Effects of Interval Training of Exercise on Prognosis of Type II Diabetes Mellitus

This paper investigates the effects of interval training of exercise on the prognosis of type II Diabetes Mellitus amongst the people aged in between 25 to 60. Literature review, aim of the study, methodology of the study and future plan are discussed.

Running head: DIABETES MELLITUS
Diabetes mellitus
Name of the student:
Name of the university
Author note:

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DIABETES MELLITUS
Table of Contents
Introduction:....................................................................................................................................2
Literature review:.............................................................................................................................3
Research question:...........................................................................................................................4
Aim:.................................................................................................................................................4
The objective of the study:..........................................................................................................5
Hypothesis:..................................................................................................................................5
Methodology:...................................................................................................................................5
Research design:..........................................................................................................................5
Ethical consideration:..................................................................................................................8
Future plans:....................................................................................................................................9
Limitation of the study:.................................................................................................................10
Expected outcome:.........................................................................................................................10
Reference:......................................................................................................................................11

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Introduction:
With the increased prevalence and incidents of diabetes type 2, diabetes has become an
epidemic problem that contributed to the premature mortality rate around the globe. A study by
Centres for Disease Control and Prevention reported that In 2007, approximately, 24 million
individuals in United Kingdome was suffering from the diabetes mellitus, and a considerate
number of individual have pre-diabetes where the blood glucose level is above normal (Xue et
al. 2018). Therefore, they are at higher risk of developing diabetes type II (mellitus) which will
further lead to other chronic diseases. Li et al. (2017) argued that type II diabetes is related to
chronic diseases such as blindness, kidney and liver disease and cardiovascular which leads to
premature morbidity. Due to high health expenditure, a significant number of individuals refuse
to seek the pharmacological help. However, very little work has been conducted over the years
that would show the non-pharmacological interventions that would reduce the prevalence of type
two diabetes. Papademetriou et al. (2017), reported that excising regularly associated with better
clinical outcomes. The exercise exhibit the improvement in the blood serum, mitochondrial
biosynthetic capacity and neurological benefits. Furthermore, it delayed the onset of diabetic
complications such as hyperglycaemia (Xue et al. 2018). Moreover, clinical applications of this
intervention is the potential barrier for achieving the full patient benefits is inadequate adherence
and lack of cost-effective interventions for a specific need for the aim. (Sallam et al. 2017) This
paper intended to investigate the effects of interval training of exercise on the prognosis of type
II Diabetes mellitus amongst the people aged in between 25 to 60 that will be conduct in between
April and May 2019.This investigation will aid in identifying the reason behind lack of
adherence to the exercise therapy as well as strategies to integrate it in the clinical practice. This

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paper will illustrate the literature review, aim of the study, the methodology of the study and
future plan in the following paragraphs.
Literature review:
According to Nowotny et al. (2017), approximately 24 million individual was affected by
diabetes mellitus ( type II). Accumulated evidence suggested that diabetes mellitus causes the
inadequate production of insulin in the peripheral tissue. Green et al. (2015), stated that in the
patient with type 2 diabetes can be physically weak and therefore, regular exercise is crucial
during walking, leisure time in order to manage the diabetes mellitus. Scheen (2015), argued that
physical exercise on the regular basis improves the control of blood glucose level and enhance
the lipid profile, blood pressure of the individuals that in turn influence the glucose metabolism.
The molecular biologist also exhibited that exercise at certain intervals enhances the metabolism
involving beta-oxidations, mitochondrial biogenesis, and glycolysis in the individuals (Portillo-
Sanchez et al. 2015). Thus, it potentially reduces or delays the onset of diabetic complications.
Sanchez-Rangel, and Inzucchi (2017), argued that exercising regularly reduces 58% risk of
developing diabetes mellitus in the population with high prediabetic symptoms. Portillo-Sanchez
et al. (2015), estimated that the percentage of the patient who is engaging in the exercise therapy
for management of the diabetes mellitus is approximately 40%. On a different note, only 28.4%
of the population were able to achieve a positive outcome after the exercise therapy.Therefore,
full adherence to physical activity as non-pharmacological interventions is essential for
achieving good interventions for the patient with diabetes mellitus. In the view point of Garber et
al. (2017), the intense exercise that lasts in between 1second to four seconds facilitates the
physiological changes in the body and influences the psychological well-being. Mann et al.

