2?

      Conclusions

      Although it does not exactly specify the effect of exercise on diabetes prevention, this meta-analysis showed evidence of its positive impact on the reduction of HbA1c in different modalities. Both aerobic activity and resistance activity and the association between them impact on the improvement of glycated levels in participants with pre-DM. This is important because we have evidence to recommend the activity that best fits the patient’s profile in face of other comorbidities that they present or even physical limitations for a certain type of exercise.

      Bringing it to clinical practice, we must make it clear that physical activity is a fundamental part of the treatment, whether it is for which way the patient prefers, but as long as it is done with adequate frequency and intensity.

      Author:

      Resident Physician (R4) in Endocrinology (HCFMUSP) ⦁ Telemedicine at Hospital Israelita Albert Einstein (HIAE) ⦁ Medical residency in Internal Medicine at the Faculty of Medicine of the University of São Paulo ( FMUSP) ⦁ Graduated in Medicine from the São Paulo State University Júlio de Mesquita Filho (UNESP) – Botucatu School of Medicine ⦁ Instagram: @luiz_ffvieira

      References :

    • Huang L, Fang Y, Tang L. Comparisons of different exercise interventions on glycemic control and insulin resistance in prediabetes: network meta-analysis. BMC Endocr. 2021 Sep 6;21(1):181. doi: 10.1186/s12902-021- 00846-y. PMID: 34488728; PMCID: PMC8422751.
    • See more benefits of being a PEBMED Portal user: See more benefits of being a user from the PEBMED Portal:

      *)

      7 days free with the Whitebook Application made for you, the doctor, designed to bring security and objectivity to your clinical decision.

      Free access to the Nursebook Access fundamental information for your daily life such as anamnesis, semiology.

      Access free Forum Space for exchanging experiences and constructive comments on topics related to Medicine and Health.

      Unlimited access Have access to news, studies, updates and more content written and reviewed by experts

      Test your knowledge Answer our quizzes and study in a simple and fun way

      Personalized content Receive studies, updates, new behaviors and other content segmented by special by email lities

      The PEBMED Portal is intended for physicians and health professionals. Our contents inform recent panoramas of medicine.

      If you are interested in publishing your curriculum on the internet, connecting with patients and increasing your differentials, create a free profile on AgendarConsulta, the partner site of PEBMED.

      Note: This article has been indexed to our site. We do not claim ownership or copyright of any of the content above. To see the article at the original source Click Here

      Related Posts
      Lockdown measures linked to an increase in drinking at home thumbnail

      Lockdown measures linked to an increase in drinking at home

      Credit: CC0 Public Domain Lockdown measures throughout 2020 have been linked to people in Scotland and England drinking more at home, according to new research. The latest study, from researchers at the University of Sheffield and University of Glasgow, measured the impact of COVID-19 restrictions in 2020 on drinking practices, using data on almost 300,000…
      Read More
      New BMW X3 Gets Diesel Option thumbnail

      New BMW X3 Gets Diesel Option

      The recently upgraded BMW X3 can now be specced with a diesel engine. It was launched in a petrol-only guise last month at prices starting from Rs 59.9 lakh (ex-showroom). The new diesel-powered X3 — the X3 xDrive20d — is, unlike its petrol counterpart, available only in one trim, the Luxury Line, and is priced…
      Read More
      Index Of News
      Total
      0
      Share