Battling
Insulin Resistance in Elderly Obese People With
Type 2 Diabetes
Bring on the heavy weights. Exercise improves
insulin resistance and has beneficial effects
in preventing and treating type 2 diabetes.
However, aerobic exercise is hindered in many
type 2 diabetic patients because of advancing
age, obesity, and other comorbid conditions. Weight
lifting or progressive resistance training (PRT)
offers a safe and effective exercise alternative
for these people.
PRT promotes favorable energy balance and reduced
visceral fat deposition through enhanced basal
metabolism and activity levels while counteracting
age- and disease-related muscle wasting.
PRT improves insulin sensitivity and glycemic
control; increases muscle mass, strength, and
endurance; and has positive effects on bone density,
osteoarthritic symptoms, mobility impairment,
self-efficacy, hypertension, and lipid profiles.
PRT also alleviates symptoms of anxiety, depression,
and insomnia in individuals with clinical depression
and improves exercise tolerance in individuals
with cardiac ischemic disease and congestive heart
failure; all of these aspects are relevant to
the care of diabetic elders.
Moreover, PRT is safe and well accepted in many
complex patient populations, including very frail
elderly individuals and those with cardiovascular
disease. The greater feasibility of using PRT
over aerobic exercise in elderly obese type 2
diabetic individuals because of concomitant cardiovascular,
arthritic, and other disease provides a solid
rationale for investigating the global benefits
of PRT in the management of diabetes. Diabetes
Care 26:1580-1588, 2003
Karen A. Willey, RN1 and Maria A. Fiatarone Singh,
MD, FRACP1,2,3
School of Exercise and Sport Science, the University
of Sydney, Lidcombe, Australia
2 Research and Training Institute, Hebrew Rehabilitation
Center for Aged, Roslindale, Massachusetts
3 Nutrition, Exercise Physiology and Sarcopenia
Laboratory, Jean Mayer USDA Human Nutrition Research
Center on Aging, Tufts University, Boston, Massachusetts
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FACT:
For each risk factor present, the risk of cardiovascular
death is about three times
greater in people with diabetes as compared to
people without the condition.
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