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(2012) showed that exercising regularly triggers the release of endorphin that binds to the
receptors that manage pain. Consequently, it reduces the feeling of pain in patients with diabetes
mellitus. The exercise therapy not only effective for the young population who has strong
physical health but also for the older individuals aged more than 65 years (Mann et al. 2017).
The reason behind it is that it also effective to reduce the mental health issues associated with
diabetes mellitus such as anxiety, major depressive disorder, and agitations (Espeland et al.
2015). However, due to the clinical benefits of physical exercise, poor adherence by the diabetes
patient has been the most identified barrier to the integration of physical exercise in the clinical
practice. A study by Fisher et al. (2018), suggested that the tendency of non-adherence to
physical exercise is mostly observed in the older populations due to weak physical status or
mobility issues. In the view of Low Wang et al. (2016), the lack of awareness and lack of
concrete clinical evidence as the non-adherence to the exercise therapy for managing the diabetes
mellitus in the population. Therefore, integrating interval exercise training in the clinical
practice long is crucial for managing patient with diabetes mellitus and individuals who are at
higher risk of developing diabetes mellitus at later stage of their life.
Research question:
Can adaptation of interval training promote better exercise adherence in the adults compared to
the traditional training of the individual for improving the clinical outcome of interventions?
Aim:
Since little evidence was found that showed the adherence of the interval training of
physical exercise, the aim of the study is to investigate the effectiveness of the interval training

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of exercise in promoting the adherence to the exercise therapy in the diabetic patient and also
evaluate the metabolic changes related to the beneficial outcome of the exercise.
The objective of the study:
 To investigate the effect of interval training of the exercise in promoting the adherence of
exercise therapy
 To evaluate the metabolic changes related to the beneficial outcome of the exercise.
 To recommend the ways to adhere to the exercise therapy for the better interventions
Hypothesis:
The null hypothesis for the study is the adaptation of the interval physical activities that
will greatly improve the adherence to the regular exercise activities amongst the diabetic patient
that will further eliminate the barriers that hinder the clinical exploitations of the beneficial
associations. The further theory suggested the effectiveness will be facilitated by better tolerance
and exercise by the clinical outcome and simplicity of the involve plan exercise.
Methodology:
Research design:
The qualitative approach will be taken for this investigation in order to obtain accurate
data for the investigations. the research will be conducted on the basis of library-based review
which will provide the analysis of the primary data from the various related relevant articles in

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order to evaluate how interval training of the physical exercise for enhancing the adherence o the
regular physical activity in the patient with Diabetes Mellitus. Specific inclusion and exclusion
criteria have been chosen as an outline for investigation of the effect of exercise which will help
in choosing the relevant article of relevant research as well as help in reducing the potential bias
which will minimize the accuracy of the investigation. the key term that will be used for the
research will include “exercise’, “glucose metabolism”, “exercise-induced metabolic changes”,
“, exercise adherence”, “exercise therapy” and “type II diabetes mellitus”.
The inclusion criteria and exclusion criteria for the study are following:
Inclusion criteria Exclusion criteria
 All relevant journal that will be
included must have been
published within last 10 years
 All relevant paper that will be
included in the study will be
peer review journal
 All relevant paper will be
included in the study will be
based on comparative study
design for comparing two
parameters.
 All relevant articles that will be
included in the study will be in
English language.
 All paper more than 10 years
will be excluded
 All non reviewed articles will
be excluded
 all articles lacking comparative
study design for comparing two
parameters will be excluded
 all articles published in other
than English article will be
excluded.
 All articles that published the
data work on other than human
subject will be eliminated.
 All paper which will discuss

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 All relevant paper that will be
included in the study will be
work on human subject.
 All relevant paper which will
discuss about the theories,
specific concepts will be
included.
other then theories, specific
concepts will be included.
The selected research articles which for investigation will be following:
Literature review table:
Name of the article Reference of the
article
Aim methods results
1. Exercise and type-2
diabetes: the American
College of Sports
Medicine and the
American Diabetes
Association: Joint
position statement
Colberg et al. 2010 To evaluate the
how physical
activity lower
the prevalence
of diabetes
Researchers
conducted
study on the
resistant
training and
aerobic.
Physical
exercise
improves the
insulin actions,
accomplished
with both
aerobic and
resistant
training.
2. , Improving patients’
adherence to physical
Qiu et al. 2012 To identify the
how physical
Researchers
conducted
The key
findings of the

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activity in diabetes
mellitus
activity lower
the prevalence
of diabetes and
come up with
interventions for
adherence to the
exercise
literature
review for
coming up
with
interventions
for better
management
and adherence
study are that
exercise
improves the
blood glucose
level and
cardiovascular
system.
Furthermore,
better adherence
techniques are
including
Education and
PA counselling,
Enhancement of
self-efficacy,
improvement
of social
environment
3. Interventions to
promote treatment
adherence in type-2
diabetes mellitus
Assande E, 2013 To identify the
how physical
activity lower
the prevalence
of diabetes and
come up with
interventions for
Researchers
conducted
literature
review for
coming up
with
interventions
The key
findings of the
study are that
exercise
improves the
blood glucose
level and

