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Current Diabetes Reports

Erschienen in:

01.11.2019 | Lifestyle Management to Reduce Diabetes/Cardiovascular Risk (B Conway and H Keenan, Section Editors)

Exercise and Cardiovascular Risk among Masters Athletes with Type 2 Diabetes

verfasst von: Erika J. Parisi, Aaron L. Baggish

Erschienen in: Current Diabetes Reports | Ausgabe 11/2019

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Abstract

Purpose of Review

This review was designed to provide a scientific and clinical framework for the care of physically active men and women with an emphasis on the management of T2DM.

Recent Findings

The preventative and therapeutic benefits of physical activity (PA) on adult onset or Type 2 Diabetes Mellitus (T2DM) are well established. Individuals diagnosed with or are at risk for T2DM should be counseled and maximally supported to pursue an active or athletic lifestyle. Optimally, this translates into the adoption of an athletic lifestyle. “Masters athletes”, men and women above the age of 35 who regularly train for and/or participate in competitive sport, represent a rapidly growing segment of the population. Although the high level of exercise characteristic of this population has numerous health benefits, it does not confer immunity from T2DM or cardiovascular (CV) disease.

Summary

Providing effective care for men and women above the age of 35 who regularly train for and/or participate in competitive sport requires an understanding of the interplay between basic exercise physiology and the pathogenesis of insulin resistance.

Centers for Disease Control and Prevention. National diabetes statistics report, 2017: estimates of diabetes and its burden on the United States. Atlanta: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2017. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html

Tayrose GA, Beutel BG, Cardone DA, Sherman OH. The masters athlete: a review of current exercise and treatment recommendations. Sports Health. 2015;7(3):270–6.PubMedPubMedCentral

Lavie CJ, Arena R, Swift DL, Johannsen NM, Sui X, Lee D-C, et al. Exercise and the cardiovascular system: clinical science and cardiovascular outcomes. Circ Res. 2015;117(2):207–19.PubMedPubMedCentral

Kolwicz SC. An “exercise” in cardiac metabolism. Front Cardiovasc Med. 2018;5:66.PubMed

Hearris MA, Hammond KM, Fell JM, Morton JP. Regulation of Muscle Glycogen Metabolism during Exercise: Implications for Endurance Performance and Training Adaptations. Nutrients. 2018;10(3):298.PubMedCentral

Volianitis S, Secher NH. Cardiovascular Control during Whole Body Exercise. J Appl Physiol. 2016;121(2):376–90.PubMedPubMedCentral

Berg JM, Tymoczko JL, Stryer L. Section 30.4 fuel choice during exercise is determined by intensity and duration of activity. In: Biochemistry 5e. New York: W H Freeman; 2002.

Bergman BC, Butterfield GE, Wolfel EE, Casazza GA, Lopaschuk GD, Brooks GA. Evaluation of exercise and training on muscle lipid metabolism. Am J Physiol. 1999;276(1):E106–17.PubMed

Kang J, Kelley DE, Robertson RJ, Goss FL, Suminski RR, Utter AC, et al. Substrate Utilization and Glucose Turnover during Exercise of Varying Intensities in Individuals with NIDDM. Med Sci Sports Exerc. 1999;31(1):82–9.PubMed

10.

Watt MJ, Heigenhauser GJF, Dyck DJ, Spriet LL. Intramuscular triacylglycerol, glycogen and acetyl group metabolism during 4 h of moderate exercise in man. J Physiol. 2002;541(Pt 3):969–78.PubMedPubMedCentral

11.

Burke LM, Hawley JA. Carbohydrate and exercise. Curr Opin Clin Nutr Metab Care. 1999;2(6):515–20.PubMed

12.

Holloszy JO, Kohrt WM, Hansen PA. The regulation of carbohydrate and fat metabolism during and after exercise. Front Biosci. 1998;3:D1011–27.PubMed

13.

