Reviewing the Impact of Physical Activity on Type 2 Diabetes

This literature review examines the significance of physical activity as an intervention for combating Type 2 Diabetes Mellitus, particularly in adults, alongside medication. It analyzes multiple research articles to assess how physical exercise regulates glucose levels compared to a sedentary lifestyle. The review covers the benefits of physical activity, such as reducing cardiovascular diseases and improving glycemic control, while also addressing limitations like the lack of knowledge among doctors in prescribing exercise therapy and the challenges faced by physically fragile patients. Specific studies highlight the effectiveness of aerobic and resistance exercises, as well as lifestyle interventions, in managing T2D and reducing cardiovascular risk factors. The review also acknowledges the economic and social burdens of T2D and the difficulties in implementing scalable and sustainable intervention approaches, especially in regions with poor education systems. Ultimately, it emphasizes the importance of lifestyle modifications, including regular physical activity, in preventing and managing Type 2 Diabetes.

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Type 2 Diabetes
Introduction
Type 2 diabetes is a metabolic disease in the body that causes the blood glucose level
to upsurge higher than standard, which is also referred to as hyperglycemia. Diabetes
Mellitus Type 2 is the most common type of diabetes, which approximately affects 90% of
the patients. It was referred to us as "adult- onset" diabetes in the past due to its diagnosis that
was done later in life. Recently, more children than adults are being diagnosed with a defect
due to the increased rate of infancy obesity. The symptoms and signs often develop
gradually; thus, it may take a long duration for an individual to discover that he has diabetes.
The signs and symptoms constitute of fatigue, heightened hunger, blurry vision, recurrent
urination, unplanned weight loss, and recurrent diseases.
Diabetes Mellitus Type 2 is triggered by the failure of the body to utilize the Insulin that
has been produced by the pancreas. On that note, the body cells can convert the glucose from
the food that we consume into energy; however, the cells are unable to utilize the glucose due
to the condition known as the insulin resistance. This state leads to sugar build up in the
bloodstream. This disorder does not have a cure, but it can be managed through engaging in
physical activities, proper diet, and loosing of weight. Diabetes Mellitus Type 2 is caused by
metabolic syndrome, extra weight, genes, broken beta cells, and bad communication amid
cells.
The purpose of this literature is to justify the significance of adults engaging in physical
activities as part of the intervention in combating Diabetes Mellitus Type 2 despite the use of
medication. Moreover, it will aid to assess whether physical exercise regulates the build-up of
glucose in the body as contrasted with a sedentary lifestyle.

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Article 1
Balducci, S., Sacchetti, M., Haxhi, J., Orlando, G., D'errico, V., Fallucca, S., Menini, S. and
Pugliese, G., 2014. Physical exercise as therapy for type 2 diabetes mellitus.
Diabetes/metabolism research and reviews, 30(S1), pp.13-23.
A sedentary lifestyle contributes to the build-up of glucose level in the bloodstream of
adults diagnosed with type 2 diabetes. According to Balducci et al., (2014, 1), this article
focuses on the benefits that emerge due to physical activity as an intervention plan for the
management of the type 2 diabetes. In addition, the script summarizes the principles of
physical activity therapy for the patients that are suffering from diabetes mellitus type 2 both
in terms of monitoring and prescribing. It grants details of physical activities that are used in
long- term research thus illustrates the factors that are used during clinical practice. The
routine physical activity that the patients with T2D ought to be able to engage without any
physical affliction includes various activities that are involved in both leisure and
occupational duration. The activities comprise of housework, gardening and walking.
The benefits that have been attributed from the article are that physical activities reduce
cardiovascular diseases (CVD), mortality in patients, and advance glycemic control. Exercise
is commended for the organization of type 2 diabetes (T2D) (Gatt et al., 2009, 32). Moreover,
this research article recommended walking to be a unique form of physical activity that has
been demonstrated by several studies in the reduction of the risk to CVD, T2D, and mortality.
The parameters that are relevant to exercise therapy are illustrated in terms of duration,
intensity, frequency, rate, and mode of progression which is a long term therapeutic
prescription (Hansen et al., 2018, 48).
The limitations that were reviewed in the article is that the majority of the doctors are
unwilling to prescribe physical activities as a remedy for diabetes mellitus type 2 patients.

