Overview of Exercise Prescription for Diabetes Patients and Its Application in Japan
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REVIEW ARTICLE
Overview of Exercise Prescription for Diabetes Patients and Its Application in Japan Yuzo Sato1 Received: 18 December 2019 / Accepted: 22 March 2020 © The Author(s) 2020
Abstract In recent years, the Westernization of dietary habits and increasingly sedentary lifestyle have contributed to a marked increase in the number of type 2 diabetes patients. Sedentary behavior may play a significant role in the development and aggravation of type 2 diabetes. The results of various follow-up studies have demonstrated that proper diet combined with physical exercise is useful in the prevention and treatment of type 2 diabetes. A nationwide survey regarding exercise therapy for diabetes patients in Japan revealed that relatively few physicians provide patients with exercise guidance because of time constraints, that the physicians do not receive additional consultation fee, and that there is a lack of specialized physical exercise educators. Physical exercise promotes the utilization of glucose and free fatty acids in the muscles, and thus lowers blood glucose (BG) levels. Dietary restriction and physical exercise are effective in the prevention and treatment of type 2 diabetes by improving the in vivo sensitivity to insulin. Most adults with diabetes should engage in 150 min or more of moderate-tovigorous intensity aerobic activity per week, spread out over at least 3 days/week, with no more than two consecutive days without activity. Mild-intensity resistance training such as half squat and calf raise is recommended for elderly individuals who have decreased muscle strength and mass (sarcopenia). Prolonged sitting should be interrupted every 30 min for BG benefits, particularly in adults with type 2 diabetes. Individuals with type 2 diabetes are also encouraged to increase their total daily unstructured physical activity (daily movement). Keywords Diabetes mellitus · Exercise prescription · Sedentary behavior · Aerobic exercise · Resistance exercise · Nationwide survey
Introduction Diabetes is a worldwide pandemic. According to the International Diabetes Federation (IDF), diabetes is a growing global problem. The number of deaths due to diabetes is 1.3 million and diabetes-related expenditure in adults (20–79 years) reaches 120.3 billion in the Western Pacific Region (2017). Furthermore, the number of diabetes patients has been predicted to increase from 163 million (2019) to 212 million (2045) in the Western Pacific Region [13]. Diabetes mellitus can be classified into the following four categories: type 1 diabetes, type 2 diabetes, gestational diabetes, and specific types of diabetes due to other causes [1].
In Japan and China, most diabetes patients are type 2. Decreased insulin secretion and insulin resistance play important roles in the occurrence and progression of type 2 diabetes. Insulin resistance is exacerbated by aspects of the modern, westernized lifestyle such as overeating (high-fat diet), sedentary state, and stressful daily life [27]. Several major randomized controlled trials, including th
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