title: Neuromuscular dysfunction in type 2 diabetes: underlying mechanisms and effect of resistance training.
abstract: Diabetic patients are at higher risk of developing physical disabilities than non-diabetic subjects. Physical disability appears to be related, at least in part, to muscle dysfunction. Several studies have reported reduced muscle strength and power under dynamic and static conditions in both the upper and lower limbs of patients with type 2 diabetes. Additional effects of diabetes include a reduction in muscle mass, quality, endurance and an alteration in muscle fibre composition, though the available data on these parameters are conflicting. The impact of diabetes on neuromuscular function has been related to the co-existence of long-term complications. Peripheral neuropathy has been shown to affect muscle by impairing motor nerve conduction. Also, vascular complications may contribute to the decline in muscle strength. However, muscle dysfunction occurs early in the course of diabetes and affects also the upper limbs, thus suggesting that it may develop independently of micro and macrovascular disease. A growing body of evidence indicates that hyperglycaemia may cause an alteration of the intrinsic properties of the muscle to generate force, via several mechanisms. Recently, resistance exercise has been shown to be an effective strategy to counteract the deterioration of muscular performance. High-intensity exercise seems to provide greater benefits than moderate-intensity training, whereas the effect of a power training is yet unknown. This article reviews the available literature on the impairment of muscle function induced by diabetes, the underlying mechanisms, and the effect of resistance training on this defect. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Movement, Human and Health Sciences, 'Foro Italico' University, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Orlando
authors.affiliation: Department of Clinical and Molecular Medicine, 'La Sapienza' University and Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.|Metabolic Fitness Association, Monterotondo, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Balducci
authors.affiliation: Department of Movement, Human and Health Sciences, 'Foro Italico' University, Rome, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Bazzucchi
authors.affiliation: Department of Clinical and Molecular Medicine, 'La Sapienza' University and Diabetes Unit, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pugliese
authors.affiliation: Department of Movement, Human and Health Sciences, 'Foro Italico' University, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Sacchetti
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D003929:Diabetic Neuropathies / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D008959:Models, Neurological; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000294:innervation* / Q000378:metabolism / Q000503:physiopathology; D009468:Neuromuscular Diseases / Q000150:complications / Q000517:prevention & control*; D010807:Physical Endurance; D055070:Resistance Training
keywords: diabetic neuropathy; muscle endurance; muscle strength; resistance exercise; type 2 diabetes