title: Ten-year experience with an exercise-based outpatient life-style modification program in the treatment of diabetes mellitus.
abstract: Exercise is frequently recommended in the treatment of diabetes mellitus. Nevertheless, its use has been limited in clinical practice, and concerns about safety and efficacy persist. We have reviewed a 10-yr experience with 255 patients enrolled in a comprehensive diabetes program that emphasized physical training. A low maximal oxygen uptake (VO2max) was found in patients with non-insulin-dependent diabetes mellitus compared with sedentary control subjects. This was not accounted for by autonomic neuropathy and is unlikely to be due to subtle differences in life-style. Exercise-related proteinuria was common and occurred in 29% of patients and was associated with higher blood pressure levels at rest and during exercise, impaired VO2max, and decreased R-R interval variation. Regular exercise was associated with a modest decrease in resting and exercise blood pressure. Glycosylated hemoglobin levels and plasma triglycerides improved only in patients with non-insulin-dependent diabetes mellitus. Insulin requirements were significantly reduced in patients with insulin-dependent diabetes mellitus. Compliance for up to 3 mo in the program was acceptable but longer-term compliance was poor. Serious complications during the program were rare. Our experience suggests a program of regular aerobic training can be safely and effectively used in an outpatient population with diabetes mellitus for up to 3 mo.
authors: Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019.
authors: S H
authors: SH
authors: Schneider
authors: A K
authors: AK
authors: Khachadurian
authors: L F
authors: LF
authors: Amorosa
authors: L
authors: L
authors: Clemow
authors: N B
authors: NB
authors: Ruderman
mesh_terms: D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000534:rehabilitation / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010101:Oxygen Consumption; D010349:Patient Compliance; D011507:Proteinuria; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides