• Diabetic – mean fasting glucose levels is >125 mg/dl
• Pre-diabetic – between 100 mg/dl and 125 mg/dl
• Normal – less 100 mg/ml
• Decreased risk of developing diabetes if you exercise
o Increased physical activity of >3 hours per
week = 70% risk reduction for diabetes
compared to those who did not
• Reduction of weight loss must be associated with a
healthy nutritional pattern
• Can improve:
o Insulin sensitivity
o Endothelial function
o Autonomic NS function
Diabetes and exercise impairment
• Loss of cardiorespiratory fitness and exercise tolerance
• Accentuates the bp response to exercise
• Reduces oxygen uptake by 15%
Due to:
• Reduced heart rate variability
• Left ventricular dysfunction
• Lower lung capacity
• Factors are sex-dependent
o In females, diabetes had a worsened effect compared to females
Diabetes exaggerates exercise effort
• Mind shift – more difficult for TIID women to exercise compared
to non-TIIP diabetes who are obese
• Measured perception of exertion with exercise (how quickly they
get tired)
• Feeling of exhaustion was quicker in TIID
Benefits of exercise
• Promote weight loss and increases muscle strength ® improved mechanisms of glucose control
because you have an increase in glucose sensitivity
• Improves cardiovascular fitness
o Improved blood flow and blood pressure
• Improves cholesterol levels (beneficial to reduce risk of atherosclerotic plaque formation)
• Releases stress (oxidative stress reduction, diminishes risk of atherosclerotic plaque)
• Increases feeling of well-being
o Release of endorphins (happy chemicals)
o Helps with anxiety
o Reduces stress
, o Better sleep
o Improves self-confidence
o Improves workflow
• Circadian misalignment – increases both diastolic and systolic blood pressure
o Decreases epinephrine expression, lacking stimulation of PNS that could decrease the bp
o An increase in pro-inflammatory markers and a decrease in anti-inflammatory markers
• Influences the supply of leukocytes and lipids in the circulation
• Influences the behaviour of endothelial cells, smooth muscle cells, and macrophages in the vessel
o Mediate atherosclerosis
• Vasoconstriction due to an increase in bp
Effects of insulin sensitivity and resistance
• Reduces oxidative stress
• Reduces glycated haemoglobin
• Modulates GLUT4 translocation
• Reduces inflammation
Changes in cellular NO, Scavenger and ROS levels in relation to physical activity:
No exercise (sedentary lifestyle) Free radicals ® stress ® glycated proteins
Moderate exercise Minimal stress to your body = body’s defence
mechanism is active
• Body produces scavengers (catalase) ®
mops up free radicals (counters the
oxidative stress
• Increase in NO, scavengers and ROS
Strenuous exercise Too much exercise leads to the accumulation
of free radicals = massive increase in ROS (and
oxidative stress)
• Strenuous exercise for diabetics, monitor
and assess limits because exercise can be
harmful