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Diabetes, Physical Activity and Exercise
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Diabetes, Physical Activity and Exercise

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 21097

Special Issue Editors

Dr. Harald Sourij

E-Mail Website
Guest Editor
Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, 8010 Graz, Austria
Interests: diabetology; exercise; glucose metabolism
Special Issues, Collections and Topics in MDPI journals
Dr. Othmar Moser

E-Mail Website
Guest Editor
Center of Sports Medicine & Sports Orthopedics, University Outpatient Clinic, University of Potsdam, Am Neuen Palais 12, 14469 Potsdam, Germany
Interests: diabetology; exercise; glucose metabolism
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Physical activity and exercise have different beneficial effects on health in the general population. Furthermore, in different chronic diseases, it has been shown that physical activity and exercise have therapeutic effects similar to those seen in pharmaceutical therapies. Especially in metabolic diseases like type 1 and type 2 diabetes, the evidence for being physically active is overwhelming, with improvements in glycemic control, cardiovascular outcomes, functional capacity, body mass index, quality of life, and mortality rates, as examples. Although these positive effects of physical activity and exercise are well described in the literature, the glycemic management around exercise still seems to be challenging, particularly in people with type 1 diabetes. Furthermore, limited data are available about the interplay of novel antidiabetic agents like GLP-1 agonists and SGLT2-2 inhibitors and exercise.

In this Special Issue titled “Diabetes, Physical Activity and Exercise”, we are seeking original data and reviews on type 1 and type 2 diabetes covering topics including but not limited to the following:

  • Glycemic management around physical activity and exercise;
  • Chronic metabolic and cardiovascular effects of physical activity and exercise;
  • Interplay of pharmacological treatment and physical activity and exercise;
  • Considerations of dietary interventions and physical activity and exercise;
  • Physical activity, exercise and mental health;
  • Hypoglycaemia, hypoglycaemia unawareness and physical activity;
  • Physiological aspects of physical activity and exercise;
  • Technology, physical activity and exercise.

Dr. Harald Sourij
Dr. Othmar Moser
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • exercise
  • physical activity
  • diabetes
  • glycemic management
  • antihyperglycemic drugs
  • dietary intervention
  • cardiovascular disease

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Published Papers (6 papers)