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DIABETES MELLITUS
adherence to the
exercise
for better
management
and adherence
with the help
of critical
appraisal tool
cardiovascular
system as well
improvement of
dietary changes.
Furthermore,
better adherence
techniques are
including self-
management
education, use
of adherence
aids and cue-
dose training
4.Non-pharmacological
interventions to reduce
the risk of diabetes in
people with impaired
glucose regulation
Gillett et al. 2012 To evaluate the
clinical
effectiveness
and cost-
effectiveness of
non-
pharmacologica
l interventions
such as physical
activity and
dietary changes
Researchers
conducted
literature
review of
paper of
randomized
trail control
using
MEDLINE
and EMBASE
The study
suggested that
non
pharmacologica
l intervention
reduced the
progression of
diabetes . best
outcome
observed in
patient who
were adhere to

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DIABETES MELLITUS
change of
lifestyle.
5. current perspectives
on physical activity and
exercise for youth with
diabetes
Pivovarov et al.
2015
To the benefits
of exercise and
reason behind
lack of
adherence to
exercise in the
paediatric
diabetes
population.
Researchers
conducted
literature
review on
peer reviewed
journal
The study
suggested The
study suggested
that exercise
management
algorithm for
insulin and
carbohydrate
intake strategy
can decrease the
progression
6. self-regulation
resources and physical
activity participation
among adults with type
II diabetes
Castonguay et al.
2017
To evaluate
how role of
self-regulation
and ego
depletion
influence lower
physical
activity.
Researchers
produced
literature
review on
effect of
physical
activity.
The study
suggested that
integrating self
regulation
training can
improve
physical
activity.
Without training
it lowers the
physical

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DIABETES MELLITUS
activity.
7. Exercise interval
training: an improved
stimulus for improving
the physiology of pre-
diabetes
Earnest 2008 To evaluate
how role of
Interval training
in improving
physiology of
diabetic patient.
Authors
conducted
literature
review on
peer reviewed
journal
The study
suggested that
physical intense
activity aerobic
metabolism, b-
oxidation,
mitochondrial
biogenesis.
Ethical consideration:
The study will conduct a library based research work and therefore no direct contact with
human participants will be included in the study. The data that will undertake in this study is pre-
existing data from the primary research work that selected based on the inclusion and exclusion
criteria, which presented in the method section above. The study may include the indirect contact
with the human participants for analysis of the personal or confidential data of primary research
work. The data collection of the investigation may involve certain sensitive and personal
disclosure but the investigation will maintain anonymity and confidentiality by adopting
appropriate data safety measures such as data coding and secure data storage. Furthermore,
during the study, no participates will be exposed to the health risk. None of the information to be
collected is anticipated to require a disclosure and barring service, DBS check thus will not
require a separate or specific ethical clearance.

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Future plans:
The next step of the study is to focus on seven journals extracted after research that was
eligible for the exclusion and inclusion criteria. The study will focus mainly on the comparative
studies that will show the comparison between two parameters such as interval training of
physical activities with other traditional therapy for the patients with diabetes mellitus. The study
will focus the data that elaborated the metabolic changes due to physical activities in the patient
with the diabetes mellitus. The study will explore the way of adherence to the exercise therapy
for managing the diabetes patient. the study will further conduct intense research for the
effectiveness of the physical activity. Moreover, the study will conduct the investigation
involving human participants during the data analysis for the effectiveness of the physical
activity and try to raise awareness in the community for adhering to the exercise therapy not only
for the patient who has diabetes mellitus. The research will try to gain social support for
improving adherence.
Time horizon:
Conceptualisation of the research
Key term database search
Research article selection
Critical study of selected articles
Analysis of the findings
Presentation of findings
Compilation of research
1-Apr 11-Apr 21-Apr 1-May 11-May

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Limitation of the study:
In the view point of Portillo-Sanchez et al. (2015), there bound to be a number of
limitations of a research study, no matter how well it is planned. The period is always a problem
or limitation in every research as well as availability of resources also remains a barrier to the
investigation. The selection biases of the research article are a potential limitation of the study.
However, the research has planned in most appropriate way for obtaining the result.
Expected outcome:
The expected outcome would be the improvement of the social support for adhering to
the regular physical activities as well as the improvement of the metabolic profile of these
patients. The finding of the work will be integrated into the clinical guideline of the management
plan of the diabetes mellitus patient. The research work will also aid in increasing awareness in
the population who refuse to follow the exercise therapy due to physical awareness. Furthermore,
the population with a high risk of developing hyperglycaemia, the investigation will help to
introduce the interval physical activities for lowering the progression of full-blown diabetes
without any pharmacological management. The investigation can further reduce health care
expenditure and global burden of the disease.

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Assande, e. 2013. Interventions to promote treatment adherence in type 2 diabetes mellitus.
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Castonguay, a., miquelon, p., & boudreau, f. 2018. Self-regulation resources and physical
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