Exercise benefits patients with type 2 diabetes
Moderate-intensity exercise reduces fat stored around the heart, in the liver and in the abdomen of people with type 2 diabetes mellitus, even in the absence of any changes in diet, according to a new study published online in the journal Radiology.
Type 2 diabetes occurs when the body does not produce enough insulin, a hormone that regulates the movement of sugar into the cells, or when the cells resist the effects of insulin. The disease can lead to a wide range of complications, including damage to the eyes and kidneys and hardening of the arteries.
Exercise is recommended for people with diabetes, but its effects on different fat deposits in the body are unclear, according to the study’s senior author, Hildo J. Lamb, M.D., Ph.D., from the Department of Radiology at Leiden University Medical Center in the Netherlands.
“Based on previous studies, we noticed that different fat deposits in the body show a differential response to dietary or medical intervention,” he said. “Metabolic and other effects of exercise are hard to investigate, because usually an exercise program is accompanied by changes in lifestyle and diet.”
For the new study, Dr. Lamb and colleagues assessed the effects of exercise on organ-specific fat accumulation and cardiac function in type 2 diabetes patients, independent of any other lifestyle or dietary changes. The 12 patients, average age 46 years, underwent MRI examinations before and after six months of moderate-intensity exercise totaling between 3.5 and six hours per week and featuring two endurance and two resistance training sessions. The exercise cycle culminated with a 12-day trekking expedition.
MRI results showed that, although cardiac function was not affected, the exercise program led to a significant decrease in fat volume in the abdomen, liver and around the heart, all of which have been previously shown to be associated with increased cardiovascular risk.
“In the present study we observed that the second layer of fat around the heart, the peracardial fat, behaved similarly in response to exercise training as intra-abdominal, or visceral fat,” Dr. Lamb said. “The fat content in the liver also decreased substantially after exercise.”
Dr. Lamb noted that the exercise-induced fat reductions in the liver are of particular importance to people with type 2 diabetes, many of whom are overweight or obese.
Exercise is safe - and highly recommended - for most people with type 2 diabetes, including those with complications. Along with diet and medication, exercise will help you lower blood sugar and lose weight.
However, the prospect of diving into a workout routine may be intimidating. If you’re like many newly diagnosed type 2 diabetics, you may not have exercised in years.
If that’s the case, don’t worry: It’s fine to start slow and work up. These tips will help you ease back into exercise and find a workout plan that works for you.
As long as you’re totaling 30 minutes of exercise each day, several brief workouts are fine, says George Griffing, MD, professor of endocrinology at the Saint Louis University School of Medicine in St. Louis.
“We need people with diabetes up and moving,” Dr. Griffing says. “If you can do your exercise in one 30 minute stretch, fine. But if not, break it up into increments you can manage that add up to at least 30 minutes each day.”
“The liver plays a central role in regulating total body fat distribution,” he said. “Therefore, reduction of liver fat content and visceral fat volume by physical exercise are very important to reverse the adverse effects of lipid accumulation elsewhere, such as the heart and arterial vessel wall.”
The findings point to an important role for imaging in identifying appropriate treatment for patients with type 2 diabetes, which the World Health Organization projects to be the seventh leading cause of death worldwide by 2030.
“In the future, we hope to be able to use advanced imaging techniques to predict in individual patients which therapeutic strategy is most effective: diet, medication, exercise, surgery or certain combinations,” Dr. Lamb said.
Why is exercise important?
As well as strengthening the cardiovascular system and the body’s muscles, many people exercise to keep fit, lose or maintain a healthy weight, sharpen their athletic skills, or purely for enjoyment.
Frequent and regular physical exercise is recommended for people of all ages as it boosts the immune system and helps protect against conditions such as:
Heart disease
Stroke
Type 2 diabetes
Cancer and other major illnesses
In fact, it is known to cut your risk of major chronic illnesses/diseases by up to 50% and reduce your risk of early death by up to 30%.
Other health benefits of exercising on a regular basis include:
Improves mental health
Boosts self esteem/confidence
Enhances sleep quality and energy levels
Cuts risk of stress and depression
Protects against dementia and Alzheimer’s disease
Furthermore, exercise is free, can be carried out anywhere at anytime and has an immediate effect on your health.
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“Exercise and Type 2 Diabetes Mellitus: Changes in Tissue-Specific Fat Distribution and Cardiac Function.” Collaborating with Dr. Lamb were Jacqueline T. Jonker, M.D., Pieter de Mol, M.D., Suzanna T. de Vries, M.D., Ralph L.Widya, M.D., Sebastiaan Hammer, M.D., Ph.D., Linda D. van Schinkel, M.D., Rutger W. van der Meer, M.D., Ph.D., Rijk O.B. Gans, M.D., Ph.D., Andrew G. Webb, Ph.D., Hermien E. Kan, Ph.D., Eelco J.P. de Koning, M.D., Ph.D., and Henk J.G. Bilo, M.D., Ph.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.
RSNA is an association of more than 51,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
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Linda Brooks
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Radiological Society of North America