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Research

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12 pages, 718 KiB  
Article
Usefulness of Aerobic Exercise for Home Blood Pressure Control in Patients with Diabetes: Randomized Crossover Trial
by Keiko Iwai, Emi Ushigome, Kazufumi Okada, Isao Yokota, Saori Majima, Naoko Nakanishi, Yoshitaka Hashimoto, Hiroshi Okada, Takafumi Senmaru, Masahide Hamaguchi, Mai Asano, Masahiro Yamazaki and Michiaki Fukui
J. Clin. Med. 2022, 11(3), 650; https://doi.org/10.3390/jcm11030650 - 27 Jan 2022
Viewed by 1829
Abstract
Hypertension usually coexists with diabetes mellitus and significantly increases the risk of macrovascular complications. Blood pressure measured at home, especially nocturnal blood pressure, is particularly important because it is more strongly associated with target organ damage than clinical blood pressure measurements. Regular moderate [...] Read more.
Hypertension usually coexists with diabetes mellitus and significantly increases the risk of macrovascular complications. Blood pressure measured at home, especially nocturnal blood pressure, is particularly important because it is more strongly associated with target organ damage than clinical blood pressure measurements. Regular moderate aerobic exercise has been shown to have anti-hypertensive effects. This study aimed to investigate the effects of aerobic exercise on home blood pressure in patients with diabetes. This randomized crossover trial was based on outpatient treatment at a university hospital. In this randomized crossover trial, 124 patients with type 2 diabetes were randomly assigned to two groups over 56 days: an exercise preceding group (exercise intervention for 28 days and then no exercise intervention for the following 28 days) and an exercise lagging group (no exercise intervention for 28 days and then exercise intervention for the following 28 days). The associations between the nocturnal blood pressure and exercise intervention were assessed accordingly. A decrease in blood pressure was observed in the morning and evening, at 2 a.m. and 3 a.m. after exercise intervention; however, there was no significant difference between groups. Moderate exercise was not effective in lowering nocturnal blood pressure in this study. Full article
(This article belongs to the Special Issue Diabetes, Physical Activity and Exercise)
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16 pages, 4775 KiB  
Article
Similar Adaptations to 10 Weeks Concurrent Training on Metabolic Markers and Physical Performance in Young, Adult, and Older Adult Women
by David C. Andrade, Marcelo Flores-Opazo, Luis Peñailillo, Pedro Delgado-Floody, Johnattan Cano-Montoya, Jaime A. Vásquez-Gómez and Cristian Alvarez
J. Clin. Med. 2021, 10(23), 5582; https://doi.org/10.3390/jcm10235582 - 27 Nov 2021
Cited by 3 | Viewed by 2500
Abstract
It has been proposed that the combination of high-intensity aerobic exercises and resistance training (RT) known as concurrent training (CT) could improve metabolic syndrome (MetS) markers, and that the exercise mixture in CT could dampen muscle anaerobic pathways, a result known as the [...] Read more.
It has been proposed that the combination of high-intensity aerobic exercises and resistance training (RT) known as concurrent training (CT) could improve metabolic syndrome (MetS) markers, and that the exercise mixture in CT could dampen muscle anaerobic pathways, a result known as the interference effect. However, there is scarce evidence on its effects in women across different ages. Therefore, we sought to determine the effects of a 10-week CT intervention on MetS markers and endurance performance in adult women and compared age-related differences between young, adult, and older participants. A total of 112 women with >1 MetS risk factors were included in the