Marliss EB, Vranic M. Intense Exercise has unique effects on both insulin release and its roles in glucoregulation: implications for diabetes. Diabetes. 2002;51(S1):S271–83.PubMed

14.

Suh S-H, Paik I-Y, Jacobs K. Regulation of blood glucose homeostasis during prolonged exercise. Mol Cells. 2007;23(3):272–9.PubMed

15.

Wahren J, Ekberg K. Splanchnic regulation of glucose production. Annu Rev Nutr. 2007;27:329–45.PubMed

16.

Lee AD, Hansen PA, Holloszy JO. Wortmannin inhibits insulin-stimulated but not contraction-stimulated glucose transport activity in skeletal muscle. FEBS Letters. 1995;361(1):51–4.PubMed

17.

DeFronzo RA, Jacot E, Jequier E, Maeder E, Wahren J, Felber JP. The effect of insulin on the disposal of intravenous glucose. Results from indirect calorimetry and hepatic and femoral venous catheterization. Diabetes. 1981;30(12):1000–7.PubMed

18.

Egan B, Zierath JR. Exercise metabolism and the molecular regulation of skeletal muscle adaptation. Cell Metabolism. 2013;17(2):162–84.PubMed

19.

Goodyear LJ, Kahn BB. Exercise, glucose transport, and insulin sensitivity. Annu Rev Med. 1998;49:235–61.PubMed

20.

Holloszy JO. Exercise-induced Increase in muscle insulin sensitivity. J Appl Physiol. 2005;99(1):338–43.PubMed

21.

Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet. 2014;383(9922):1068–83.PubMed

22.

Oguntibeju OO. Type 2 diabetes mellitus, oxidative stress and inflammation: examining the links. Int J Physiol Pathophysiol Pharmacol. 2019;11(3):45–63.PubMedPubMedCentral

23.

Zhang N, Yang X, Zhu X, Zhao B, Huang T, Ji Q. Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors: National Health and Nutrition Examination Survey (NHANES) 1999–2010. J Int Med Res. 2017;45(2):594–609.PubMedPubMedCentral

24.

Neuenschwander M, Ballon A, Weber KS, Norat T, Aune D, Schwingshackl L, et al. Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies. BMJ. 2019;366:l2368.PubMedPubMedCentral

25.

Scheen AJ. Pathophysiology of type 2 diabetes. Acta Clin Belg. 2003;58(6):335–41.PubMed

26.

Fowler MJ. Microvascular and macrovascular complications of diabetes. Clinical Diabetes. 2008;26(2):77–82.

27.

Schellenberg ES, Dryden DM, Vandermeer B, Ha C, Korownyk C. Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med. 2013;159(8):543–51.PubMed

28.

Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care. 2007;30(2):203–9.PubMed

29.

McTiernan A, Sorensen B, Irwin ML, Morgan A, Yasui Y, Rudolph RE, et al. Exercise effect on weight and body fat in men and women. Obesity. 2007;15(6):1496–512.PubMed

30.

Slentz CA, Aiken LB, Houmard JA, Bales CW, Johnson JL, Tanner CJ, et al. Inactivity, exercise, and visceral fat. STRRIDE: a randomized, controlled study of exercise intensity and amount. J Appl Physiol. 2005;99(4):1613–8.PubMed

31.

Irwin ML, Yasui Y, Ulrich CM, Bowen D, Rudolph RE, Schwartz RS, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA. 2003;289(3):323–30.PubMed

32.

Wenger HA, Bell GJ. The interactions of intensity, frequency and duration of exercise training in altering cardiorespiratory fitness. Sports Med. 1986;3(5):346–56.PubMed

33.

Duscha BD, Slentz CA, Johnson JL, Houmard JA, Bensimhon DR, Knetzger KJ, et al. Effects of exercise training amount and intensity on peak oxygen consumption in middle-age men and women at risk for cardiovascular disease. Chest. 2005;128(4):2788–93.PubMed

34.

Henriksen EJ. Invited review: Effects of acute exercise and exercise training on insulin resistance. J Appl Physiol. 2002;93(2):788–96.PubMed

35.

