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Exercise and Type 2 diabetes: the metabolic benefits and challenges

Diane Cooper & Donal J O Gorman

Regular exercise is known to decrease the risk of all-cause mortality, improve insulin sensitivity and decrease blood glucose in patients with Type 2 diabetes. These improvements have been associated with increased skeletal muscle glucose disposal and a decreased hepatic glucose production. In recent times exercise has been linked to improved cognitive function and a reduced risk of dementia. In addition, the changes in hepatic gene expression are very rapid and suggest a direct impact of exercise. Therefore, the benefits of exercise may be more wide ranging than previously believed. Despite the known benefits it has been a challenge to influence policy makers to incorporate exercise into the management of Type 2 diabetes. This is partly owing to a lack of randomized controlled trials to determine the optimal exercise prescription and the variability in study design. In order to affect an increase in daily physical activity there is a need to develop new screening and monitoring tools to provide individual guidelines.