study. Participants were allocated to different groups according to the following cutoff age ranges: 20–29years (y), n = 25; 30–39y, n = 35; 40–49y, n = 43; and 50–59y, n = 53. Participants performed 10 weeks of CT, including resistance training (RT), involving six major muscle groups, and high-intensity interval training (HIIT) in a cycle ergometer. Anthropometric, cardiovascular, metabolic, and performance outcomes were assessed before and after the intervention. The CT induced significant improvements in waist circumference (WC) (20–29y: –2.5; 30–39y: –4.1; 40–49y: –4.2; 50–59y: –2.8 Δcm) and the distance achieved in the six-minute walking test (6Mwt) (20–29y: +47.6; 30–39y: +66.0; 40–49y: +43.0; 50–59y: +58.6 Δm) across all age groups, without significant differences between groups. In addition, a significant correlation was found between 6Mwt and WC, independent of age. In conclusion, our results showed that a 10-week CT intervention improved MetS risk factors in women, suggesting that the beneficial effects promoted by CT are independent of age and confirming CT as an effective, age-independent training regimen to improve metabolic health in women. Full article
(This article belongs to the Special Issue Diabetes, Physical Activity and Exercise)
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11 pages, 520 KiB  
Article
Clinical and Dietary Determinants of Muscle Mass in Patients with Type 2 Diabetes: Data from the Diabetes and Lifestyle Cohort Twente
by Annis C. Jalving, Milou M. Oosterwijk, Ilse J. M. Hagedoorn, Gerjan Navis, Stephan J. L. Bakker and Gozewijn D. Laverman
J. Clin. Med. 2021, 10(22), 5227; https://doi.org/10.3390/jcm10225227 - 10 Nov 2021
Cited by 1 | Viewed by 2012
Abstract
Low muscle mass in patients with type 2 diabetes is associated with a progressively higher risk of morbidity and mortality. The aim of this study was to identify modifiable targets for intervention of muscle mass in type 2 diabetes. Cross-sectional analyses were performed [...] Read more.
Low muscle mass in patients with type 2 diabetes is associated with a progressively higher risk of morbidity and mortality. The aim of this study was to identify modifiable targets for intervention of muscle mass in type 2 diabetes. Cross-sectional analyses were performed in 375 patients of the Diabetes and Lifestyle Cohort Twente-1 study. Muscle mass was estimated by 24 h urinary creatinine excretion rate (CER, mmol/24 h). Patients were divided in sex-stratified tertiles of CER. To study determinants of CER, multivariable linear regression analyses were performed. Protein intake was determined by Maroni formula and by a semi-quantitative Food Frequency Questionnaire. The mean CER was 16.1 ± 4.8 mmol/24 h and 10.9 ± 2.9 mmol/24 h in men and women, respectively. Lower CER was significantly associated with older age (p < 0.001) as a non-modifiable risk factor, whereas higher BMI (p = 0.015) and lower dietary protein intake (both methods p < 0.001) were identified as modifiable risk factors for lower CER. Overall body mass index (BMI) was high, even in the lowest CER tertile the mean BMI was 30.9 kg/m2, mainly driven by someone’s body weight (p = 0.004) instead of someone’s height (p = 0.58). In the total population, 28% did not achieve adequate protein intake of >0.8 g/kg/day, with the highest percentage in the lowest CER tertile (52%, p < 0.001). Among patients with type 2 diabetes treated in secondary care, higher BMI and low dietary protein intake are modifiable risk factors for lower muscle mass. Considering the risk associated with low muscle mass, intervention may be useful. To that purpose, dietary protein intake and BMI are potential targets for intervention. Full article
(This article belongs to the Special Issue Diabetes, Physical Activity and Exercise)
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Review