Naci H, Ioannidis JPA. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. BMJ. 2013;347:f5577–7.PubMedPubMedCentral

36.

Whyte LJ, Ferguson C, Wilson J, Scott RA, Gill JMR. Effects of single bout of very high-intensity exercise on metabolic health biomarkers in overweight/obese sedentary men. Metabolism. 2013;62(2):212–9.PubMed

37.

Malin SK, Rynders CA, Weltman JY, Barrett EJ, Weltman A. Exercise intensity modulates glucose-stimulated insulin secretion when adjusted for adipose, liver and skeletal muscle insulin resistance. PLoS One. 2016;11(4):e0154063.PubMedPubMedCentral

38.

Rynders CA, Weltman JY, Jiang B, Breton M, Patrie J, Barrett EJ, et al. Effects of exercise intensity on postprandial improvement in glucose disposal and insulin sensitivity in prediabetic adults. J Clin Endocrinol Metab. 2014;99(1):220–8.PubMed

39.

Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med. 2016;2(1):e000143.PubMed

40.

Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–47.PubMed

41.

Wilson PW. Diabetes mellitus and coronary heart disease. Am J Kidney Dis. 1998;32(5 Suppl 3):S89–100.PubMed

42.

McGill HC, McMahan CA. Determinants of atherosclerosis in the young. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Am J Cardiol. 1998;82(10B):30T–6T.PubMed

43.

Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979;241(19):2035–8.PubMed

44.

Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the american heart association. Circulation. 1999;100(10):1134–46.PubMed

45.

Aubert R. Diabetes in America. 2nd ed. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995.

46.

Wingard DL, Barrett-Connor EL, Scheidt-Nave C, McPhillips JB. Prevalence of cardiovascular and renal complications in older adults with normal or impaired glucose tolerance or NIDDM: a population-based study. Diabetes Care. 1993;16(7):1022–5.PubMed

47.

O’Leary DH, Polak JF, Kronmal RA, Kittner SJ, Bond MG, Wolfson SK, et al. Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study. The CHS Collaborative Research Group. Stroke. 1992;23(12):1752–60.PubMed

48.

Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16(2):434–44.PubMed

49.

Folsom AR, Eckfeldt JH, Weitzman S, Ma J, Chambless LE, Barnes RW, et al. Relation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke. 1994;25(1):66–73.PubMed

50.

Nelson RG, Knowler WC, Pettitt JD, Bennett PH, National Diabetes Data Group. Kidney disease in diabetes. In: Diabetes in America. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995: 349–400.

51.

King P, Peacock I, Donnelly R. The UK prospective diabetes study (UKPDS): clinical and therapeutic implications for type 2 diabetes. Br J Clin Pharmacol. 1999;48(5):643–8.PubMedPubMedCentral

52.

Riddle MC. Effects of intensive glucose lowering in the management of patients with type 2 diabetes mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Circulation. 2010;122(8):844–6.PubMedPubMedCentral

53.

Duckworth WC, McCarren M, Abraira C. VA Diabetes Trial. Glucose control and cardiovascular complications: the VA Diabetes Trial. Diabetes Care. 2001;24(5):942–5.PubMed

54.

ADVANCE Collaborative Group, Patel A, MacMahon S, Chalmers J, Neal B, Billot L, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560–72.

55.

Li TY, Rana JS, Manson JE, Willett WC, Stampfer MJ, Colditz GA, et al. Obesity as compared with physical activity in predicting risk of coronary heart disease in women. Circulation. 2006;113(4):499–506.PubMedPubMedCentral

56.

Lee IM, Paffenbarger RS. Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study. Am J Epidemiol. 2000;151(3):293–9.PubMed

57.

Gill JMR, Malkova D. Physical activity, fitness and cardiovascular disease risk in adults: interactions with insulin resistance and obesity. Clin Sci. 2006;110(4):409–25.PubMed

58.