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This is because the majority of the doctors lack the knowledge on the implementation of
physical exercise therapy, especially in long -term workout routines. On the other hand, the
other routine physical activities like housework and gardening had limited evidence in
regards to the risk reduction on patients with T2D. Patients with T2D, however, can
physically be fragile, thus making it challenging to participate in the physical activities that
have been recommended by the doctor.
Article 2
Chudyk, A. & Petrella, R.J. 2011, Effects of exercise on cardiovascular risk factors in type 2
diabetes: a meta-analysis, Diabetes care,34 (5), pp. 1228-37.
Contrary, it has been noted that they are some of the challenges that may hinder the T2D
patients from actively engaging in the physical activities, which is one of the efficient risk
intervention plan apart from medication. In regards to this article, Chudyk & Petrella, (2011,
5) illustrates the effects of workout on cardiovascular risk features in T2D. These articles
focus on the impact of the work out on cardiovascular risk factors in T2D that is unclear
despite it being the vital management intervention plan for mitigating the effects of diabetes.
The strength of the research is based on universal reviewing of literature between 1970
and 2009 that justifies that aerobic workouts alone or mixed with resistance physical activity
enhances the SBP control, glycemic, waist circumference, and triglycerides. The resistance
training is beneficial because it facilitates rapid burning of calories on patients that have
developed T2D due to obesity (Yang et al., 2014, 44).
However, the shortcomings that were evident from the research is the unclear impact of
resistance workouts independently on cardiovascular risk fabricators in T2D. Thus resistance
exercise alone is not much effective in regulating glucose level in the body (Teychenne et al.,
2015, 105).

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Article 3
Zanuso, S., Jimenez, A., Pugliese, G., Corigliano, G. and Balducci, S., 2010. Exercise for the
management of type 2 diabetes: a review of the evidence. Acta diabetologica, 47(1),
pp.15-22.
Despite the unclear impacts of the resistance exercise when performed alone, we
discovered that they are evidence that needs to be revised in the management of T2D. In
regards to Zanuso et al. (2010, 1) the article targets to disparagingly review more evidence
that is relevant to the affiliation amid metabolic outcomes and exercise. Exercise is the
immediate management strategy that is often advised by the doctors from the patients that
have freshly been diagnosed with T2D.
The review indicates that the impacts of aerobic exercise can be well developed; thus,
vigorous aerobic exercise programs can lead to a high increase in insulin sensitivity and
VO2max. In addition, resistance training is seen to be an efficient intervention plan in the
control of glycemic. Combined exercise training appears to define the additional variation in
HbA1c as contrasted to resistance and aerobic training independently (Liu et al., 2015, 27).
Exercise training has been noted to improve regulation of glucose regardless of it being
resistance, aerobic, or combined training. High-intensity interval training is time efficient and
beneficial since it is effective. Physical activities in adults are crucial and useful because it
regulates the danger of developing insulin resistance, impaired glucose, and T2D. High
energy expenditure has the upper hand in reversing obesity that is affiliated with T2D, thus
boosting the insulin act through the short-term impacts.
The negative impacts that have been discovered in this study article due to intense aerobic
exercise include reduction of the HbA1c. On the other hand, T2D was termed to be the
significant economic and communal health burden in the 21st century; therefore the majority

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of the people in the globe are affected by T2D, and the population of the patients keeps
growing up due to the economic pressures in the majority of the nations. There is a challenge
in the management and treatment of the T2D due to inferior intervention approaches that
have been established; hence, they are not scalable, sustainable, affordable, and efficacious.
Low cardiovascular activities increase the mortality rate of T2D.
Article 4
Herbst, A., Kapellen, T., Schober, E., Graf, C., Meissner, T., Holl, R.W. and DPV‐Science‐
Initiative, 2015. Impact of regular physical activity on blood glucose control and
cardiovascular risk factors in adolescents with type 2 diabetes mellitus–a multicenter study
of 578 patients from 225 centres. Pediatric diabetes, 16(3), pp.204-210.
Adults engaging in low physical activities results in negative impacts that are not
recommended by specialists. Nevertheless, according to Herbst et al. (2015, 3), systematic
physical activity has an effect on cardiovascular peril factors and blood glucose control in
patients with T2D. This article evaluates the affiliation amid metabolic control, regular
physical activity, treatment routines, and metabolic risk factors.
The strength of the research justifies that engaging in regular exercise activities is the
appropriate intervention plan that is beneficial for T2D patients. Daily physical activities
have been evidenced to improve the health and regulate the danger of obese, non-
communicable infections, some types of cancers, and cardiovascular diseases. Aerobic
exercise enhances the uptake of the insulin-stimulated glucose and reduction in the blood
glucose level.
The limitation that has been noted from this article is that a vast population of people that
are subjected to T2D are at higher risk of developing CVD or to perish due to hitches that are
affiliated to CVD. Moreover, according to meta-analyses, patients with T2D that often

