Adding regular physical exercise to dietary interventions can have beneficial additive effects for patients with type 2 diabetes (T2D), according to a study published in the journal Nutrition, Metabolism and Cardiovascular Diseases.1 The authors of the study said knowledge on this issue is key to refining treatment strategies in T2D.
Lifestyle changes, including diet and exercise, play a fundamental role in improving diabetes outcomes. Both interventions have shown to help manage T2D by improving HbA1c levels and reducing the risk of cardiovascular events.2 Although previous research has shown the beneficial effects that diet and exercise can have on T2D outcomes, there is currently a lack of data on their combined effect in this patient population.
Put It Into Practice
Incorporate these strategies into your pharmacy practice to improve patient outcomes.
- Inform patients that adding regular physical exercise to a healthy diet can have additive benefits for managing type 2 diabetes.
- Explain that there are different exercise types based on individual patient capabilities and that more frequent exercise has greater benefits.
- Advise patients to maintain their exercise and diet routines over a long period of time to achieve sustained improvements.
“T2D is a chronic metabolic disease with steadily increasing prevalence,” the authors wrote. “By implementing lifestyle changes, multiple beneficial effects including weight loss and improved glycemic control, can be achieved. This can sometimes even lead to a remission of the disease. Therefore, in addition to pharmacological therapy, a healthy diet and regular exercise are recommended as effective treatment strategies.”
READ MORE: Oral Semaglutide Reduced MACE Risk in T2D with CVD, CKD
Investigators from the Institute of Cardiovascular Research and Sport Medicine at German Sport University and the IST University of Applied Sciences conducted a study to assess the effects of combined diet and exercise interventions in patients with T2D. Data for the study was gathered from a systematic literature search conducted on PubMed, Web of Science, SPORTDiscus and BISp Surf databases. Studies were included if they were in English or German, had adult patients with T2D, and had at least 1 type of diet and exercise intervention.
In total, 11 studies involving 599 patients between the ages of 35 and 80 years were included in the study. The studies were all published between 2002 and 2024, and had observation periods varying from 8 weeks to 24 months. The studies compared either the effects of a combined intervention versus a diet-only intervention or different combinations of diet and exercise. Eight of the studies were used to compare the effects of a diet-only intervention versus a diet and exercise intervention.
Investigators found that adding exercise to a conventional diet increased physical fitness and performance in patients with T2D, but improvements in glycemic control, anti-glycemic medication, body architecture, waist circumference, lean body mass, fat mass, and lipid profile or triglyceride levels were far less frequent. However, when exercise was added to low-carb diets with either high fat or high protein, improved effects were seen on anti-glycemic medication use, triglyceride levels and high-density lipoprotein levels.
Additionally, a running endurance training showed significantly higher improvements for waist circumference, triglyceride levels and lipid profile compared to soccer. A combined exercise training intervention done 6 times a week showed greater improvements in physical fitness compared to a similar program done 3 times a week.
“[T]his review finds that adding regular exercise to a dietary intervention can have additive effects for T2D patients,” the authors concluded. However, further high-quality studies are needed to determine the long-term efficacy of combining different dietary interventions with different exercise programs and to clarify the role of other interacting factors such as patients’ medication…Given the pivotal role of diet and exercise interventions in addition to the medical treatment of T2D patients, knowledge on this issue is crucial for refining treatment strategies and primary care recommendations. Everyone involved in counseling people with diabetes should expand their knowledge in this field.”
READ MORE: Diabetes Resource Center
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References
1. Amerkamp J, Benli S, Isenmann E, et al. Optimizing the lifestyle of patients with type 2 diabetes mellitus - Systematic review on the effects of combined diet-and-exercise interventions. Nutr Metab Cardiovasc Dis. 2024/09/01. 10.1016/j.numecd.2024.09.016.
2. Yeh YK, Yen FS, Hwu CM. Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes. J Diabetes Investig. 2023 Aug;14(8):936-939. doi: 10.1111/jdi.14043. Epub 2023 Jun 20. PMID: 37337794; PMCID: PMC10360374.