Lee DC, Sui X, Blair SN. Does physical activity ameliorate the health hazards of obesity? Br J Sports Med. 2009;43(1):49–51.PubMed

59.

Austin MA, Breslow JL, Hennekens CH, Buring JE, Willett WC, Krauss RM. Low-density lipoprotein subclass patterns and risk of myocardial infarction. JAMA. 1988;260(13):1917–21.PubMed

60.

Austin MA, Edwards KL. Small, dense low density lipoproteins, the insulin resistance syndrome and noninsulin-dependent diabetes. Curr Opin Lipidol. 1996;7(3):167–71.PubMed

61.

Austin MA, King MC, Vranizan KM, Krauss RM. Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk. Circulation. 1990;82(2):495–506.PubMed

62.

Grundy SM. Small LDL, atherogenic dyslipidemia, and the metabolic syndrome. Circulation. 1997;95(1):1–4.PubMed

63.

Lamprea-Montealegre JA, Zelnick LR, Hall YN, Bansal N, de Boer IH. Prevalence of hypertension and cardiovascular risk according to blood pressure thresholds used for diagnosis. Hypertension. 2018;72(3):602–9.PubMedPubMedCentral

64.

Mourad J-J, Le Jeune S. Blood pressure control, risk factors and cardiovascular prognosis in patients with diabetes: 30 years of progress. J Hypertens Suppl. 2008;26(3):S7–13.PubMed

65.

Mitchell GF, Hwang S-J, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010;121(4):505–11.PubMedPubMedCentral

66.

Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovasc Dis. 2012;1(4).

67.

American Diabetes Association. 4. Lifestyle Management: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S38–50.

68.

Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD. Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29(6):1433–8.PubMed

69.

Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343–50.PubMed

70.

•• Wasfy MM, Baggish AL. Exercise dose in clinical practice. Circulation. 2016;133(23):2297–313. This article is novel in that it outlines the aims to guide the prescription dosing of physical activity in clinical practice. PubMedPubMedCentral

71.

Blackwell DL, Clarke TC. State variation in meeting the 2008 federal guidelines for both aerobic and muscle-strengthening activities through leisure-time physical activity among adults aged 18–64: United States, 2010–2015. Natl Health Stat Report. 2018;112:1–22.

72.

Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020. Geneva: World Health Organization; 2013.

73.

Umpierre D, Ribeiro PAB, Kramer CK, Leitão CB, Zucatti ATN, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011;305(17):1790–9.PubMed

74.

Balducci S, Zanuso S, Nicolucci A, De Feo P, Cavallo S, Cardelli P, et al. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med. 2010;170(20):1794–803.PubMed

75.

Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health: a recommendation from the centers for disease control and prevention and the american college of sports medicine. JAMA. 1995;273(5):402–7.PubMed

76.

• Smith AD, Crippa A, Woodcock J, Brage S. Physical activity and incident type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of prospective cohort studies. Diabetologia. 2016;59(12):2527–45. Findings from this review confirm that increased levels of physical activity are associated with decreased incidence of Type 2 Diabetes Mellitus. Moreover, there is also proven health benefits for individuals who regularly participate in physical activity exposures which exceed the nationally recommended guidelines.PubMedPubMedCentral

77.

Keshel TE, Coker RH. Exercise training and insulin resistance: a current review. J Obes Weight Loss Ther. 2015;5(Suppl 5):S5–003.PubMedPubMedCentral

78.

Clarke PM, Walter SJ, Hayen A, Mallon WJ, Heijmans J, Studdert DM. Survival of the fittest: retrospective cohort study of the longevity of Olympic medalists in the modern era. BMJ. 2012;345:e8308.PubMed

79.

Reimers CD, Knapp G, Reimers AK. Does physical activity increase life expectancy? A review of the literature. J Aging Res. 2012;2012:243958.PubMedPubMedCentral

80.

Kettunen JA, Kujala UM, Kaprio J, Bäckmand H, Peltonen M, Eriksson JG, et al. All-cause and disease-specific mortality among male, former elite athletes: an average 50-year follow-up. Br J Sports Med. 2015;49(13):893–7.PubMed

81.

