Type II Diabetes
Type II Diabetes is a major public health issue and in 2019, it was estimated that around the world more than 4 million deaths in people aged 20-79 were attributable to diabetes and it's complications. On an individual level, it has been estimated that a 50 year old with diabetes has a six year lower life expectancy than a similar person without diabetes.
This page is intended as a learning resource for those interested in the relationship between physical activity and Type II Diabetes.
Study Questions
Why is Diabetes a public health priority? (e.g. Seshasi et al, 2011)
What are the long-term health complications of hyperglycemia?
Describe how blood glucose is regulated.
What types of Diabetes exist and how do they vary?
What are the modifiable and non-modifiable risk factors for TIID?
What is the link between physical activity levels, sedentary lifestyles and the onset of TIID?
What are the links between activity levels, Cardiorespiratory fitness and strength and TIID?
What are the links between dietary intake and onset of TIID?
How can nutritional and physical activity changes impact the management of TIID?
How do different types of physical activity impact on the condition?
What medications are used to manage TIID and how do they work?
What is the relationship between excess body fat and TIID? How does this relationship vary across populations and individuals?
What is Insulin resistance and how does it link to TIID?
How does gender interact with the risk factors for TIID?
How does ethnic background interact with the risk factors for TIID?
How successful have interventions been in addressing TIID? (e.g. Gong et al, 2019; Lindstrom et al, 2013) How have these worked for different genders and ethnic groups?
Recommended Chapters
Gill, J.M.R. (2021) Type 2 Diabetes. In Stensel, D.J., Hardman, A.E. and Gill, J.M.R. Physical Activity and Health: The Evidence Explained. (3rd Ed) Routledge. [companion website]
Robinson, S. (2022) Diabetes. In Robinson, S. (2021). Priorities for Health Promotion and Public Health. Londen: Routledge.
Further Reading
Ashton, R. E., Tew, G. A., Aning, J. J., Gilbert, S. E., Lewis, L., & Saxton, J. M. (2020). Effects of short-term, medium-term and long-term resistance exercise training on cardiometabolic health outcomes in adults: systematic review with meta-analysis. British journal of sports medicine, 54(6), 341-348. http://dx.doi.org/10.1136/bjsports-2017-098970
Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses. PloS one, 13(3). doi: 10.1371/journal.pone.0194127
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., ... & Tate, D. F. (2016). Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079.
Hex, N., Bartlett, C., Wright, D., Taylor, M., & Varley, D. (2012). Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine, 29(7), 855-862.
Forouhi, N. G., & Wareham, N. J. (2019). Epidemiology of diabetes. Medicine, 47(1), 22-27. https://doi.org/10.1016/j.mpmed.2018.10.004
Gill, J. M., & Cooper, A. R. (2008). Physical activity and prevention of type 2 diabetes mellitus. Sports Medicine, 38(10), 807-824. https://doi.org/10.2165/00007256-200838100-00002
Gong, Q., Zhang, P., Wang, J., Ma, J., An, Y., Chen, Y., ... & Roglic, G. (2019). Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study. The lancet Diabetes & endocrinology, 7(6), 452-461. https://doi.org/10.1016/S2213-8587(19)30093-2
Harmer, A. R., & Elkins, M. R. (2015). Amount and frequency of exercise affect glycaemic control more than exercise mode or intensity. Br J Sports Med, 49(15), 1012-1014. http://dx.doi.org/10.1136/bjsports-2013-093225
Hemmingsen, B., Gimenez‐Perez, G., Mauricio, D., i Figuls, M. R., Metzendorf, M. I., & Richter, B. (2017). Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, (12). https://doi.org/10.1002/14651858.CD003054.pub4
Igarashi, Y., Akazawa, N., & Maeda, S. (2021). The relationship between the level of exercise and hemoglobin A1c in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Endocrine, 74(3), 546-558. https://doi.org/10.1007/s12020-021-02817-8
Karstoft, K., & Pedersen, B. K. (2016). Exercise and type 2 diabetes: focus on metabolism and inflammation. Immunology and cell biology, 94(2), 146.