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engage in systematic physical activities have reduced the effect of HbA1c (Yardley et al.,
2014, 106). There is no firm association amid metabolic control and physical activities; thus,
the lifestyle that the patients live has an impact on the T2D.
Article 5
Chen, L., Pei, J.H., Kuang, J., Chen, H.M., Chen, Z., Li, Z.W. and Yang, H.Z., 2015. Effect
of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism,
64(2), pp.338-347.
Lifestyle intervention is a crucial step in T2D patients. Therefore, Chen et al., (2015, 2)
elaborate on this article the impacts on lifestyle intercession on clinic risk dynamics in
patients with T2D is still unclear. The significance function of meta-analysis in this concept
was to determine the effects that emerge due to the broad lifestyle change. This lifestyle
change may comprise of the education, work out and diet on medical fabricators that are
danger dynamics for CVD in patients that have T2D.
The benefits that were obtained from the research article through the use of meta-analysis
elaborated the significance of lifestyle intercession in regulating the risk dynamics that are
associated with the CVD (Naci et al., 2018, 273). In the event that a person has been
diagnosed with T2D, effective lifestyle intervention will be essential since it will prolong the
life span of the patients hence it will lower the cholesterol level and blood glucose level in the
body (Schellenberg et al., 2013, 109). The intervention period is shorter, thus making it more
reliable and less economical. The research proved that lifestyle intervention programs might
be useful in regulating the fasting plasma glucose level in obese patients. Lifestyle
modification is recommended as T2D therapy in adults apart from the use of medications,
exercise, and engaging in physical activities (Huan et al., 2016, 27). The standard lifestyle
modification will lead to the reduction of cardiovascular risk factors and enhanced glycemic

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control. Lifestyle intervention interrupts the inception and reduces the risk of developing T2D
in the body.
On the other hand, we discovered that sedentary lifestyle in adult's propagates the effects
of T2D. Thus the patients who have been diagnosed with T2D are advised to avoid the
sedentary lifestyle because it will increase the risk factors of the CVD causing death if not
properly managed (Balducci et al., 2012, 22). The challenging aspect of lifestyle intervention
is the localized regions in the globe that have poor education systems. Thus advocating for
lifestyle changes in these regions will be hectic since the residents both the elderly and the
young lack educational background of the T2D (Creamer et al., 2016, 33). Accumulation of
body fat triggers the release of insulin in the body which is affiliated to T2D and CVD.
Article 6
Winnick, J.J., Sherman, W.M., Habash, D.L., Stout, M.B., Failla, M.L., Belury, M.A. and
Schuster, D.P., 2008. Short-term aerobic exercise training in obese humans with type 2
diabetes mellitus improves whole-body insulin sensitivity through gains in peripheral, not
hepatic insulin sensitivity. The Journal of Clinical Endocrinology & Metabolism, 93(3),
pp.771-778.
Body fat accumulation has got numerous negative impacts on the health of an individual
since it triggers the release of insulin, which can cause T2D. This study article in regards to
Winnick et al., (2008, 3) emphasize the impacts that emerge from short-term, aerobic
exercise program in people who are obese. Therefore, the T2D enhances the insulin
sensitivity of the body through the use of the peripherals. The purpose of the study is to
determine the impacts of aerobic exercise working out on hepatic and peripheral insulin
sensitivity throughout hyperinsulinemic compress state.