Folsom AR, Kushi LH, Hong CP. Physical activity and incident diabetes mellitus in postmenopausal women. Am J Public Health. 2000;90(1):134–8.PubMedPubMedCentral

82.

Redmon JB, Bertoni AG, Connelly S, Feeney PA, Glasser SP, Glick H, et al. Effect of the look AHEAD study intervention on medication use and related cost to treat cardiovascular disease risk factors in individuals with type 2 diabetes. Diabetes Care. 2010;33(6):1153–8.PubMedPubMedCentral

83.

Valero-Elizondo J, Salami JA, Osondu CU, Ogunmoroti O, Arrieta A, Spatz ES, et al. Economic impact of moderate-vigorous physical activity among those with and without established cardiovascular disease: 2012 medical expenditure panel survey. J Am Heart Assoc. 2016;5(9):1–11.

84.

Shapero K, Deluca J, Contursi M, Wasfy M, Weiner RB, Lewis GD, et al. Cardiovascular risk and disease among masters endurance athletes: insights from the Boston MASTER (Masters Athletes Survey To Evaluate Risk) Initiative. Sports Med Open. 2016;2:29.PubMedPubMedCentral

85.

Morrison BN, McKinney J, Isserow S, Lithwick D, Taunton J, Nazzari H, et al. Assessment of cardiovascular risk and preparticipation screening protocols in masters athletes: the Masters Athlete Screening Study (MASS): a cross-sectional study. BMJ Open Sport Exerc Med. 2018;4(1):e000370.PubMedPubMedCentral

86.

Aizer A, Gaziano JM, Cook NR, Manson JE, Buring JE, Albert CM. Relation of vigorous exercise to risk of atrial fibrillation. Am J Cardiol. 2009;103(11):1572–7.PubMedPubMedCentral

87.

La Gerche A, Burns AT, Mooney DJ, Inder WJ, Taylor AJ, Bogaert J, Macisaac AI, Heidbüchel H, Prior DL. Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J. 2012;33(8):998–1006.

88.

Shave R, Oxborough D. Endurance exercise and myocardial fibrosis: let us keep the risk in perspective. Circ Cardiovasc Imaging. 2016;9(11):e005511.

89.

Möhlenkamp S, Lehmann N, Breuckmann F, Bröcker-Preuss M, Nassenstein K, Halle M, et al. Running: the risk of coronary events : Prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J. 2008;29(15):1903–10.PubMed

90.

Baggish AL, Levine BD. Coronary artery calcification among endurance athletes: “hearts of stone.”. Circulation. 2017;136(2):149–51.PubMed

91.

Aengevaeren VL, Mosterd A, Braber TL, Prakken NHJ, Doevendans PA, Grobbee DE, et al. Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. Circulation. 2017;136(2):138–48.PubMed

92.

Donnelly JE, Hillman CH, Castelli D, Etnier JL, Lee S, Tomporowski P, et al. Physical activity, fitness, cognitive function, and academic achievement in children: a systematic review. Med Sci Sports Exerc. 2016;48(6):1197–222.PubMedPubMedCentral

93.

Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/exercise and diabetes: a position statement of the american diabetes association. Diabetes Care. 2016;39(11):2065–79.PubMed

94.

Lobelo F, Rohm Young D, Sallis R, Garber MD, Billinger SA, Duperly J, et al. Routine assessment and promotion of physical activity in healthcare settings: a scientific statement from the american heart association. Circulation. 2018;137(18):e495–522.PubMed

Titel: Exercise and Cardiovascular Risk among Masters Athletes with Type 2 Diabetes
verfasst von: Erika J. Parisi
Aaron L. Baggish
Publikationsdatum: 01.11.2019
Verlag: Springer US
Erschienen in: Current Diabetes Reports / Ausgabe 11/2019
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-019-1229-z

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Purpose of Review

Recent Findings

Summary

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