Evidence summary (Updated 2022)
Those with type 2 diabetes have lower fitness levels than those without . Observational studies have shown that regular exercise is associated with improved fitness and lower risk of all-cause and CV mortality in those with type 2 diabetes ?[2-5].
A more recent systematic review which analysed 10 randomised controlled trials showed that high intensity interval training can improve cardiovascular fitness, however, caution is advised to avoid a sudden increase in level of physical activity due to increased risk of cardiovascular death . HIIT training has showed a cardiac protective role in diabetic patients by reducing cardiac output by 21%, stroke volume by 13%, heart rate by 9% and improves left ventricular function by improving left ventricular filling and emptying during exercise . Aerobic exercise and/or a higher intensity exercise will lead to improvement in the quality of life of heart failure patients with T2DM . Exercise also improves inflammatory profile, helps to lower LDL cholesterol and can prevent deterioration in LDL and total cholesterol profile .
Quality of Evidence
Grade A – High Quality
Strength of recommendation
Grade 1 – Strong recommendation
Recent evidence review has strengthened the evidence that physical activity in particular high intensity exercise such as HIIT has shown an overall improvement in cardiac function in diabetic patients, thereby reducing complications related to the heart. However, caution is advised to avoid a sudden increase in level of physical activity due to increased risk of cardiovascular death.
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 Sargeant, J.A., Yates, T., McCann, G.P., Lawson, C.A., Davies, M.J., Gulsin, G.S. and Hen- son, J., 2018. Physical activity and structured exercise in patients with type 2 diabetes mellitus and heart failure. Practical Diabetes, 35(4), pp.131-138b.
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