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12 pages, 598 KiB  
Review
Physiological Responses to Combat Sports in Metabolic Diseases: A Systematic Review
by Max Lennart Eckstein, Melanie Schwarzinger, Sandra Haupt, Nadine Bianca Wachsmuth, Rebecca Tanja Zimmer, Harald Sourij, Paul Zimmermann, Beate Elisabeth Maria Zunner, Felix Aberer and Othmar Moser
J. Clin. Med. 2022, 11(4), 1070; https://doi.org/10.3390/jcm11041070 - 18 Feb 2022
Cited by 1 | Viewed by 2547
Abstract
The aim of this systematic review was to investigate how individuals with metabolic diseases respond to combat sports and if they are feasible, safe, and applicable. A systematic literature search was conducted in PubMed, from inception until 22 January 2021. Studies were included [...] Read more.
The aim of this systematic review was to investigate how individuals with metabolic diseases respond to combat sports and if they are feasible, safe, and applicable. A systematic literature search was conducted in PubMed, from inception until 22 January 2021. Studies were included if combat sport exercise sessions were clearly defined and participants had the following types of metabolic disease: type 1 or 2 diabetes mellitus, metabolic syndrome, overweight, and obesity. Eleven studies, involving 472 participants of all age groups with type 1 diabetes mellitus, metabolic syndrome, overweight, or obesity were included in this systematic review. No studies involving combat sports and individuals with type 2 diabetes were found. Combat sports showed improved HbA1c levels over time in individuals with type 1 diabetes mellitus, which was not significantly different compared to the control group (p = 0.57). During the follow-up period, glycaemic variability decreased in those actively participating in combat sports. Fat-mass was higher in athletes performing combat sports with metabolic syndrome, compared to athletes without an increased cardiometabolic risk. In overweight/obese adolescents, combat sports showed improved parameters of physical fitness, cardio autonomic control, strength, and body composition compared to control groups. In all studies included in this systematic review, no adverse event associated with combat sports was reported. In conclusion, combat sports are safe and feasible in individuals with diabetes and/or obesity. For individuals with type 2 diabetes mellitus, no recommendations can be made, due to the lack of evidence in this cohort. Future studies investigating combat sports and metabolic diseases should aim for a structured exercise regimen and acknowledge the experience of the participants prior to starting an exercise intervention involving combat sports. Full article
(This article belongs to the Special Issue Diabetes, Physical Activity and Exercise)
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22 pages, 375 KiB  
Review
The Application of Exercise Training for Diabetic Peripheral Neuropathy
by Clifton J. Holmes and Mary K. Hastings
J. Clin. Med. 2021, 10(21), 5042; https://doi.org/10.3390/jcm10215042 - 28 Oct 2021
Cited by 21 | Viewed by 6681
Abstract
Diabetic peripheral neuropathy (DPN) is the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes. It is associated with pain, paresthesia, sensory loss, muscle atrophy with fat infiltration, and muscular dysfunction typically starting [...] Read more.
Diabetic peripheral neuropathy (DPN) is the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes. It is associated with pain, paresthesia, sensory loss, muscle atrophy with fat infiltration, and muscular dysfunction typically starting distally in the feet and progressing proximally. Muscle deterioration within the leg and foot can lead to muscle dysfunction, reduced mobility, and increases the risk of disability, ulceration, and amputation. Exercise training is an established method for increasing the different components of physical fitness, including enhancing body composition and improving neuromuscular strength. A number of experimental studies have utilized exercise training to treat various impairments associated with DPN, such as nerve conduction velocity, pain tolerance, and balance. However, the broad spectrum of exercise training modalities implemented and differences in target outcome measurements have made it difficult to understand the efficacy of exercise training interventions or provide appropriate exercise prescription recommendations. Therefore, the aims of this review were to (1) briefly describe the pathophysiology of DPN and (2) discuss the effects of exercise training interventions on sensorimotor, metabolic, and physical functions in people with DPN. Full article
(This article belongs to the Special Issue Diabetes, Physical Activity and Exercise)
12 pages, 1630 KiB  
Review
Time in Range for Closed-Loop Systems versus Standard of Care during Physical Exercise in People with Type 1 Diabetes: A Systematic Review and Meta-Analysis
by Max L. Eckstein, Benjamin Weilguni, Martin Tauschmann, Rebecca T. Zimmer, Faisal Aziz, Harald Sourij and Othmar Moser
J. Clin. Med. 2021, 10(11), 2445; https://doi.org/10.3390/jcm10112445 - 31 May 2021
Cited by 35 | Viewed by 4562
Abstract
The aim of this systematic review and meta-analysis was to compare time in range (TIR) (70–180 mg/dL (3.9–10.0 mmol/L)) between fully closed-loop systems (CLS) and standard of care (including hybrid systems) during physical exercise in people with type 1 diabetes (T1D). A systematic [...] Read more.
The aim of this systematic review and meta-analysis was to compare time in range (TIR) (70–180 mg/dL (3.9–10.0 mmol/L)) between fully closed-loop systems (CLS) and standard of care (including hybrid systems) during physical exercise in people with type 1 diabetes (T1D). A systematic literature search was conducted in EMBASE, PubMed, Cochrane Central Register of Controlled Trials, and ISI Web of Science from January 1950 until January 2020. Randomized controlled trials including studies with different CLS were compared against standard of care in people with T1D. The meta-analysis was performed using the random effects model and restricted maximum likelihood estimation method. Six randomized controlled trials involving 153 participants with T1D of all age groups were included. Due to crossover test designs, studies were included repeatedly (a–d) if CLS or physical exercise interventions were different. Applying this methodology increased the comparisons to a total number of 266 participants. TIR was higher with an absolute mean difference (AMD) of 6.18%, 95% CI: 1.99 to 10.38% in favor of CLS. In a subgroup analysis, the AMD was 9.46%, 95% CI: 2.48% to 16.45% in children and adolescents while the AMD for adults was 1.07% 95% CI: −0.81% to 2.96% in favor of CLS. In this systematic review and meta-analysis CLS moderately improved TIR in comparison to standard of care during physical exercise in people with T1D. This effect was particularly pronounced for children and adolescents showing that the use of CLS improved TIR significantly compared to standard of care. Full article
(This article belongs to the Special Issue Diabetes, Physical Activity and Exercise)
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