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duration and intensity). Performing aerobic and anaerobic intensity exercise improved
glycemic control (0.51% and 0.38% of HbA 1
c reductions) in comparison
to the control group, respectively), though the improvement was better when both
were combined (additional 0.46% reduction).
The group assigned to the aerobic intensity training showed a higher weight
reduction as well as BMI reduction in comparison with the control group; the
combination of both types of exercise was not higher than that in each of the
interventions performed individually. The adverse effects were more frequent in
those patients who did exercise (musculoskeletal pain or traumatisms), though no
differences were observed as regards the hypoglycaemia stages. Although it is a
high quality trial, it does present extrapolation problems to other contexts.
The effects of exercise on morbimortality have been assessed in several
long-term cohort studies involving a wide range of population groups (99-103).
The inclusion criteria are variable as regards risk factors, cardiovascular disease
antecedents or pharmacological treatments followed. The interventions vary as
regards type and intensity of the exercise performed. The performance of continuous
aerobic physical exercise for more than 120 minutes per week reduces the risk
of coronary and cerebrovascular disease, both in women (100) and men (103).
Improved physical condition, associated with higher exercise intensity reduces
death risk (101), regardless of the obesity level (99).
Cohort
studies
2+
Evidence summary
2+ Physical exercise performed on a regular basis reduces the risk of coronary and cerebrovascular
disease (100; 103). Improved physical condition, associated with higher exercise
intensity reduces death risk (101), regardless of the obesity level (99).
1+ The aerobic and anaerobic intensity physical exercise programs are effective to improve
glycemic control (0.6% of HbA 1
c reductions) and can improve the response to insulin
and TG levels (97; 98).
1++ In DM 2 patients who are motivated and without severe complications, the combination
of aerobic and anaerobic intensity exercise is higher in each of the modalities individually
as regards the improvement of glycemic control (98).
1+ Most of the interventions consist of three sessions per week in non-consecutive days; the
exercise is performed under supervision and gradually (97; 98).
Recommendations
A
DM 2 patients are recommended to perform regular and continuous aerobic and anaerobic
intensive physical exercise, or preferably a combination of both. The recommended
frequency is three weekly sessions on alternate days, gradual as regards duration and
intensity and preferably, under supervision.
58 CLINICAL PRACTICE GUIDELINES IN THE NHS