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© 2003 by the American Diabetes Association, Inc.
Reviews/Commentaries/Position Statements |
Battling Insulin Resistance in Elderly Obese People With Type 2 Diabetes
Bring on the heavy weights
1 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
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.
Abbreviations: 1RM, one repetition maximum • ADA, American Diabetes Association • BP, blood pressure • CWT, circuit-type weight training • HR, heart rate • IGT, impaired glucose tolerance • IOP, intraocular pressure • PRT, progressive resistance training • RPP, rate-pressure product
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