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The process was prosperous; thus, It was noted that exercise workouts did not affect the
peripheral glucose uptake during the truncated – dose insulin. In addition, it did not change
the endogenous glucose generation during the elevated dose-insulin. Nonetheless, exercise
workouts for seven days improved peripheral and the entire body level of insulin sensitivity.
Therefore, the enhancement of the insulin sensitivity in the body has been contributed by the
short- term aerobic workouts, which are as a result of the peripherals and not the sensitivity
of hepatic insulin. Short -term workouts impact the production of insulin; thus, it suppresses
the production of hepatic glucose. Work-out programs facilitated the enhancement of the
action of insulin in the absenteeism of weight loss. Workouts play a vital part in the treatment
and prevention of the insulin resistance that leads to the development of T2D (Dart, Nguyen,
and Colditz, 2016, 173). Moreover, workouts have short -term impacts that enhance the
insulin action that aids to reverse and mitigate obesity. Work out improves the glucose
transporter 4 in skeletal muscles, and as this impact gets exhausted, it is substituted by the
upsurge in sensitivity of insulin.
The limitation that was noted from the research is that hepatic insulin sensitivity in adults
is not propagated due to engagement the short term aerobic workouts.
Discussion
The research has evidenced that Physical activity in the adults to be suitable intervention
plan that needs to be adopted and enhanced in mitigation and treatment of T2D (Sigal et al.,
2018, 44). This is because physical therapy aids to improve the quality of life and as well as
maintain the therapeutic goals.
In order to mitigate the impact of T2D in adults, it is essential to reduce the sedentary
time. Therefore it is advisable for the adults that have T2D to minimize the amount of time
that they utilize on routine sedentary behavior. The prolonged sitting practice among the
adults should be avoided by engaging in light activities after 30 minutes to regulate the blood

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glucose level in the body. Increased rate of morbidity and mortality is associated with a high
amount of sedentary time amid the adults. Daily exercise is essential; hence, the adults should
not allow a minimum of two days to elapse without working out to improve the insulin
action. Resistance and aerobic exercise are ideal for adults with T2D for optimal health
outcomes and glycemic.
The research is not in opposition to the recent practice guidelines; thus, physical exercise
remedy is being deliberated for consent as a recommended treatment in the US by the Food
and Drug Administration (FDA). This is because physical intervention plan targets a larger
population and is effective as compared to the dietary modifications and pharmacological
therapies that are majorly focused on individual patients.
They are risks that are affiliated with physical therapy in the management of T2D. On that
note their some work out precautions that people with T2D should take into considerations.
This precaution enables patients with diabetes to keep away from problems that can lead to
unreasonable work out decisions. This condition can be detrimental when the patient has
consumed too much capsule comparative to work out when he has consumed too little
carbohydrate comparative to work out and joined impacts of medication and food imbalances
on relative to the workouts. These prescriptions are essential to patients who take medication
(Mendes et al., 2016, 22).
Adequate knowledge has been obtained from the research; hence, no specific aspect needs
more clarification. The cause, mitigation, and treatment measures for patients with T2D have
been broadly researched and elaborated.
Conclusion

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In conclusion, physical activities have been evidence to be a suitable intervention plan for
the management of adults developing T2D since it involves daily activities such as walking.
Therefore, it is crucial for patients to be aware of their blood sugar level, before doing
workouts. This is because it is dangerous to exercise when blood sugar is high and can lead to
CVD complications. Consumption of plenty of water before, during, and after workouts is
recommended for diabetic patients since it keeps their body hydrated.
References

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Balducci, S., Sacchetti, M., Haxhi, J., Orlando, G., D'errico, V., Fallucca, S., Menini, S. and
Pugliese, G., 2014. Physical exercise as therapy for type 2 diabetes mellitus.
Diabetes/metabolism research and reviews, 30(S1), pp.13-23.
Balducci, S., Zanuso, S., Cardelli, P., Salvi, L., Bazuro, A., Pugliese, L., Maccora, C.,
Iacobini, C., Conti, F.G., Nicolucci, A. and Pugliese, G., 2012. Effect of high-versus low-
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of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism, 64(2),
pp.338-347.
Chudyk, A. & Petrella, R.J. 2011, Effects of exercise on cardiovascular risk factors in type 2
diabetes: a meta-analysis, Diabetes care,34 (5), pp. 1228-37.
Creamer, J., Attridge, M., Ramsden, M., Cannings‐John, R. and Hawthorne, K., 2016.
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cardiovascular risk factors in adolescents with type 2 diabetes mellitus–a multicenter study of
578 patients from 225 centres. Pediatric diabetes, 16(3), pp.204-210.
Huang, X.L., Pan, J.H., Chen, D., Chen, J., Chen, F. and Hu, T.T., 2016. Efficacy of lifestyle
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Winnick, J.J., Sherman, W.M., Habash, D.L., Stout, M.B., Failla, M.L., Belury, M.A. and
Schuster, D.P., 2008. Short-term aerobic exercise training in obese humans with type 2
diabetes mellitus improves whole-body insulin sensitivity through gains in peripheral, not
hepatic insulin sensitivity. The Journal of Clinical Endocrinology & Metabolism, 93(3),
pp.771-778.
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22.

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