Kirwan, J. P., Sacks, J., & Nieuwoudt, S. (2017). The essential role of exercise in the management of type 2 diabetes. Cleveland Clinic journal of medicine, 84(7 Suppl 1), S15. doi: 10.3949/ccjm.84.s1.03
Kumar, A. S., Maiya, A. G., Shastry, B. A., Vaishali, K., Ravishankar, N., Hazari, A., ... & Jadhav, R. (2019). Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Annals of physical and rehabilitation medicine, 62(2), 98-103. https://doi.org/10.1016/j.rehab.2018.11.001
Lindström, J., Peltonen, M., Eriksson, J. G., Ilanne-Parikka, P., Aunola, S., Keinänen-Kiukaanniemi, S., ... & Tuomilehto, J. (2013). Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS). Diabetologia, 56(2), 284-293. https://doi.org/10.1007/s00125-012-2752-5
Liu, Y., Ye, W., Chen, Q., Zhang, Y., Kuo, C. H., & Korivi, M. (2019). Resistance exercise intensity is correlated with attenuation of HbA1c and insulin in patients with type 2 diabetes: a systematic review and meta-analysis. International journal of environmental research and public health, 16(1), 140. https://doi.org/10.3390/ijerph16010140
Mendes, R., Sousa, N., Almeida, A., Subtil, P., Guedes-Marques, F., Reis, V. M., & Themudo-Barata, J. L. (2016). Exercise prescription for patients with type 2 diabetes—a synthesis of international recommendations: narrative review. Br J Sports Med, 50(22), 1379-1381. http://dx.doi.org/10.1136/bjsports-2015-094895
Mirahmadizadeh, A., Khorshidsavar, H., Seif, M., & Sharifi, M. H. (2020). Adherence to Medication, Diet and Physical Activity and the Associated Factors Amongst Patients with Type 2 Diabetes. Diabetes Therapy, 1-16. https://doi.org/10.1007/s13300-019-00750-8
Mozaffarian, D., Kamineni, A., Carnethon, M., Djoussé, L., Mukamal, K. J., & Siscovick, D. (2009). Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study. Archives of internal medicine, 169(8), 798-807.
O’Hagan, C., De Vito, G., & Boreham, C. A. (2013). Exercise Prescription in the Treatment of Type 2 Diabetes Mellitus. Sports Medicine, 43(1), 39-49.[abstract]
Polonsky, K.S. (2012) The Past 200 Years in Diabetes N Engl J Med 367:1332-1340 DOI: 10.1056/NEJMra1110560 [full text]
Qiu, S., Cai, X., Yang, B., Du, Z., Cai, M., Sun, Z., ... & Schumann, U. (2019). Association between cardiorespiratory fitness and risk of type 2 diabetes: A meta‐analysis. Obesity, 27(2), 315-324. https://doi.org/10.1002/oby.22368
Rydén, L., Grant, P. J., Anker, S. D., Berne, C., Cosentino, F., ... & Xuereb, R. G. (2013). ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). European heart journal, 34(39), 3035-3087. https://doi.org/10.1093/eurheartj/eht108
Sattar, N., & Gill, J. M. (2014). Type 2 diabetes as a disease of ectopic fat?. BMC medicine, 12(1), 1-6. https://doi.org/10.1186/s12916-014-0123-4
Schwarz, P. E., Greaves, C. J., Lindström, J., Yates, T., & Davies, M. J. (2012). Nonpharmacological interventions for the prevention of type 2 diabetes mellitus. Nature Reviews Endocrinology, 8(6), 363-373. https://doi.org/10.1038/nrendo.2011.232
Schwingshackl, L., Missbach, B., Dias, S., König, J., & Hoffmann, G. (2014). Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis. Diabetologia, 57(9), 1789-1797. https://doi.org/10.1007/s00125-014-3303-z
Seshasai, S.R., Kaptoge, S., Thompson, A., Di Angelantonio, E., Gao, P., Sarwar, N., ... & Emerging Risk Factors Collaboration. (2011). Diabetes mellitus, fasting glucose, and risk of cause-specific death. The New England journal of medicine, 364(9), 829-841. https://doi.org/10.1056/NEJMoa1008862
Smith, A. D., Crippa, A., Woodcock, J., & Brage, S. (2016). Physical activity and incident type 2 diabetes mellitus: a systematic review and dose–response meta-analysis of prospective cohort studies. Diabetologia, 59(12), 2527-2545. https://doi.org/10.1007/s00125-016-4079-0
Turner, G., Quigg, S., Davoren, P., Basile, R., McAuley, S. A., & Coombes, J. S. (2019). Resources to guide exercise specialists managing adults with diabetes. Sports medicine-open, 5(1), 1-12. https://doi.org/10.1186/s40798-019-0192-1
Umpierre, D., Ribeiro, P. A., Kramer, C. K., Leitão, C. B., Zucatti, A. T., Azevedo, M. J., ... & Schaan, B. D. (2011). Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA, 305(17), 1790-1799.
Valabhji, J., Barron, E., Bradley, D., Bakhai, C., Fagg, J., O’Neill, S., ... & Smith, J. (2020). Early outcomes from the English National health service diabetes prevention programme. Diabetes Care, 43(1), 152-160. https://doi.org/10.2337/dc19-1425
Zanuso, S., Jimenez, a, Pugliese, G., Corigliano, G., & Balducci, S. (2010). Exercise for the management of type 2 diabetes: a review of the evidence. Acta Diabetologica, 47(1), 15–22. doi:10.1007/s00592-009-0126-3 [full text]